LSD and anxiety disorders
At Triptherapie, we are supporting more and more people who are struggling with generalised anxiety disorder (GAD). This condition is known for chronic worrying, tension and a feeling of insecurity that can severely impact daily life. Standard therapies and medication, such as SSRIs or benzodiazepines, do not always provide the desired relief and are often not sustainable.
The revival of research into psychedelics is changing that. LSD (lysergide) in particular is back in the spotlight as a potential 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 correct LSD dosage?
In September 2025, JAMA Psychiatry published the largest modern clinical study to date on LSD for generalised anxiety disorder. In this study, 198 adults with a 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 monitored for several months.
25 to 50 µg
At these lower doses, the researchers observed hardly any difference compared to 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 with microdosing, in this study this proved insufficient to cause a significant reduction in generalised anxiety.
100 µg
This dosage yielded the best results. Participants reported a clear and clinically relevant reduction in their anxiety symptoms, which moreover 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 typically see with traditional medication, where symptoms often return quickly after stopping.
200 µg
At this higher dosage, a clear reduction in anxiety also occurred, comparable to the 100 µg group. However, the researchers noted that the experience was often more intense and sometimes accompanied by temporary discomforts, such as anxious moments or physical restlessness during the peak. Despite this intensity, many participants subsequently reported a sense of relief and greater acceptance.
What makes this study extra special is that psychotherapy was not permitted during the sessions. The participants were merely guided and monitored in a safe, pleasant environment, but without therapeutic intervention or in-depth guidance. Nevertheless, the effects on anxiety reduction proved to be strong and long-lasting. Coincidentally, a week or so ago and before this research was published, we wrote that psychotherapy is often unnecessary for effectiveness. You can read how that comes about and the biological mechanism behind the positive effect of psychedelics here:
Combining LSD with psilocybin or MDMA
Alongside LSD sessions, we also sometimes use combinations of substances. We always do this carefully, with a focus on safety, personal circumstances, and therapeutic goals. Not every client has the same need or reacts the same way to a specific dose. Therefore, we determine the best approach on an individual basis, and other conditions alongside the 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 has a powerful effect on the cognitive level: it opens the mind, promotes creative thought processes and helps to view entrenched patterns from a different perspective.
- Psilocybin delves deeper into the emotional and spiritual layers, making it easier for people to access feelings that have often been suppressed for a long time.
- The combination can provide clearer visual effects and therefore pictorial insights.
The synergy between these two substances can lead to powerful breakthroughs: clients experience that their fears are intertwined with unprocessed emotions and are given the opportunity to experience these in a safe environment and let them go. We notice that for many people with anxiety and depression, this is an intense but transformative path, which often brings lasting inner peace and a greater appreciation for life.
Candy flip (LSD + MDMA)
For clients with anxiety symptoms that closely resemble post-traumatic stress disorder (PTSD), we sometimes deploy a different combination: the candy flip, a session involving LSD and MDMA.
- MDMA often gives people an increased level of positive feelings, security, and empathy, and can strengthen the degree of connectedness. This can help to approach painful memories without being overwhelmed by fear or flashbacks.
- 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 process their traumas more visually and see a significant increase in their quality of life.
Guided LSD session at Triptherapie
At Triptherapie we believe that guidance and integration are sometimes essential, but often offer significant added value. This applies regardless of the chosen dosage or combination, but at higher dosages, guidance progressively becomes a requirement for safety and efficacy. A good psychedelic session is a profound process that begins with careful preparation, which influences the session itself.
First, we take ample time to get to know you and your situation. We discuss your medical background, your current symptoms, your lifestyle, and your personal goals. Together, we look at which dosage and which remedies are most appropriate. We also guide you in the weeks leading up to the session with practical advice on nutrition, supplements, and exercise, so that your body and mind are in the best condition 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 the feeling of safety; those 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 desired: a listening ear, a reassuring word, breathing exercises or an intervention to break through a certain resistance.
After the session, you may need extra attention. The experience itself can be intense, but lasting change is also brought about by what you do with the insights afterwards. That is why we pay a great deal of attention to integration. During the integration conversation, we help you to understand the experience, to apply new perspectives in your daily life, and to maintain the path towards greater inner peace.
The amount of therapeutic support
During LSD sessions, it is important that we coordinate with you regarding your need for therapeutic guidance and the role of the therapist assisting you. Therefore, you can always discuss with us how much guidance and which form of therapy suits you. Some clients choose a pure psychedelic experience with the presence of an experienced tripsitter, who offers security and ensures that everything proceeds calmly and safely. Others need more substantive guidance, where we can deploy various methods, such as:
- Psychological guidance: support from a psychologist who helps process anxiety patterns and understand underlying themes.
- IFS (Internal Family Systems): a method that helps you get to know and integrate parts of yourself better. This can be particularly valuable in cases of inner conflict or persistent anxieties.
- Cognitive behavioural therapy (CBT): to practise new thought patterns and let go of old, anxiety-driven beliefs.
- EMDR: a proven effective method for PTSD and trauma-related complaints, which sometimes works even deeper in combination with psychedelics.
- Mindfulness and breathing techniques: to find calm during the session, release tension and get more in touch with the here and now.
- Spiritual guidance: for clients who are open to a broader, consciousness-oriented approach to their issues 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 that is gentle 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 customisation as a basis. When filling out the intake form, you can already indicate your preferences so that we can help match you with a therapist or tripsitter.