Anxiety disorders are a leading cause of disability, and over half of affected individuals do not respond to standard treatments. This review of preclinical and clinical research on LSD finds that while it can worsen anxiety in the short term, it produces lasting reductions in anxiety. Only two randomized controlled trials combining LSD with psychotherapy have been conducted in patients with anxiety disorders, showing good safety and sustained decreases in anxiety. The effects may involve serotonin receptors and brain networks such as the default mode network. It remains unknown whether LSD works alone or only with psychotherapy, and whether microdosing produces the same long-term benefits as full doses.
A 21-day mobile-accessible programme called the Digital Intervention for Psychedelic Preparation (DIPP) is being tested for feasibility and preliminary efficacy in a randomised controlled trial. The study will recruit 40 non-treatment-seeking adults without a clinical diagnosis, randomly assigning them to either a guided meditation with music condition or a music-only condition. After the digital intervention, all participants will attend an in-person supervised psilocybin session with a standardised 25 mg dose. Primary outcomes include recruitment efficiency, retention, and adherence; secondary outcomes assess preparedness, quality of the psychedelic experience, and wellbeing, with follow-ups up to 9 months. The trial is registered as NCT06815653.