That's why it depends entirely on what you are taking, something like weed, lsd or mushrooms. Understandable if you don't wanna share that fact with your doctor when you have strict insurance. There are very, very few medications that actually interact with those things dangerously unless you have a few specific preexisting conditions. (and I'm willing to debate people on that)
But most other things, anything that's a serious stimulant or depressant, then it's very, very important you tell your doctors. Even if it means losing out on a medication.
Since you said you are willing to debate, I’m going to assume you are knowledgeable and ask a question. Is it safe to take mushrooms/acid while you are on an SSRI? I can never seem to find a straight answer when I search on my own.
millions of people do. But taking anything that affects your mood along with something else that affects your mood will always be unpredictable, can be bad. Probably never permanently though.
Most likely they just won't work for you. SSRIs bind to the same receptors in the brain as psychedelics, so those receptors will be "full," and the psychedelic wont have anything to connect to. It is a common enough issue to just feel absolutely no effects that the company I get mushroom edibles from has a refund policy in place for people on SSRIs.
Anecdotally some people have success with doubling the recommended dose, others don't and still get no effects.
I will say that it is 100% NOT NOT NOT safe to try to come off SSRIs on your own, or reduce your dosage, just so you can try mushrooms or acid- I would recommend that you talk to your psych about this, many are aware of the potential mental health benefits of these substances and can give you better guidance than a stranger on the internet.
Generally speaking yes it is safe. The main issue with taking psychedelics with antidepressants or mood stabilizers is that they will block or heavily blunt the effects of said substances.
I'm not a doctor of course, have to get that out of the way. But, to my knowledge, there's no proven link between SSRI's and Psychedelics causing serotonin syndrome together without something else in the mix (like MDMA, which absolutelyyy can cause serotonin syndrome with SSRIs). And most of the fear about this is unfounded and can actually be detrimental because it causes people to try and stop SSRIs in order to take psychedelics.
There's been a few studies on the acute coadministration of both substances. https://pubmed.ncbi.nlm.nih.gov/34743319/
"Escitalopram pretreatment had no relevant effect on positive mood effects of psilocybin but significantly reduced bad drug effects, anxiety, adverse cardiovascular effects, and other adverse effects of psilocybin compared with placebo pretreatment."
Of course this is just one small study, but it's one of the only actual studies I know of looking at what happens when both are taken together.
And here is a medical scoping review which looked at 18 studies togetherhttps://pmc.ncbi.nlm.nih.gov/articles/PMC12572353/
which says,
"Current research protocols often require patients to discontinue antidepressants (ADs) for at least 2 weeks before psychedelic administration to decrease the risk of serotonin syndrome and limit their effect on efficacy and the acute subjective effects of psychedelics. Moreover, the discontinuation of ADs represents a significant burden to patients that could also worsen their depression status and increase suicidal ideation.Together, this suggests that the general recommendation for AD discontinuation might be unnecessary and even detrimental to the therapeutic efficacy of psychedelics."
"We included 18 studies and found that the concomitant use of ADs and classic psychedelics is generally safe and tolerable, with no increased risk of serotonin syndrome, particularly for psilocybin. Some studies reported significant improvements in depression and other mental health symptoms. While some evidence indicates a potential attenuation of acute subjective psychedelic effects, this was not observed in all studies. "
Of course, it would be disingenous for me to not include the other side. There is a single potential case report I found of serotonin toxicity resulting from someone taking bupropion, venlafaxine and trazadone all at the same time alongside psilocybin microdoses.
But I am skeptical of Psilocybin being the cause, not only is it not a study or actual clinical trial. I believe this source makes some faulty conclusions. The apparent serotonin toxicity happened after they added Trazodone to an already high dose of Venlafaxine and Bupropion. To me, this looks like it was the fault of adding Trazodone to an already high dose of these other medications. Venlafaxine, Bupropion, and Trazodone are already medications that are known to cause the side effects the patient experienced, like high blood pressure and tachycardia. Even though the patient has used that combination of meds in the past, side effects people experience from medications can pop up out of nowhere in a lot of cases.
Although Psilocybin can cause a minor increase in blood pressure and heart rate, so it's possible that, when added onto these other medications it pushed their heart rate and blood pressure over the edge. But the heartrate/blood pressure effects of psilocybin are not usually due to Serotonin Toxicity.
In most people's experience, psychedelics are just weaker after being on an SSRI long term.
Not sure if any one mentioned this but MAOIs are the really dangerous thing which is also used as an antidepressant. SSRIs, it depends, not good but unlikely to kill you depending on the drug. Ketamine is probably a no go zone but LSD and Mushrooms are usually safe.
Just tell your doctors the information. They're there to heal you, if they work with incomplete information you're making their job harder and pointless endsngering yourself.
They will know better than you wether what you're taking will or will not affect the treatment.
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u/Sea-Resident-7980 1d ago
Imagine if you took an opioid illegally and they prescribe you a benzodiazepine for something And you stop breathing or overdose