Positive expectations predict improved mental-health outcomes linked to psychedelic microdosing
Open accessAbstract
Psychedelic microdosing describes the ingestion of near-threshold perceptible doses of classic psychedelic substances. Anecdotal reports and observational studies suggest that microdosing may promote positive mood and well-being, but recent placebo-controlled studies failed to find compelling evidence for this. The present study collected web-based mental health and related data using a prospective (before, during and after) design. Individuals planning a weekly microdosing regimen completed surveys at strategic timepoints, spanning a core four-week test period. Eighty-one participants completed the primary study endpoint. Results revealed increased self-reported psychological well-being, emotional stability and reductions in state anxiety and depressive symptoms at the four-week primary endpoint, plus increases in psychological resilience, social connectedness, agreeableness, nature relatedness and aspects of psychological flexibility. However, positive expectancy scores at baseline predicted subsequent improvements in well-being, suggestive of a significant placebo response. This study highlights a role for positive expectancy in predicting positive outcomes following psychedelic microdosing and cautions against zealous inferences on its putative therapeutic value.
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Agreeableness and openness to experience did not change at all after MD compared to baseline in the current study, contrasting results from earlier MD studies.
“Agreeableness and openness to experience did not change at all after MD compared to baseline in the current study, contrasting results from earlier MD studies (12, 28).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
The citation supports a contrast for agreeableness: Table 2 in Results > Exploratory analyses reports a significant increase from baseline after four weeks of microdosing (mean difference 0.37, p = .001). It does not support the same contrast for openness, which showed no statistically significant change (p = .318). The citing authors’ finding in their own study is not attributed to this source. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAgreeableness was increased after MD in a general population sample.
“Agreeableness was increased after MD in a general population sample (12)”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
Other studies did not find a conscientiousness increase after MD in a general population sample and a general sample without individuals diagnosed with a mood, anxiety, substance use, psychotic or dissociative disorder.
“but other studies did not find this effect in a general population sample (12) and a general sample without individuals diagnosed with a mood, anxiety, substance use, psychotic or dissociative disorder (13).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
Neuroticism decreased after MD in healthy adults and a general population sample.
“Neuroticism decreased after MD in healthy adults (29) and a general population sample (12)”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
The decrease in neuroticism reported here is consistent with two previous prospective MD studies.
“The decrease in neuroticism reported here is consistent with two previous prospective MD studies (12, 29).”
From Trait mindfulness and personality characteristics in a microdosing ADHD sample: a naturalistic prospective survey study (2023) · cites this paper as [12]
Positive expectancy scores regarding the effects of microdosing at baseline predicted subsequent improvements in wellbeing.
“Kaertner et al. (2021) found that positive expectancy scores regarding the effects of microdosing at baseline predicted subsequent improvements in wellbeing.”
From Psychedelic Microdosing, Mindfulness, and Anxiety: A Cross-Sectional Mediation Study (2023) · cites this paper as Kaertner et al. (2021)
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“This phenomenon has not been explored in detail in modern clinical trials of psychedelics; however, a recent trial of microdosing of psychedelics showed that positive expectation of improvement predicted scores of well-being (Kaertner et al. 2021).”
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Expectancy Effects in Psychedelic Trials
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The risk of chronic psychedelic and MDMA microdosing for valvular heart disease
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Greater subjective effects of a low dose of LSD in participants with depressed mood
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How Psychedelic-Assisted Treatment Works in the Bayesian Brain
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Psychedelic Therapy: A Primer for Primary Care Clinicians—Ketamine
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“In addition, Kaertner et al. (2021) found that positive expectancy scores regarding the effects of microdosing at baseline predicted subsequent improvements in wellbeing.”
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Expectancy Effects Cannot Be Neglected in MDMA-Assisted Therapy Research
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The Pharmacology and Clinical Applications of Psychedelic Medicines Within Midwifery Practice
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Understanding the Experience of Ketamine-Assisted Therapy and the Importance of Context
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Microdosing psychedelics has no impact on cognitive function in naturalistic settings
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- Authors
- Kaertner, L. S., Steinborn, M. B., Kettner, H., Spriggs, M. J., Roseman, L., Buchborn, T., Balaet, M., Timmermann, C., Erritzoe, D., & Carhart-Harris, R. L.
- Affiliations
- University of Würzburg (DE)
- Imperial College London (GB)
- ORCID
- Venue
- Scientific Reports
- Published
- 2021-01-21
- Volume
- 11
- Issue
- 1
- Pages
- 1941-1941
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7820236
- OpenAlex
- W3122801192
- Cited by
- 145
- References
- 76
- Citations by year
- 2026: 6 · 2025: 26 · 2024: 34 · 2023: 37 · 2022: 24 · 2021: 18
- FWCI
- 19.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Online Publication Service of Würzburg University (Würzburg University) (submittedVersion, cc-by)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (ACF-2013-21-501, CL-2017-21-004)
- Academy of Medical Sciences (SGL019\1063)
- Imperial College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- psychedelic microdosing, positive expectations, placebo response, psychological well-being, state anxiety, depressive symptoms, emotional stability, psychological resilience, social connectedness, agreeableness, nature relatedness, psychological flexibility, classic psychedelics
- MeSH terms
- Adult, Affect, Anxiety, Dose-Response Relationship, Drug, Emotions, Female, Hallucinogens, Humans, Lysergic Acid Diethylamide, Male, Mental Health, Middle Aged, Motivation, Psilocybin, Quality of Life, Placebo Effect, Outcome Assessment, Health Care
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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