Microdosing: Does It Work for ALL Drugs? A Psychiatrist Explains

Dr. Tracey Marks
13 Sept 202307:40
EducationalLearning
32 Likes 10 Comments

TLDRDr. Tracey Marks discusses microdosing, a practice typically associated with psychedelics like LSD, where small doses are taken for potential cognitive benefits without hallucinations. She explains the concept of pharmacokinetics and the minimum effective dose for prescription drugs, cautioning against microdosing these medications due to the risk of ineffectiveness and side effects. She advises that slow metabolizers may benefit from lower doses and highlights the importance of consulting a pharmacist when considering altering medication dosage forms.

Takeaways
  • 🧪 Microdosing typically refers to taking a small fraction of a dose of psychedelic substances like LSD or psilocybin to gain benefits without the dissociative effects.
  • 🧬 The concept of microdosing is not well-established scientifically, with some studies showing brain activity changes and others indicating potential worsening of mental functions.
  • 🚫 Psychedelics are illegal in most states, making reliable sourcing a challenge and a legal risk.
  • 💊 Prescription medications have specific pharmacokinetics designed for absorption, distribution, metabolism, and excretion in the body.
  • 🔍 The minimum effective dose is the smallest amount of a drug that produces a therapeutic response, with doses below this unlikely to be beneficial.
  • 🧬 Prozac, an antidepressant, has a minimum therapeutic dose of 20 milligrams, and taking less may not be effective but could still cause side effects.
  • 🧪 Metabolism of psychiatric medications can vary greatly due to genetic factors, affecting how individuals respond to different doses.
  • 💊 For slow metabolizers, taking lower doses of medication might be beneficial, but precise measurement is necessary to achieve microdosing levels.
  • 💊 Liquid forms of medication or certain capsule forms allow for more precise dosing, which can be advantageous for individuals requiring microdosing.
  • 🚫 Extended-release medications should not be cut or crushed as it disrupts their time-release mechanism, except for specific formulations designed for such manipulation.
  • ⏳ A slow titration process, where medication is started at a low dose and gradually increased, may require longer times to achieve desired therapeutic effects.
Q & A

  • What is the primary focus of Dr. Tracey Marks' videos?

    -Dr. Tracey Marks focuses on mental health education in her videos.

  • What does the term 'microdosing' typically refer to in the context of substances?

    -Microdosing usually refers to taking a very small dose of a psychedelic substance, like LSD or psilocybin, to experience cognitive and emotional benefits without the dissociative effects.

  • What are some reported benefits of microdosing psychedelics?

    -Advocates of microdosing report benefits such as enhanced creativity, improved mood, increased energy, and heightened focus.

  • What is the current state of scientific research on the benefits of microdosing psychedelics?

    -The scientific research is still catching up with the claims of microdosing's benefits, with some studies showing changes in brain activity and others indicating potential negative effects on mental functions.

  • Why is microdosing prescription medication different from microdosing psychedelics?

    -Prescription medications have specific pharmacokinetics designed for therapeutic effects, and microdosing them may not provide the intended benefits due to the concept of the minimum effective dose.

  • What is the minimum effective dose in pharmacology?

    -The minimum effective dose is the smallest amount of a drug that produces a therapeutic response, and doses below this are unlikely to be effective for symptoms and only expose the patient to side effects.

  • How does the body metabolize psychiatric medications?

    -Most psychiatric medications are metabolized in the liver, a process that can be influenced by an individual's genetic makeup.

  • What is the significance of being a slow metabolizer when it comes to medication dosage?

    -Slow metabolizers break down medication less quickly, which can lead to an accumulation of the drug in the system and a higher likelihood of experiencing side effects from normal doses.

  • Can you microdose an antidepressant like Prozac?

    -Microdosing an antidepressant like Prozac is not recommended because the minimum therapeutic dose is typically higher than what would be considered a microdose, and it may not be effective.

  • Why is it not advisable to cut or crush extended-release medications?

    -Cutting or crushing extended-release medications can damage the coating or mechanism that allows for gradual release of the drug, potentially leading to a loss of the extended-release feature.

  • What is the process of titration in medication dosing?

    -Titration is the process of starting with a low dose of medication and gradually increasing it to achieve a better therapeutic effect, which may be necessary for some individuals to manage side effects or find the right dosage.

Outlines
00:00
💊 Understanding Microdosing and Prescription Medication

Dr. Tracey Marks introduces the concept of microdosing, typically associated with psychedelic substances like LSD or psilocybin, where a small dose is taken to gain benefits without the dissociative effects. She explains the appeal of microdosing, such as enhanced creativity and focus, while noting that scientific research is still in progress. Dr. Marks also addresses the legality of psychedelics and the pharmacokinetics of prescription medications, emphasizing the difference between recreational drugs and those prescribed for medical purposes. She highlights the importance of the minimum effective dose and how individual metabolism can affect the dosage required for therapeutic effects.

05:00
🧪 Adjusting Medication Dosage for Personal Metabolism

The script delves into the practical aspects of adjusting medication dosage based on one's metabolic rate, discussing how slow and rapid metabolizers may require different dosages for effective treatment. Dr. Marks uses Prozac as an example to illustrate the challenges of microdosing antidepressants, pointing out the difficulty of accurately measuring sub-therapeutic doses and the potential for side effects even at low doses. She advises that medications in liquid form or with specific formulations, like VYVANSE's spansules, may offer more flexibility for those needing to microdose. The video also touches on the implications of altering medication forms, such as extended-release tablets, and the potential impact on medication effectiveness. Lastly, Dr. Marks discusses the concept of titration and the potential for slower onset of medication effects when starting at lower doses.

Mindmap
Keywords
💡Microdosing
Microdosing typically refers to the practice of taking a very small, sub-perceptual dose of a psychedelic substance like LSD or psilocybin. The goal is to experience subtle cognitive and emotional benefits without the intense effects associated with a full dose. In the context of the video, microdosing is initially discussed in relation to psychedelics but is then contrasted with the concept of adjusting prescription medication doses to manage side effects.
💡Pharmacokinetics
Pharmacokinetics is the study of how a drug is absorbed, distributed, metabolized, and excreted by the body. It is a fundamental concept in understanding the behavior of prescription medications. In the video, Dr. Marks explains that unlike recreational drugs, prescription medications are designed with specific pharmacokinetics in mind, which is crucial for determining the minimum effective dose and managing side effects.
💡Minimum Effective Dose
The minimum effective dose is the smallest amount of a drug that produces a therapeutic response. It is a principle in pharmacology that ensures the medication is effective while minimizing side effects. The video script uses this concept to discuss the challenges of microdosing prescription medications, as doses below the minimum effective dose may not provide therapeutic benefits.
💡Prozac
Prozac, also known by its generic name fluoxetine, is an antidepressant medication. In the video, Dr. Marks uses Prozac as an example to illustrate the concept of minimum effective dose and the challenges of microdosing, explaining that the smallest dose available is 10 milligrams and the usual effective dose ranges from 20 to 60 milligrams.
💡Metabolism
Metabolism, in the context of medication, refers to how quickly an individual's body processes and breaks down drugs. The video discusses how different metabolic rates can affect the efficacy of medications, with slow metabolizers requiring smaller doses and rapid metabolizers needing higher doses for the medication to be effective.
💡Genetic Testing
Genetic testing can help determine an individual's metabolic status, which can influence how they respond to medications. In the video, Dr. Marks mentions that while genetic testing can be expensive and not universally accessible, it can provide insights into whether an individual is a slow, rapid, or normal metabolizer of medications.
💡Side Effects
Side effects are the unintended consequences of taking a medication, which can include nausea, diarrhea, or trouble sleeping. The video script discusses how side effects can be a reason for individuals to consider microdosing or adjusting their medication dosage to find a balance between therapeutic effects and tolerability.
💡Extended Release
Extended release formulations are designed to release the medication slowly over time, typically to maintain a therapeutic effect for an extended period, such as 24 hours. The video explains that cutting or crushing extended release medications can disrupt this mechanism, leading to a loss of the intended slow-release effect.
💡Titration
Titration is the process of starting a medication at a low dose and gradually increasing it to achieve the desired therapeutic effect. The video mentions that some individuals may require a slower titration process, which can involve taking smaller doses over a longer period to adjust to the medication.
💡Zoloft
Zoloft, known generically as sertraline, is another antidepressant medication. In the video, Dr. Marks uses Zoloft as an example to discuss the potential effects of taking a smaller dose than prescribed, such as 1/4 or 1/8 of a tablet, and the implications this might have on the time it takes to achieve the desired therapeutic effect.
💡VYVANSE
VYVANSE is a medication that comes in a capsule form with spansules inside, allowing for the medication to be opened and portioned if necessary while still maintaining its extended release properties. The video uses VYVANSE as an example to illustrate that not all extended release medications are the same and some can be adjusted in dosage under certain conditions.
Highlights

Microdosing typically refers to taking a small dose of psychedelic substances like LSD or psilocybin.

Microdosing aims to provide cognitive and emotional benefits without the dissociative effects.

Advocates of microdosing report benefits such as enhanced creativity and improved mood.

Scientific research on microdosing benefits is still in its early stages.

Some studies show brain activity changes similar to those taking larger doses of psychedelics.

Other studies indicate that microdosing can worsen some mental functions.

The legality of psychedelics varies, with many states considering them illegal.

Prescription medications have specific pharmacokinetics designed for their intended effects.

The minimum effective dose is the smallest amount that produces a therapeutic response.

Prozac, an antidepressant, has a minimum therapeutic dose of 20 milligrams for normal metabolizers.

Genetic testing can determine an individual's drug metabolism status, affecting dosage requirements.

Slow metabolizers may experience side effects from normal doses and require smaller amounts.

Rapid metabolizers need higher doses for the medication to be effective.

Microdosing prescription medication like Prozac may not be effective due to the minimum therapeutic dose.

Prescription medications in liquid form or that can be easily divided are preferable for microdosing attempts.

Extended-release medications should not be cut or crushed as it affects their release mechanism.

Some medications, like VYVANSE, have spansules that maintain their pharmacokinetics even when opened.

A slow titration schedule may require medications in liquid form or easily divisible tablets.

Reducing the dose of antidepressants may prolong the time to achieve desired therapeutic effects.

Transcripts

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MicrodosingMental HealthPsychiatristPrescription MedicationPsychedelic SubstancesCognitive BenefitsSide EffectsPharmacokineticsTherapeutic DoseSlow MetabolizerExtended Release