What is the advantage of microdosed psilocybin over prescription medication?

This is part 2 of the series: Can microdosing psilocybin treat addiction?
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Can I get addicted to psilocybin when I microdose?
What is the scientific evidence on microdosing psilocybin for addiction recovery?

Pharmacology offers a variety of dependence treatment options, as well as medication to treat conditions frequently comorbid with addiction, such as depression, anxiety, or PTSD.

The class of drugs called selective serotonin reuptake inhibitors (SSRIs) is most closely related to psilocybin in that it impacts the same neurotransmitter system in the brain, albeit in a different way.

Studies show that antidepressants can be helpful in nicotine dependence with or without comorbid depression, and may be beneficial in alcohol, cocaine, or opioid dependence with comorbid depression. Interestingly, SSRIs do not seem to offer significant advantages in substance‑use disorders compared with other types of antidepressants.

People struggling with addiction may opt for microdosing psilocybin over antidepressants for a variety of reasons, including:

• Differences in side‑effect profiles: certain individuals may experience too many undesirable side effects of prescription drugs and fewer or more manageable side effects when microdosing psilocybin.
• More flexibility in use: microdosing psilocybin typically involves non‑daily protocols or intuitive, flexible approaches with rest and break periods, whilst antidepressants rely on daily regular intake.
• Lower risk of withdrawal: stopping antidepressants can evoke withdrawal symptoms. For psilocybin, a classic withdrawal syndrome is unlikely, since microdosing is typically non-daily with built-in breaks.
• Drug resistance: certain conditions are not helped by synthetic medications, in which case psilocybin offers an interesting alternative to explore.
• Accessibility and costs: antidepressants require a medical prescription. On the other hand, legality and access to psilocybin differ by geographic location.
• Ethical considerations: personal or ethical concerns about the pharmaceutical industry.
• Preference for a natural* substance instead of a synthetically manufactured one.

For many addictions, standard medications remain the first‑line treatment where available, but people with legal access and who do not meet the exclusion criteria may consider microdosing psilocybin for addiction a viable alternative.

See sources.

* [Opinion:] This will hold for as long as psilocybin‑containing mushrooms and truffles available on the market remain unmodified for increased potency, which would eventually create fungi far removed from what can be called natural. This problem is already present due to profit‑driven crossbreeding of cannabis.

Do you have any questions about this text? Ask them in the comments below. They are answered by Lina B. Russell, an addiction recovery coach specialised in microdosing psilocybin.

Previous in the series:
Can microdosing psilocybin treat addiction?
Can I get addicted to psilocybin when I microdose?
What is the scientific evidence on microdosing psilocybin for addiction recovery?