6 months of microdosing for treatment-resistant depression — honest numbers

Background: I have treatment-resistant depression. I've tried four SSRIs, two SNRIs, bupropion, lamictal, and TMS. None produced sustained remission. My psychiatrist knew I was going to try microdosing and agreed to monitor me.

Protocol: Fadiman protocol, 0.1g dried B+ on Day 1, off Day 2-3, repeat. I used the PHQ-9 scale weekly and a daily 1-10 mood rating in my journal.

Months 1-2: Consistent improvement. My PHQ-9 dropped from 16 (moderately severe) to 8 (mild). Daily mood average went from 3.8 to 5.9. I noticed the effect most clearly on "on" days — a kind of motivation and mild emotional brightness that had been absent for years. Side effects were minimal: occasional headaches on day 1, mild alertness making sleep harder if I dosed after noon.

Months 3-4: The effect stabilized. PHQ-9 held at 9-10. I was functioning better — working more consistently, exercising again — but the emotional brightness of months 1-2 was less prominent. Tolerance was accumulating despite the 2-day breaks. I extended the off period to 3 days for a month. Some of the brightness returned.

Months 5-6: Diminishing returns. PHQ-9 crept back to 12. I took a full 4-week break. In the break month my mood dipped back to near baseline. After the break I resumed — month 6 results were back to the month 1-2 range.

Conclusion: Microdosing is working for me in a way nothing else has, but it requires cycling and breaks to maintain effectiveness. It is not a replacement for therapy — my weekly sessions are what give the elevated mood somewhere to go.