LSD and anxiety disorders
At Triptherapie, we counsel an increasing number of people struggling with generalised anxiety disorder (GAD). This condition is known for chronic brooding, tension and a sense of insecurity that can severely affect daily life. Regular therapies and medication, such as SSRIs or benzodiazepines, do not always provide the desired relief and are often not sustainable.
The resurgence of research into psychedelics is changing this. LSD (lysergide) in particular is once again in the spotlight as a possible treatment for anxiety disorders. The intriguing thing is that a single session can provide months of reduction in anxiety symptoms. But what is the best dosage for anxiety reduction?
Science and the right LSD dosage?
In September 2025, JAMA Psychiatry published the largest modern clinical study of LSD in generalised anxiety disorder to date. In this study, 198 adults with moderate to severe anxiety disorder were randomly assigned to different groups. Each participant received a single dose of 25, 50, 100 or 200 micrograms of LSD (MM120, pharmaceutical tartrate) or a placebo, after which they were followed for several months.
25 and 50 µg
At these lower doses, the researchers saw little difference from the placebo group. This suggests that microdoses or very low doses for severe anxiety are often too subtle to achieve a clear therapeutic effect. Although some people experience a slight improvement in mood or focus when microdosing, in this study this did not appear to be enough to cause a significant reduction in generalised anxiety.
100 µg
This dosage produced the best results. Participants reported a clear and clinically relevant reduction in their anxiety symptoms, which also persisted for at least 12 weeks after the session. The effect was greater than in the placebo group and lasted much longer than what we usually see with traditional medication, where symptoms often return quickly after stopping.
200 µg
At this higher dose, a clear reduction in anxiety also occurred, similar to the 100 µg group. However, the researchers did note that the experience was often more intense and was sometimes accompanied by temporary discomfort, such as anxious moments or physical restlessness during the peak. Despite this intensity, many participants reported a sense of relief and greater acceptance afterwards.
What makes this study extra special is that psychotherapy was not allowed during the sessions. Participants were guided and monitored only in a safe, pleasant space, but without therapeutic intervention or in-depth guidance. Yet the effects on anxiety reduction were found to be strong and long-lasting. Coincidentally, we wrote a week or so ago and before this study was made public that psychotherapy is often not required for effectiveness. You can read about why that is and the biological workings behind the positive effects on psychedelics here:
Combining LSD with psilocybin or MDMA
Besides LSD sessions, we also sometimes deploy combinations of substances. We always do this carefully, keeping in mind safety, personal situation and therapeutic goals. Not every client has the same needs or reacts the same to a certain dose. Therefore, we look at each individual to see what the best approach is, and other complaints besides anxiety may play a role in choosing a particular combination.
Wizard flip (LSD + psilocybin)
For clients struggling with both anxiety and depression, the so-called wizard flip (the combination of LSD and psilocybin) often proves particularly valuable.
- LSD works strongly on the cognitive level: it opens the mind, promotes creative thinking processes and helps to see stuck patterns from a different perspective.
- Psilocybin goes deeper into the emotional and spiritual layers, giving people easier access to feelings that have often been suppressed for a long time.
- The combination can provide clearer visual effects and therefore visual insights.
The synergy between these two tools can lead to powerful breakthroughs: clients experience that their fears are intertwined with unprocessed emotions and are given the opportunity to live through and release them in a safe environment. We find that, for many people with anxiety and depression, this is an intense but transformative path, often providing lasting inner and greater appreciation for life.
Candy flip (LSD + MDMA)
For clients with anxiety symptoms very similar to post-traumatic stress disorder (PTSD), we sometimes deploy a different combination: the candy flip, a session with LSD and MDMA.
- MDMA often produces in people an increased level of positive feelings, safety, empathy and can strengthen the degree of connectedness. This can help people approach painful memories without being overwhelmed by anxiety or re-experiences.
- LSD thereby offers the opportunity to explore deeper layers of consciousness and restructure old beliefs or traumas from a new perspective.
- The combination often creates a trip that is considered safe.
Together, this can create a unique and powerful dynamic in which people can better visually process their traumas and see their quality of life increase significantly.
Guided LSD session at Triptherapie
At Triptherapie, we believe that guidance and integration are sometimes essential, but often add considerable value. This is regardless of the chosen dosage or combination, but at higher dosages, guidance becomes more and more of a requirement for safety and effectiveness. A good psychedelic session is deep process that starts with careful preparation, which has an impact during the session itself.
Beforehand, we take extensive time to get to know you and your situation. We discuss your medical background, your current complaints, your lifestyle and your personal goals. Together, we consider which dosage and which remedies are most appropriate. We also guide you in the weeks before the session with practical advice on nutrition, supplements and exercise, so that your body and mind are in the best shape for the journey. This biochemical support helps to optimally prepare your brain and body for the experience.
During the session itself, we provide safety and feel safe, which are two different things! For some clients, our presence in the background is enough to feel safe and let go completely. For others, active guidance is required: a listening ear, a reassuring word, breathing exercises or an intervention to get through a particular resistance.
After the session, you may need extra attention. The experience itself can be intense, but the lasting change arises partly from what you do with the insights afterwards. That is why we pay a lot of attention to integration. during the integration session, we help you to understand the experience, to apply new perspectives in your daily life and to hold on to the path to more inner peace.
The amount of therapeutic support
In LSD sessions, it is important that we coordinate with you on the need for therapeutic guidance and the function of the therapist helping you. Therefore, you can always discuss with us how much guidance and what form of therapy suits you. Some clients opt for a pure psychedelic experience with the presence of an experienced tripsitter, who provides safety and makes sure everything is calm and safe. Others need more substantive guidance, where we can use different methods, such as:
- Psychological counselling: support from a psychologist to help work through anxiety patterns and understand underlying themes.
- IFS (Internal Family Systems): a method that helps to get to know and integrate parts of yourself better. This can be particularly valuable when dealing with inner conflicts or persistent fears.
- Cognitive behavioural therapy (CBT): to practice new thinking patterns and release old, fear-driven beliefs.
- EMDR: a proven effective method for PTSD and trauma-related symptoms, which sometimes works even deeper when combined with psychedelics.
- Mindfulness and breathing techniques: to find peace during the session, release tension and get more in touch with the here and now.
- Spiritual counselling: for clients open to a broader, consciousness-based approach to their complaints and life questions.
Our role is to help you find the right balance between the inner work you do yourself and the professional support we provide. Sometimes this is mild guidance in the background, sometimes it is an intensive therapeutic journey. Everything is aimed at giving you the best experience and the most sustainable result, always with safety and personal alignment as the basis. While filling in the intake, you can already indicate your preferences in any case so we can help you pair up with a therapist or tripsitter.
