[Opgelost] Clonazepam, Lamotrigine, Citalopram and psychedelics

You are currently using three psychoactive medications that influence the brain’s neurotransmitter systems in different ways:

1. Citalopram – an SSRI antidepressant that increases serotonin levels by blocking reuptake.
2. Lamotrigine – a mood stabilizer and anti-epileptic that reduces glutamate activity and stabilizes mood, often prescribed for bipolar disorder or seizures.
3. Clonazepam – a benzodiazepine that enhances GABA activity, reducing anxiety and neural excitability.

Each of these medications individually affects how psychedelics like psilocybin or MDMA work — and together, they significantly blunt, delay, or alter the psychedelic experience.

⚠️ Interactions with Psychedelics

1. Citalopram (SSRI):
   Safe to combine with psilocybin in controlled settings, but it dampens the emotional and visual intensity of the trip. It should never be combined with MAOIs or high-dose MDMA because of the risk of serotonin syndrome.

2. Lamotrigine:
   Often reduces the intensity of psychedelics (especially LSD and psilocybin). However, it also reduces the risk of mania or psychosis for those with bipolar tendencies. Many psychiatrists prefer clients to stay on Lamotrigine for stability.

3. Clonazepam:
   Strongly suppresses the effects of psychedelics. It can be used as a “trip stopper” if someone becomes overwhelmed, but if taken regularly, it will likely prevent meaningful psychedelic effects.

Therapeutic Recommendation

Given this combination, a psilocybin or truffle session may still be possible, but the results will likely be muted. The safest approach depends on your goals:

1. If emotional stability is the priority (especially for bipolar or anxiety disorders):
   Continue your current medication and discuss with a medical professional before considering any psychedelic experience. A mild psilocybin session can still provide subtle insight and relaxation, even if not intense.

2. If deep therapeutic transformation is your goal:
   In collaboration with your psychiatrist, you may explore gradual tapering of Clonazepam first (since it has the strongest dampening effect), and possibly Citalopram later. Lamotrigine is usually kept as a safety measure to prevent mood instability.
   Only after full withdrawal (under medical supervision) would a therapeutically guided psilocybin or MDMA session be advisable.

3. Never stop medications abruptly.
   Sudden withdrawal, especially from Clonazepam or Lamotrigine, can cause seizures, mood swings, or severe anxiety. Always coordinate with your prescribing doctor.

Extra caution:

Besides the dampening effect of this medication we should be extra aware of Borderline personality disorders. In case someone uses these medications for BPD a psychedelic session might be not suitable. Do you have Borderline? Ask your doctor for more advice.

In Summary

Recommended approach:

Discuss this with your doctor: Keep Lamotrigine for stability, consider tapering off Clonazepam first, and discuss with your doctor whether maintaining or tapering Citalopram fits your goals. Only then consider a psilocybin-based psychedelic therapy for optimal emotional healing and safety.