The old advice on combining psilocybin with antidepressants
Generally, the combination of psychedelics such as psilocybin, MDMA and LSD with psychoactive medication discouraged. In a number of cases the combination can be bad for health and in other cases it is out of caution. While completing the intake via our site you came across this message:
Please note! Fill in the form below if you do not have any of the following contraindications.
– Pregnancy
– Schizophrenia
– Borderline
- Psychosis susceptibility (or history of psychosis)
– Severe blood pressure/heart conditions
– Cerebral haemorrhages
Furthermore, the medications below cannot be combined with psychedelics:
– SSRI, SNRIs, TCAs and MAO inhibitors (serotonergic medication)
– Lithium
– Benzodiazepines (Valium, Oxazepam, Xanax, etc.)
– Heart and blood pressure medication
– Opioids (tramadol, morphine and codeine)
* Never stop your medication without speaking to your doctor first who prescribes your medication. In some cases you can taper off and then fill out the form two weeks after tapering off and still start your treatment.
According to the schedule below, we previously advised against the combination of SSRIs and psilocybin because it would reduce the effect and make the outcomes unpredictable.
SSRIs and psilocybin
New research now shows that combining SSRIs and psilocybin can be done safely. From the schematic results, you can deduce that there is not that much difference between Placebo with psilocybin and Escitalopram with psilocybin. In general, it can be stated that slightly more effect is achieved when no SSRI is used and that the effects of psilocybin also kick in sooner without an SSRI. Furthermore, there is no difference in the increase of BDNF, the neurotrophin responsible for neuroplasticity. The flattening of emotions caused by the SSRI can also mean that negative and positive feelings are experienced less intensely, which can be both an advantage and a disadvantage.
Read it here full research
So SSRIs no longer need to be tapered off first before a psychedelic session?
So there isn't really any necessity to taper off SSRIs. In the past, we have helped a lot of people after they had tapered off SSRIs. A large number of these people stopped taking the medication after the session, and that seems preferable to us than continuing to use the medication. From now on, you can therefore choose for yourself whether to continue using SSRIs or whether to use the psychedelic session as an opportunity to try and live medication-free. If you want to taper off the medication, ask your treating physician how best to do that in your case. Since June 2022, we therefore also admit people who continue to use SSRIs.
A summary of antidepressants and psilocybin as a combination
Below we outline the current state of affairs (April 2023) regarding the use of psilocybin and antidepressants such as SSRIs, SNRIs, MAOIs and TCAs.
Psilocybin and SSRIs/SNRIs
Recent research therefore shows 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 produce dangerous interactions when used with psilocybin. Nevertheless, these medications have a slight influence on the effects of psilocybin. Under the influence of SSRIs/SNRIs, the effects of psilocybin appear to be slightly diminished and the emotions/feelings become less intense.
Psilocybin and MAOI
Although MAOIs, such as phenelzine (Nardil) and tranylcypromine, are no longer widely prescribed, they can strongly influence psilocybin. Combining these medications with psychedelics such as psilocybin is currently discouraged because MAOIs prevent psychedelics and serotonin from being broken down. Aside from the fact that psilocybin works much more strongly in combination with MAOIs, the risk of serotonin syndrome is increased to such an extent that it is strongly advised against.
Psilocybin and eating disorders
The combination of psilocybin and tricyclic antidepressants (amitriptyline, clomipramine, desipramine, dosulepin, doxepin, imipramine, maprotiline and nortriptyline) is currently not recommended due to a lack of research. The mechanism of action of tricyclic antidepressants is similar to that of an SSRI and we expect that in the future studies will be published showing that the combination is considered possible. For those who do not wish to wait for the research, it is recommended to seek advice from the treating physician. Tapering off or switching to an SSRI may be a possibility.
Undergoing a psilocybin session?
You can sign up for our services via the intake. We will then check whether you can safely have a session and we will provide advice on the dosage. After that, it is possible to reserve a date for your session.