New research suggests that low doses of MDMA, commonly known as ecstasy, can help to reduce the challenging effects associated with psychedelic drugs like LSD (lysergic acid diethylamide) and psilocybin, the active component in magic mushrooms. The findings, published in Scientific Reports, shed new light on the effects of “candy flipping” and “hippy flipping”‘ – terms used for the co-administration of LSD or psilocybin with MDMA.
MDMA, psilocybin, and LSD are psychoactive substances known for their potent effects on human perception, mood, and consciousness. The motivation for this study was rooted in the growing interest in the therapeutic potential of these substances. Psilocybin and LSD — when combined with supportive psychotherapy — have shown considerable promise in clinical research for treating a range of psychiatric disorders, including depression, anxiety, and post-traumatic stress disorder.
However, a significant concern associated with their use is the potential for challenging psychological experiences, often referred to as “bad trips.” These can include feelings of fear, grief, and paranoia. Anecdotal reports suggested that MDMA, known for its empathogenic and euphoric effects, might help mitigate these negative experiences. This led researchers to systematically investigate whether co-using MDMA with psychedelics like psilocybin or LSD could indeed alter the nature of the psychedelic experience.
“While psychedelic experiences can often be pleasant, there is also the possibility of having challenging acute experiences. Many individuals are understandably hesitant to receive psychedelic therapy due to fears of having a challenging experience,” said study author Richard Zeifman, a postdoctoral fellow in the NYU Langone Center for Psychedelic Medicine.
“We were interested in examining whether co-use of MDMA with psilocybin/LSD may help to reduce the intensity of challenging experiences. We were also interested in studying previous anecdotal reports suggesting that combining MDMA with psilocybin/LSD increased positive experiences, such as feelings of love and self-compassion.”
The study was conducted through two online surveys, targeting individuals who planned to use psychedelic substances in naturalistic settings. Participants were required to be at least 18 years old and fluent in English. The final sample included 698 individuals, with 342 reporting LSD use and 356 reporting psilocybin use during their experience. Additionally, 27 of these individuals co-used MDMA with psilocybin or LSD.
Participants completed surveys both before and after their psychedelic experiences. These surveys collected demographic information, personal and psychiatric history, details about their planned psychedelic use, and the specific context in which the use occurred. To measure the effects of the psychedelic experience, researchers used the Challenging Experience Questionnaire (CEQ) for negative experiences and self-constructed items for positive experiences like self-compassion, love, and gratitude. The revised Mystical Experience Questionnaire (MEQ-30) was used to assess mystical-type experiences.
The researchers found that participants who co-used a low dose of MDMA with psilocybin or LSD reported significantly lower levels of total challenging experiences compared to those who used psilocybin or LSD alone. Specifically, there were reductions in experiences of grief and fear. Additionally, these individuals reported higher levels of positive experiences such as self-compassion, feelings of love, and gratitude.
“Use of MDMA in combination with classic psychedelics like psilocybin and LSD may reduce the intensity of challenging experiences, such as fear and sadness, and increase positive experiences, such as love, gratitude, and self-compassion,” Zeifman told PsyPost.
Interestingly, this beneficial effect was not observed with medium to high doses of MDMA. There were also no significant differences observed in the mystical-type experiences or feelings of compassion between the groups.
“We were surprised that low-dose MDMA, rather than medium-high dose MDMA, was associated with less distressing and more positive experiences,” Zeifman said.
But the study, like all research, includes limitations. The study’s design was observational and relied on self-reported data, which can introduce biases. The sample size, particularly of those who co-used MDMA, was relatively small, and the study did not control for the exact dosage of MDMA.
“The study includes very important limitations and is unable to provide any strong conclusions regarding the effects of using MDMA in combination with psilocybin/LSD,” Zeifman explained. “Our study had a rather small sample size, was not conducted in a controlled environment, did not use a representative or clinical sample, and we do not know exactly how much MDMA participants used. It will be important for future research to examine the effects of combining MDMA with psilocybin/LSD to determine whether it is safe or beneficial.”
The study, “Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences“, was authored by Richard J. Zeifman, Hannes Kettner, Broc A. Pagni, Austin Mallard, Daniel E. Roberts, David Erritzoe, Stephen Ross, and Robin L. Carhart-Harris.
