The old advice about combining psilocybin with antidepressants
Generally, the combination of psychedelics such as psilocybin, MDMA and LSD with psychoactive medication is not advised. In some cases, the combination can be bad for your health and in other cases it is out of caution. While completing the intake through our site, we came across this notification:
NB! Complete the form below if you do not have one of the following contraindications.
– Pregnancy
– Schizophrenia
– Borderline
– Psychosis sensitivity (or history of psychosis)
– Severe Blood Pressure/heart complaints
– Brain hemorrhages
Furthermore, the following medications cannot be combined with psychedelics:
- SSRI, SNRI, TCA and MAO inhibitors (serotonergic medications)
– Lithium
– Benzodiazepines (Valium, Oxazepam, XANAX, etc.)
– Heart and blood pressure medications
– Opoids (tramadol, morphine and codeine)
* Never just stop taking your medication, but consult your doctor who prescribes that medication to you. In some cases you can taper off and then complete the form two weeks after tapering off and start your process.
According to the schedule below, we previously advised against the combination of SSRI and psilocybin because it would reduce the effect and the results would become unpredictable.
SSRI and psilocybin
New studies now show that combining SSRI and psilocybin can be done safely. From the schematic results, you can see that there is not that much difference between Placebo with psilocybin and Escitalopram with psilocybin. In general, though, you can say that just more effect is achieved when no SSRI is used and that the effect of psilocybin also starts earlier without an SSRI. Furthermore, there is no difference in the increase of BDNF, the neurotrophin that causes neuroplasiticity. The flattening of emotions by the SSRI may also cause negative and positive feelings to be experienced less strongly, which can be an advantage and disadvantage.
Read it here full investigation
So don't reduce the SSRI first before a psychedelic session?
There is therefore no real need to reduce the SSRI. In the past we have helped a lot of people after they had come off the SSRI. A large number of these people stopped taking the medication after the session and we think that is better than continuing to use the medication. From now on you can choose whether you continue to use SSRIs or whether you use the psychedelic session to try to live a drug-free life. If you want to reduce the medication, ask your treating doctor how you can best reduce this in your case. From June 2022, we will also admit people who continue to use SSRI.
A summary of the antidepressants and psilocybin as a combination
Below we summarize the current state of affairs (April 2023) regarding the use of psilocybin and antidepressants such as SSRI SNRI, MAOI and TCA.
Psilocybin and SSRI/SNRI
The latest studies therefore show that the use of SSRI (citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine (Seroxat) and sertraline (Zoloft)) and SNRI (venlafaxine (Efexor when used with psilocybin. However, these medications do have some influence on the effect of psilocybin. Under the influence of SSRI/SNRI, the effects of psilocybin seem to decrease slightly and the emotions/feelings become less intense.
Psilocybin and MAOi
Although MAOIs, such as phenelzine (Nardil) and tranylcypromine, are no longer widely available, they can strongly influence psilocybin. It is currently not recommended to combine these medications with psychedelics such as psilocybin because MAOi prevent psychedelics and serotonin from being broken down. Apart from the fact that psilocybin has a much stronger effect in combination with MAOi, the risk of serotonin syndrome is increased to such an extent that it is not recommended.
Psilocybin and TCA
The combination of psilocybin and TCAs (amitriptyline, clomipramine, desipramine, dosulepin, doxepin, imipramine, maprotiline and nortriptyline) is currently not recommended due to a lack of research. The effect of TCA is similar to the effect of an SSRI and we expect that studies will be published in the future that the combination is considered possible. For those who do not wish to wait for the examination, it is recommended to seek advice from the treating physician. Tapering or switching to an SSRI may be a possibility.
Have a psilocybin session?
You can register for our services via the intake. We will then check whether you can safely do a session and provide advice on the dosage. It is then possible to reserve a date for your session.