This article is not legal or medical advice
As the interest in psychedelic-assisted healing grows, many therapists and spiritual practitioners are looking for legal and effective ways to integrate these substances into their work. At the Psychedelic Society of Utah Conference, pharmacist Mindy Madeo shared valuable insights into the practice of microdosing psilocybin and LSD, the current research, and the challenges of sourcing and regulation. With over 20 years of experience in pharmacy—including five years specializing in cannabis and psychedelic medicine—Madeo is a trusted expert in this field. She now runs Rebel Pharmacist, a consulting service dedicated to educating patients and practitioners about psychedelic medicine.
What is Microdosing?
Microdosing involves taking a sub-perceptual dose of a psychedelic, meaning it does not cause hallucinations or an altered state of consciousness. The most commonly microdosed substances are psilocybin (magic mushrooms) and LSD, both of which work on serotonin receptors and promote neuroplasticity. “Psilocybin is better for feeling—it enhances emotional connection and spirituality—whereas LSD is better for thinking, promoting creativity and focus,” Madeo explained.
Standard microdosing amounts include:
Psilocybin: 125-250 mg (milligrams)
LSD: 10-20 mcg (micrograms)
Potential Benefits of Microdosing
Traditionally, psychedelics have been studied for their antidepressant and anti-anxiety properties, but Madeo highlighted additional potential benefits:
ADHD and focus enhancement
Pain relief and reduced inflammation
Improved sleep and emotional regulation
Reduction in substance use, including alcohol and nicotine
Although anecdotal reports are promising, rigorous scientific research is still lacking. “The more controlled the study, the less benefit we seem to see,” Madeo noted. This could be due to difficulties in blinding psychedelic studies or the differences between synthetic and natural compounds used in research trials.
Microdosing Protocols
There are several approaches to microdosing, each with different dosing schedules:
Fadiman Protocol: One day on, two days off (repeat for two months, then take a break).
Stamets Protocol: Four days on, three days off, often paired with lion’s mane and niacin to enhance cognitive benefits.
Intuitive Dosing: Taking microdoses only when needed, allowing for emotional processing and self-awareness.
“It’s important to take breaks to avoid tolerance buildup and potential heart risks,” Madeo advised, referring to concerns about 5-HT2B receptor activation, which is linked to heart valve issues in some medications.
Challenges in Sourcing and Regulation
The biggest challenge facing practitioners and patients is legality. Psilocybin and LSD remain Schedule I substances in the U.S., meaning they are illegal to produce, possess, or distribute. However, spores and grow kits are legal, creating a gray market for home cultivation.
“There is a rising issue with mislabeled products, particularly in vape shops and online markets,” Madeo warned.
Many so-called ‘magic mushroom’ products contain Amanita muscaria (muscimol) instead of psilocybin. Unlike psilocybin, muscimol acts on GABA receptors, producing sedative and dissociative effects rather than classic psychedelic experiences. Some products also contain synthetic hallucinogens, prescription drugs, or even toxic compounds.
To ensure safety, Madeo encourages practitioners to educate patients about trusted sources and third-party lab testing where possible.
Microdosing and SSRI Interactions
A common question for therapists is whether patients on SSRIs (Selective Serotonin Reuptake Inhibitors) can microdose psychedelics.
Key Findings on SSRI and Psilocybin Interactions:
Microdosing while on SSRIs appears to be safe, but may result in blunted effects.
Long-term SSRI use may cause serotonin receptor downregulation, reducing the effectiveness of psychedelics.
Some patients use psilocybin as a bridge while tapering off SSRIs, though this should always be done under medical supervision.
“The biggest risk of stopping SSRIs is a treatment gap, which can be catastrophic for some patients,” Madeo emphasized. Therapists should work closely with prescribing doctors to ensure safe transitions.
Harm Reduction and Best Practices
For practitioners supporting clients through psychedelic experiences, harm reduction is crucial. Madeo outlined six key principles:
Ensure product safety: Ask where substances are sourced and watch for mislabeling.
Dosing awareness: Encourage conservative dosing and avoiding the ‘more is better’ mindset.
Take breaks: Reducing frequency prevents tolerance and minimizes potential heart risks.
Support integration: Encourage therapy, journaling, or meditation to process experiences.
Monitor drug interactions: Be aware of contraindications, especially with lithium, bipolar disorder, and certain heart conditions.
Respect cultural origins: Acknowledge indigenous traditions that pioneered psychedelic medicine.
Summary
Microdosing offers a promising tool for mental health and cognitive enhancement, but legal and scientific uncertainties remain. For therapists and spiritual practitioners, staying informed and prioritizing safe, ethical practices is essential.
For more guidance, visit Rebel Pharmacist or connect with Mindy Madeo for psychedelic consulting.
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