The old advice about combining psilocybin with antidepressants
In general, the combination of psychedelics such as psilocybin, MDMA and LSD Not recommended with psychoactive medication. In some cases, the combination can be detrimental to health, and in others, it's a precautionary measure. While completing the intake form on our website, I encountered this message:
Please note! Complete the form below if you do not have any of the following contraindications.
-Pregnancy
– Schizophrenia
– Borderline
– Psychosis sensitivity (or history of psychosis)
– Severe blood pressure/heart problems
– Brain hemorrhages
Furthermore, the following medications cannot be combined with psychedelics:
– SSRI, SNRI, TCA and MAO inhibitors (serotonergic medication)
– Lithium
– Benzodiazepines (Valium, Oxazepam, XANAX, etc.)
– Heart and blood pressure medication
– Opioids (tramadol, morphine and codeine)
* Never stop taking your medication without consulting your doctor. who prescribes the medication for you. In some cases, you can reduce your dosage and then complete the form and start your treatment two weeks after reducing it.
According to the chart below, we previously advised against the combination of SSRIs and psilocybin because it would reduce their effectiveness and make the outcomes unpredictable.
SSRI and psilocybin
New studies now show that combining SSRIs and psilocybin can be done safely. The results shown in the diagram suggest that there isn't much difference between placebo and psilocybin and escitalopram and psilocybin. Generally speaking, a slightly greater effect is achieved without an SSRI, and the onset of psilocybin's effects occurs more quickly without the SSRI. Furthermore, there's no difference in the increase in BDNF, the neurotrophin responsible for neuroplasticity. The blunting of emotions caused by the SSRI can also reduce the intensity of negative and positive feelings, which can be both an advantage and a disadvantage.
Read it here full investigation
So no more tapering off an SSRI before a psychedelic session?
So, there's really no need to taper off your SSRI. In the past, we've helped many people who had tapered off their SSRIs. Many of these people stopped taking their medication after the session, and we think that's better than continuing to use them. From now on, you can choose whether to continue taking your SSRI or use the psychedelic session to try to live medication-free. If you want to taper off your medication, ask your doctor how best to do so in your specific case. Starting in June 2022, we will also admit people who continue using SSRIs.
A list of antidepressants and psilocybin in 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 show that the use of SSRIs (citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine (Seroxat), and sertraline (Zoloft)) and SNRIs (venlafaxine (Efexor XR) and duloxetine (Cymbalta)) does not cause dangerous interactions when used with psilocybin. However, these medications do influence the way psilocybin works to some extent. Under the influence of an 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 common, they can still strongly influence psilocybin. Combining these medications with psychedelics like psilocybin is currently not recommended because MAOIs prevent the breakdown of psychedelics and serotonin. Besides the fact that psilocybin is much more potent when combined with MAOIs, the risk of serotonin syndrome is so increased 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 TCAs is similar to that of an SSRI, and we expect future studies to be published that will consider the combination feasible. Those who do not wish to wait for research are advised to consult their doctor. Tapering off or switching to an SSRI may be an option.
Want to undergo a psilocybin session?
You can register for our services through our intake. We'll then check if you can safely participate in a session and advise you on dosage. Afterward, you can reserve a date for your session.