LSD, the classic psychedelic known for its intense and varied cerebral effects, has been studied for its potential role in treating addiction, anxiety, and depression. But most psychonauts will tell you that LSD can also cause negative experiences that include fleeting unpleasant thoughts and feelings, or even moments of mania. Because research shows greater therapeutic benefit from a “positive” psychedelic experience, finding a way to create or predict a good trip would be ideal for those taking LSD to improve their mental health.
That’s where MDMA (also known as ecstasy or molly) comes in. Anecdotal evidence suggests that MDMA—an empathogen that promotes feelings of wellbeing, connection, and pleasure—can help “soften” some of the harder edges of an LSD trip. Known as candy flipping, simultaneous dosing with LSD and MDMA is already a common practice in some circles. And now, a clinical trial will investigate its effects.
Researchers at the Liechti Lab at the University Hospital in Basel, Switzerland, in cooperation with the psychedelics pharmaceutical company, MindMed, have announced a new Phase 1 trial to study the felt experiences of volunteers who candy flip. If successful, the study could lay the groundwork for a longer-term effort to develop a relatively comfortable and safe protocol for patients undergoing psychedelic-assisted therapy.
Spearheaded by psychedelics researcher and professor Matthias Liechti, MD, the study aims to discover whether MDMA, with its suite of prosocial effects, can help alleviate or reduce the potential downsides of LSD such as intrusive thoughts, anxiety, paranoia, and the temporary loss of trust. In essence, because it helps foster positive emotions, researchers theorize that MDMA can work as an “optimizer” for LSD.
The double blind, placebo-controlled study will include 24 healthy adult participants with ten or fewer previous psychedelic experiences. On separate occasions, each participant will receive one of four possible drug combinations:
· 100 micrograms LSD + 100 milligrams MDMA
· 100 micrograms LSD + MDMA placebo
· LSD placebo + 100 milligrams MDMA
· LSD placebo + MDMA placebo
During the experience, Liechti and his team will evaluate participants’ autonomic responses, including body temperature, heart rate, and blood pressure; post-trip, volunteers will respond to questionnaires evaluating the perceived positive and negative effects of their dose.
Down the road, candy flipping may benefit patients seeking treatment for depression, anxiety, and other conditions. “The hypothesis,” Liechti wrote in an email to DoubleBlind, “is that an overall better mood effect would increase long-term benefit in any psychiatric condition.” But because this trial will exclude those with previous psychiatric diagnoses, said Liechti, future studies will be needed to investigate the effects of candy flipping in a mental health treatment setting.
To date, only one other trial has addressed the effects of combining MDMA and LSD. Conducted in the late 1990s, the first candy flipping study found a greater “MDMA-like response” in rats that were co-administered the two substances. Real-world candy flippers report that the synergy can produce powerful experiences related—but not identical—to what they experience when tripping on LSD or MDMA alone. And while many people say that MDMA can indeed soften or smooth out their LSD experience, others report intense, occasionally uncomfortable trips when combining the two substances.
The trial is set to begin in late 2020 with initial results expected in 2022.
To read more about candy flipping, including harm reduction practices, check out DB’s story on it here.