Psychedelic Microdosing vs TMS for Depression

Microdosing versus TMS for depression

People with severe depression sometimes ask how psychedelic microdosing compares with TMS. The two are not equivalent. TMS is FDA-cleared for major depressive disorder. Psychedelic microdosing is not an approved treatment for depression, and the substances involved remain illegal under federal law. This page is educational and compares what each approach actually involves.

What TMS is

TMS is a non-invasive treatment that uses magnetic pulses to stimulate brain regions involved in mood. It is FDA-cleared for major depressive disorder, is delivered in an office by trained staff, and is often covered by insurance for treatment-resistant depression. See our TMS program and our guide to treatment-resistant depression.

What psychedelic microdosing is

Microdosing means taking small, repeated, sub-hallucinogenic doses of a psychedelic such as psilocybin or LSD. These substances are Schedule I under federal law, meaning they are illegal to possess or use outside of authorized research. Microdosing is not an FDA-approved treatment for depression or any condition.

What the research shows about microdosing

• A double-blind, placebo-controlled study of psilocybin microdosing found that it did not reduce symptoms of depression or anxiety compared with placebo.
• Surveys of people who microdose note that they often do so as self-managed treatment despite the substances being prohibited, and researchers have called for controlled trials before any conclusions.

The best-controlled evidence to date does not show that microdosing improves depression beyond placebo.

How they compare

TMS is FDA-cleared, delivered under clinical supervision, and studied in large trials for depression. Microdosing is not approved, involves illegal substances, and is not supported by controlled evidence for depression. For someone with severe or treatment-resistant depression, TMS and other established treatments are the appropriate options to discuss with a clinician.

TMS at Exxceed Wellness

We provide TMS and other evidence-based care for adults with treatment-resistant depression in Hayward, CA. We do not provide or advise psychedelic microdosing. See our TMS program or contact us.

Frequently asked questions

Is microdosing a proven treatment for depression?

No. In a double-blind, placebo-controlled study, psilocybin microdosing did not outperform placebo for depression or anxiety. It is not an approved treatment.

Is TMS a better option than microdosing?

TMS is FDA-cleared for depression and is delivered under clinical supervision. Microdosing is not approved and uses illegal substances. Discuss evidence-based options with a clinician.

Is microdosing legal?

The psychedelics used for microdosing are Schedule I under federal law. Possession and use outside authorized research are illegal.

References

Based on research indexed in PubMed:

1. Marschall J, et al. Psilocybin microdosing does not affect emotion-related symptoms and processing: A preregistered field and lab-based study. J Psychopharmacol. 2022;36(1):97-113. DOI.
2. Lea T, et al. Microdosing psychedelics: Motivations, subjective effects and harm reduction. Int J Drug Policy. 2020;75:102600. DOI.
3. U.S. FDA milestones for TMS devices: PMC.

Educational information only, not medical advice, and not an endorsement of any illegal substance. TMS is FDA-cleared for major depressive disorder. Psychedelic microdosing is not an approved treatment and involves substances that are illegal under federal law. Outcomes vary, and candidacy for any treatment is determined by a qualified clinician. Consult a clinician about your specific situation.