• Context of the study — In 2020, MindMed published the findings of their Phase 1 trials of MM120,⁵ which is an “oral pharmaceutical formulation of LSD.”⁶ After positive Phase 2b results, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation for MM120 in generalized anxiety disorder in 2024.⁷

• Continuing the research — The Phase 2b trials published in JAMA took place across 22 outpatient psychiatric research sites in the United States and involved 198 participants between the ages of 18 and 74. Every participant had a confirmed diagnosis of moderate-to-severe GAD, defined by a score of 20 or higher on the Hamilton Anxiety Rating Scale (HAM-A), a widely accepted clinical measure of anxiety severity.

• Conducting Phase 2b trials — Participants were randomly assigned to one of five groups — placebo, 25 micrograms (μg), 50 μg, 100 μg, or 200 μg of MM120. The trial’s main measure of success was whether anxiety scores on the HAM-A dropped meaningfully, in a dose-dependent way, after four weeks. A reduction of 2.5 points on the HAM-A is considered clinically important.

Figure 1. The Phase 2b trial randomly assigned 198 adults to placebo or one of four single doses of MM120, with the main measure at week 4 and follow-up through week 12.

• Findings of the trials — The standout result was that 100 micrograms emerged as the optimal dose. At this dose, about 65% of participants experienced a clinical response at week 12, which means their anxiety scores fell by at least half. Even more compelling, 47.5% of these individuals reached remission, with anxiety levels so low they were considered minimal.

• The 100 μg dose stood out — Again, it had the best combination of strong anxiety reduction and sustained effects with manageable side effects.

• Effects were better as time went on — By the four-week mark, the benefits of MM120 were already strong. The mean reduction in HAM-A scores at the 100 μg dose was −19.2 points, compared to −14.2 in the placebo group. While placebo effects were notable, the improvements at 100 μg and 200 μg went beyond what would be expected from placebo alone.

Figure 2. Average HAM-A score changes at week 4 were largest at the 100 μg and 200 μg doses; the 25 μg and 50 μg doses did not differ meaningfully from placebo.

• What makes this trial stand out is the robustness of the results — Improvements at 100 μg lasted through week 12. While the 200 μg dose also produced reductions in anxiety, its side effects were less favorable, making the 100 μg dose the “sweet spot” for balancing benefit with tolerability. The lower doses of 25 μg and 50 μg, by contrast, did not produce meaningful effects compared to placebos.

• A possible respite from polypharmacy — For patients who have cycled through selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or cognitive therapy without consistent results, this study presents a glimpse of a new therapeutic model — one that does not rely on chronic daily dosing.

• It is important to temper expectations — The results do not mean LSD is an instantly proven or approved treatment. Keep in mind, this was a Phase 2b trial, which is designed to test the concept in a controlled environment. The study also lasted only 12 weeks, so it’s hard to accurately predict what happens after that.

In addition, the trial excluded individuals with more complicated psychiatric or medical conditions, so it’s harmful to assume the results apply to everyone.

• Mental effects — The most common experiences at the 100 μg and 200 μg doses were visual changes, such as illusions or hallucinations, which occurred in 92.5% to 100% of participants, respectively. In addition, 27.5% of participants in the 100 μg group experienced euphoria, while 15% of the 200 μg group experienced it.

• Physical side effects — Nausea was frequent, affecting 40% to 60% of the 100 μg and 200 μg group, respectively.

Figure 4. Visual changes, nausea, and euphoria were reported at both the 100 μg and 200 μg doses.

• Two participants described feeling severely intoxicated — However, these effects were resolved by the end of the dosing session. Importantly, there was one serious adverse event — a panic attack that occurred 97 days later in a person in the 50 μg group, but investigators determined this was not related to MM120.

• Psilocybin and ketamine — Psilocybin, another psychedelic, has been studied in depression and shows long-lasting benefits after one or two doses. However, trials specifically in anxiety disorders are fewer, and its use is not yet approved. Esketamine, a ketamine derivative, in contrast, is FDA-approved for treatment-resistant depression and offers rapid relief, but the effects often fade within days or weeks, requiring repeated administration.

In this sense, MM120 appears to be unique — one dose led to improvements that lasted three months, something not seen in ketamine trials and only beginning to emerge in psilocybin research.

• SSRIs and benzodiazepines — SSRIs are the current first-line treatment for GAD, but many patients fail to respond adequately, and side effects such as sexual dysfunction or weight gain often result in discontinuation. Benzodiazepines work quickly, but carry the risks of tolerance, dependence, and withdrawal. As noted by the researchers:⁹

“Serotonin reuptake inhibitors are commonly prescribed as first-line treatment, but a lack of efficacy and the adverse effects can contribute to disease burden, treatment nonadherence, and treatment discontinuation. Benzodiazepines have shown acute efficacy in patients with GAD, but their use is limited by adverse effects and risk of misuse or dependence.”

1. Breathe through your nose — Inhaling through your nose helps filter, warm, and moisten the air before it reaches your lungs. This process supports better oxygen absorption and keeps carbon dioxide levels balanced, which may support soothing your nervous system. When you feel uneasy, try slowing down and focusing on steady nasal breaths.

2. Practice horizontal breathing — Rather than taking vertical breaths that cause your chest to rise and activate stress responses, shift to horizontal breathing. This technique involves widening your ribcage outward instead of lifting it upward. Breathing this way eases tension and may help keep your nervous system from slipping into a stress-driven state.

3. Breathe more gently, not more often — Quick, forceful breaths can heighten anxiety by pushing your oxygen-carbon dioxide balance out of sync. The goal is to breathe fewer times per minute and with a softer rhythm. This steadiness preserves healthy carbon dioxide levels, which may help quiet your mind and lower stress hormones like cortisol.

4. Make controlled breathing a habit — Regularly practicing mindful breathing techniques may reshape how your brain responds to pressure. Methods such as alternate nostril breathing or the Buteyko approach encourage slower, more intentional breaths. Over time, this may activate your parasympathetic nervous system, creating calmness and improving your resilience against anxiety.