Thread by @GidMK

The largest/only RCT of microdosing psilocybin (shrooms) for mental health has just come out, and it found no benefit

It is also one of the most methodologically beautiful pieces of research I have ever seen. Amazing innovation

elifesciences.org/articles/62878…

Doing research on shrooms is hard, because they're mostly illegal and there are a lot of restrictions in most places

Much of the research is simply observational, asking people who already take shrooms what they think of the experience

So what did the researchers do?

They asked people who were already going to microdose shrooms to BLIND AND RANDOMIZE THEMSELVES

Super cool idea, and impressively sound methodology

Basically, they got people to put the drug and a placebo into opaque pills, then randomize the selection of the drug so that they didn't know what they were taking over the course of 4 weeks

Is this open to some bias? Yes, absolutely

Is it a genius idea that allows you to conduct really difficult research on illegal drugs cheaply and ethically? Also yes

Each participant had 4 weeks of randomly taking either a placebo or psilocybin, then recording their mood and mental health on a dozen questionnaires. A slightly modified randomized-crossover trial

And at the end of the study, the researchers found that there was no meaningful difference between people randomly allocated to take shrooms compared to those who had taken a placebo

Now, there are drawbacks to this methodology. Firstly, you can only run a study like this on people who were already planning on microdosing psilocybin and who are easy to find online, which it turns out is a somewhat specific group

There's also definitely potential for unblinding bias - as the researchers note, it's likely that some people checked to see which pills they were taking

But all in all, this is not only a really interesting study answering a useful question, it's also a research innovation that's going to be invaluable for the future of research into illegal drugs