In recent years, there has been growing interest among adults with ADHD in the practice of microdosing classic psychedelics such as psilocybin and LSD. The internet is full of personal accounts describing improved concentration, better impulse control, and enhanced well-being. However, a recent review conducted by researchers from Wroclaw Medical University shows that the currently available scientific evidence does not allow the effectiveness of psychedelics in treating ADHD to be confirmed. This is an area of intensive research, but not a therapy ready for clinical practice.
Growing interest, few answers
For several years, psychedelics have been at the center of psychiatric research. Scientists have been investigating their potential use in the treatment of depression, anxiety disorders, and post-traumatic stress disorder, among other conditions. This has led to questions about their possible role in ADHD as well.
The authors of a review published in the International Journal of Molecular Sciences analyzed the available literature on the use of classic psychedelics in adults with ADHD and identified five studies that met the inclusion criteria.
Interest in psychedelics for ADHD reflects a broader trend in research exploring their potential applications in psychiatry. At the same time, more adults are recognizing difficulties related to attention, impulsivity, and emotional regulation. Some patients do not achieve sufficient improvement or experience adverse effects from standard medications, leading them to seek alternative solutions, - says Prof. Donata Kurpas of Wroclaw Medical University, a co-author of the publication.
What has actually been studied?
The researchers identified only five studies that met the criteria for scientific evaluation. These included three observational studies on psychedelic microdosing, one randomized clinical trial using low doses of LSD, and one pilot study examining the experiences of participants involved in ritual ayahuasca use, a psychoactive plant-based brew traditionally used by some Amazonian communities.
In the observational studies, participants often reported short-term improvements in concentration, mood, and emotional regulation. The problem is that such study designs cannot determine whether the improvements were actually caused by the substances themselves.
These findings are interesting because they show what users experience and why the topic attracts attention. At the same time, naturalistic studies are highly susceptible to expectancy effects, self-suggestion, participant selection bias, and lack of dose standardization. They do not allow conclusions about treatment efficacy, - emphasizes Prof. Kurpas.
Why are psychedelics being considered at all?
Classic psychedelics such as psilocybin and LSD primarily act on serotonin receptors, particularly the 5-HT2A receptor. Research suggests that they may influence neural plasticity, emotional processing, and the organization of brain networks involved in attention and self-regulation. These mechanisms are the reason researchers are considering their potential relevance to ADHD.
These are biologically interesting hypotheses. However, it is important to remember that ADHD is not primarily a serotonergic disorder. Dopaminergic and noradrenergic systems, as well as executive functions related to motivation, impulse control, and emotional regulation, play key roles. Any potential effect of psychedelics on ADHD symptoms, therefore, remains largely a research hypothesis at this stage, - the expert explains.
Particularly important was the only randomized, double-blind clinical trial, which compared low doses of LSD with a placebo in adults with ADHD. Improvements were observed in both the LSD and placebo groups. However, the differences between the groups were not statistically significant.
A subjective feeling of improvement does not always indicate a genuine pharmacological effect. In psychiatry, patient expectations can strongly influence outcomes.
What do we still not know?
The authors of the review point out that the current state of knowledge does not answer the most important questions regarding the effectiveness and safety of psychedelics in ADHD. Existing studies involved small participant groups, different substances, varying doses, and short follow-up periods.
We need well-designed randomized clinical trials with placebo controls, clear ADHD diagnoses, standardized protocols, and longer follow-up periods. It is important to assess not only symptoms but also patients' everyday functioning, including work, relationships, sleep quality, and emotional regulation,- says Prof. Kurpas.
The researcher also highlights safety concerns.
It is particularly important to assess risks in individuals with anxiety disorders, depression, bipolar disorder, psychosis risk, or those taking psychotropic medications. From a public health perspective, we cannot move ahead of the scientific evidence, - she emphasizes.
Experts also remind patients with ADHD that they should not abandon diagnostic evaluation, psychoeducation, psychotherapy, lifestyle modifications, or treatments with established effectiveness. If a patient is considering psychedelic use or already has experience with it, these issues should be discussed with a physician and based on reliable scientific evidence rather than solely on internet testimonials.
Therefore, the message for patients should be clear: the topic requires further research, but at present, psychedelics should not be presented as an alternative to evidence-based ADHD diagnosis and treatment.
