LSD, a perception-altering psychedelic drug, is used as one supervised full dose for anxiety and low mood, or as repeated tiny "microdoses" for well-being. Full-dose trials, the largest company-funded, report rapid relief lasting months. Microdosing has not shown lasting benefit beyond expectation except longer sleep; aging effects unknown. Risks: frightening experiences, temporary blood-pressure rises and serious psychiatric reactions in people prone to psychosis or bipolar illness. Legal status limits access. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Resting blood pressure | <120/80 mmHg | Cardiovascular strain risk |
| Resting heart rate | 50–70 bpm | Stimulant effect baseline |
| Electrocardiogram (QTc) | QTc <440 ms (men), <460 ms (women) | Rhythm screening |
| Echocardiogram (heart ultrasound) | No more than trace valve regurgitation | Valve safety with repeated dosing |
| ALT and AST | ALT <25 U/L; AST <25 U/L | Liver clearance capacity |
| GAD-7 anxiety score | <5 | Defines anxiety response |
| PHQ-9 depression score | <5 | Defines mood response |
| CYP2D6 genotype | Normal metabolizer (no target range) | Predicts exposure |
Cadence: Baseline before a first full dose or microdosing course, including a pregnancy test where relevant; blood pressure and heart rate before dosing and hourly for the first 8 hours of a full-dose session; symptom questionnaires at 1 day, 1 week, 4 weeks and 12 weeks after dosing, then every 3–6 months; for repeated microdosing, blood pressure weekly, an echocardiogram before courses beyond about 8 weeks and every 6–12 months while dosing continues; CYP2D6 genotype optional, one-time.