Medication Interactions with Psilocybin

Critical safety information about medication interactions: what to know and when to consult healthcare providers

⚠️ Critical Safety Warning

Psilocybin can interact dangerously with many medications, particularly MAOIs, SSRIs, and other antidepressants. These interactions can be fatal. Always consult healthcare professionals before using psilocybin if you take any medications.

Introduction to Medication Interactions

Psilocybin can interact with many medications, potentially causing serious or fatal reactions. Understanding medication interactions is essential for safety. Some interactions, particularly with MAOIs and certain antidepressants, can be life-threatening.

This comprehensive guide covers medication interactions: MAOIs (extremely dangerous), SSRIs and antidepressants, other medications, why interactions occur, symptoms of dangerous interactions, and when to consult healthcare providers. Understanding these interactions helps prevent serious harm.

Safety must always be the top priority. If you take any medications, consult healthcare professionals before considering psilocybin use. Never assume a medication is safe to combine without thorough research and medical consultation.

MAOIs (Monoamine Oxidase Inhibitors)

Extremely Dangerous

MAOIs with psilocybin can cause:

  • Serotonin syndrome (potentially fatal)
  • Severe reactions
  • Life-threatening complications
  • Never combine

Common MAOIs

MAOIs include:

  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)
  • Isocarboxazid (Marplan)
  • Selegiline
  • Moclobemide
  • Others

SSRIs and Antidepressants

SSRIs

SSRIs (Selective Serotonin Reuptake Inhibitors):

  • Can cause serotonin syndrome
  • Risk of dangerous interactions
  • Generally should be avoided
  • Consult healthcare providers

Other Antidepressants

Other antidepressants:

  • SNRIs
  • Tricyclics
  • Various others
  • Potential interactions
  • Consult healthcare providers

Other Medications

Various Interactions

Other medications may interact:

  • Various psychiatric medications
  • Other medications
  • Research thoroughly
  • Consult healthcare providers

Comprehensive Medication Interaction Database

Critical Risk Categories

Medications are categorized by interaction risk level:

  • EXTREME RISK (❌): Life-threatening, NEVER combine
  • HIGH RISK (⚠️): Serious adverse effects likely, strongly avoid
  • MODERATE RISK (⚡): Potential for adverse effects, exercise extreme caution
  • LOW RISK (ℹ️): Minor interactions possible, monitor closely
  • MINIMAL/NO KNOWN RISK (✓): No significant interactions documented

Antidepressants - Detailed Breakdown

❌ EXTREME RISK: MAOIs (Monoamine Oxidase Inhibitors)

Mechanism of Danger: MAOIs prevent the breakdown of serotonin and other monoamines. When combined with psilocybin (which increases serotonin), this creates dangerously high serotonin levels leading to potentially fatal serotonin syndrome.

Medication (Brand Name) Generic Name Type Washout Period
Nardil Phenelzine Irreversible MAOI 14 days minimum
Parnate Tranylcypromine Irreversible MAOI 14 days minimum
Marplan Isocarboxazid Irreversible MAOI 14 days minimum
Emsam Selegiline (patch) MAOI-B (becomes non-selective at high doses) 14 days minimum
Eldepryl, Zelapar Selegiline (oral) MAOI-B 14 days minimum
Azilect Rasagiline MAOI-B (Parkinson's treatment) 14 days minimum
Manerix, Aurorix Moclobemide Reversible MAOI (RIMA) 24-48 hours (shorter due to reversibility)
Ayahuasca brews Harmine, Harmaline (from B. caapi) Reversible MAOI 24 hours minimum

Symptoms of MAOI-Psilocybin Interaction:

  • Rapid onset of severe symptoms (minutes to hours)
  • Severe headache
  • Extremely high blood pressure (hypertensive crisis)
  • Tachycardia (rapid heart rate 120+ BPM)
  • Profuse sweating
  • Hyperthermia (body temperature above 40°C/104°F)
  • Muscle rigidity
  • Seizures
  • Loss of consciousness
  • CALL 911 IMMEDIATELY IF SUSPECTED

⚠️ HIGH RISK: SSRIs (Selective Serotonin Reuptake Inhibitors)

Mechanism: SSRIs increase serotonin availability in the brain. While less dangerous than MAOIs, combination with psilocybin can still cause serotonin syndrome and may significantly dampen or block psychedelic effects.

Brand Name Generic Name Half-life Recommended Washout Effect on Psychedelics
Prozac Fluoxetine 4-6 days (longest) 4-6 weeks Significantly dampened
Zoloft Sertraline 26 hours 2-3 weeks Moderately dampened
Lexapro, Cipralex Escitalopram 27-32 hours 2-3 weeks Moderately dampened
Celexa Citalopram 35 hours 2-3 weeks Moderately dampened
Paxil Paroxetine 21 hours 2-3 weeks Strongly dampened
Luvox Fluvoxamine 15 hours 2-3 weeks Moderately dampened

Important Notes on SSRIs:

  • DO NOT abruptly stop SSRIs - causes withdrawal symptoms (brain zaps, dizziness, mood changes)
  • Taper slowly under medical supervision (typically 10-25% dose reduction every 2-4 weeks)
  • Washout period = 5 half-lives minimum for drug to clear body
  • Many users report diminished or absent psychedelic effects even after tapering
  • Risk of serotonin syndrome increases if combined while active

⚠️ HIGH RISK: SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

Brand Name Generic Name Half-life Recommended Washout
Effexor Venlafaxine 5 hours 7-14 days
Cymbalta Duloxetine 12 hours 2-3 weeks
Pristiq Desvenlafaxine 11 hours 2 weeks
Fetzima Levomilnacipran 12 hours 2 weeks

⚡ MODERATE RISK: Tricyclic Antidepressants (TCAs)

Mechanism: TCAs affect multiple neurotransmitter systems. Lower serotonin syndrome risk than SSRIs/SNRIs but cardiovascular effects can be concerning.

Brand Name Generic Name Primary Concern Washout Period
Elavil Amitriptyline Cardiovascular effects 1-2 weeks
Tofranil Imipramine Cardiovascular effects 1-2 weeks
Pamelor Nortriptyline Cardiovascular effects 1-2 weeks

⚡ MODERATE RISK: Atypical Antidepressants

Brand Name Generic Name Mechanism Interaction Level
Wellbutrin Bupropion NDRI (dopamine/norepinephrine) Low-moderate risk; doesn't affect serotonin but may lower seizure threshold
Remeron Mirtazapine Alpha-2 antagonist Moderate risk; affects serotonin indirectly
Trazodone Trazodone SARI Moderate-high risk; serotonin activity
Viibryd Vilazodone SSRI + 5-HT1A agonist High risk; similar to SSRIs
Trintellix Vortioxetine Multimodal High risk; serotonin modulation

Psychiatric Medications

⚠️ HIGH RISK: Lithium

Extreme Caution Required:

  • Medication: Lithium (Lithobid, Eskalith) - mood stabilizer for bipolar disorder
  • Risk: Multiple case reports of seizures when combined with psychedelics
  • Mechanism: Lithium lowers seizure threshold; psilocybin may potentiate this
  • Additional concerns: Increased risk of serotonin syndrome, unpredictable effects
  • Recommendation: AVOID combination; consult psychiatrist if considering
  • Half-life: 18-36 hours (but takes weeks to fully clear due to body stores)

⚡ MODERATE RISK: Antipsychotics

Typical (First-Generation) Antipsychotics:

Brand Name Generic Name Effect on Psychedelics
Haldol Haloperidol Blocks effects (used as trip killer)
Thorazine Chlorpromazine Blocks effects

Atypical (Second-Generation) Antipsychotics:

Brand Name Generic Name Effect/Risk
Abilify Aripiprazole May dampen effects
Risperdal Risperidone Blocks most effects
Zyprexa Olanzapine Blocks most effects
Seroquel Quetiapine Blocks most effects

Note: If prescribed antipsychotics, do not use psilocybin without medical supervision - indicates serious mental health condition.

⚡ MODERATE RISK: Benzodiazepines and Anxiolytics

Brand Name Generic Name Effect on Psychedelics Safety Profile
Xanax Alprazolam Dulls intensity, can abort trip Generally safe; used as trip-killer
Ativan Lorazepam Reduces anxiety but dampens experience Generally safe
Valium Diazepam Reduces intensity Generally safe; good trip-killer
Klonopin Clonazepam Significantly dampens experience Generally safe

Note: Benzos are often kept on hand as "trip killers" for difficult experiences. Physical danger is low, but they significantly reduce the therapeutic/experiential quality.

Stimulants and ADHD Medications

⚠️ HIGH RISK: Amphetamines

Brand Name Generic Name Risk
Adderall Amphetamine salts Cardiovascular strain, anxiety amplification, possible serotonin syndrome
Vyvanse Lisdexamfetamine Cardiovascular strain, prolonged stimulation
Dexedrine Dextroamphetamine Similar to Adderall

Recommendation: Skip dose on day of use; avoid combination

ℹ️ LOW-MODERATE RISK: Methylphenidate

Brand Name Generic Name Note
Ritalin, Concerta Methylphenidate Lower interaction risk than amphetamines but still increases cardiovascular load

Cardiovascular Medications

⚡ MODERATE RISK: Blood Pressure Medications

  • Beta Blockers (Propranolol, Atenolol): May reduce anxiety but also dampen emotional experience
  • ACE Inhibitors: Generally compatible but monitor blood pressure
  • Calcium Channel Blockers: Generally compatible
  • Note: Psilocybin can temporarily increase blood pressure and heart rate

Pain Medications

❌ EXTREME RISK: Tramadol

  • Drug: Tramadol (Ultram)
  • Risk: HIGH serotonin syndrome risk - tramadol has SSRI-like properties
  • Recommendation: NEVER combine with psilocybin
  • Washout: 3-4 days

⚡ MODERATE RISK: Opioids

Type Examples Risk
Opioid analgesics Oxycodone, Hydrocodone, Morphine May reduce psychedelic effects; respiratory depression if overdosed

Note: Avoid combining downers (opioids) with psychedelics - difficult to gauge effects.

Other Common Medications

✓ MINIMAL RISK: Generally Safe Combinations

Medication Type Examples Notes
Antibiotics Amoxicillin, Azithromycin Generally safe; avoid linezolid (MAOI properties)
Antihistamines Loratadine, Cetirizine Safe; may cause drowsiness
Proton Pump Inhibitors Omeprazole, Pantoprazole Safe
Thyroid medications Levothyroxine Safe
Birth control Oral contraceptives Safe
Asthma inhalers Albuterol, inhaled corticosteroids Safe

Why Interactions Occur

Mechanisms

Interactions occur because:

  • Serotonin system involvement
  • Shared mechanisms
  • Excess serotonin risk
  • Various mechanisms

Interactive Medication Interaction Checker

🔍 Quick Interaction Checker Tool

Search for your medication to check potential interactions with psilocybin:

⚠️ This tool is for educational purposes only. Always consult a healthcare professional before making any medication decisions.

💊 Advanced Multi-Medication Interaction Analyzer

Check interactions for multiple medications at once and see combined risk assessment:

Hold Ctrl/Cmd to select multiple

📅 Washout Period Calculator

Calculate the recommended waiting period after stopping your medication:

⚠️ Never stop medications abruptly. Always taper under medical supervision.

(function() { const medications = [ // MAOIs - EXTREME RISK { name: "Phenelzine", brand: "Nardil", risk: "extreme", category: "MAOI", washout: "14+ days", notes: "Life-threatening. Never combine. Causes fatal serotonin syndrome." }, { name: "Tranylcypromine", brand: "Parnate", risk: "extreme", category: "MAOI", washout: "14+ days", notes: "Life-threatening. Never combine. Causes fatal serotonin syndrome." }, { name: "Isocarboxazid", brand: "Marplan", risk: "extreme", category: "MAOI", washout: "14+ days", notes: "Life-threatening. Never combine." }, { name: "Selegiline", brand: "Emsam/Eldepryl", risk: "extreme", category: "MAOI", washout: "14+ days", notes: "MAOI-B, but dangerous at higher doses." }, { name: "Rasagiline", brand: "Azilect", risk: "extreme", category: "MAOI", washout: "14+ days", notes: "Parkinson's medication with MAOI properties." }, { name: "Moclobemide", brand: "Manerix/Aurorix", risk: "extreme", category: "MAOI (reversible)", washout: "24-48 hours", notes: "Reversible MAOI, but still dangerous." }, // SSRIs - HIGH RISK { name: "Fluoxetine", brand: "Prozac", risk: "high", category: "SSRI", washout: "4-6 weeks", notes: "Long half-life. Dampens psychedelic effects. Serotonin syndrome risk." }, { name: "Sertraline", brand: "Zoloft", risk: "high", category: "SSRI", washout: "2-3 weeks", notes: "Dampens effects. Serotonin syndrome risk. Do not stop abruptly." }, { name: "Escitalopram", brand: "Lexapro/Cipralex", risk: "high", category: "SSRI", washout: "2-3 weeks", notes: "Dampens effects. Risk of serotonin syndrome." }, { name: "Citalopram", brand: "Celexa", risk: "high", category: "SSRI", washout: "2-3 weeks", notes: "Dampens effects. Risk of serotonin syndrome." }, { name: "Paroxetine", brand: "Paxil", risk: "high", category: "SSRI", washout: "2-3 weeks", notes: "Strongly dampens effects. Difficult withdrawal." }, { name: "Fluvoxamine", brand: "Luvox", risk: "high", category: "SSRI", washout: "2-3 weeks", notes: "Dampens effects. Risk of serotonin syndrome." }, // SNRIs - HIGH RISK { name: "Venlafaxine", brand: "Effexor", risk: "high", category: "SNRI", washout: "7-14 days", notes: "Short half-life but difficult withdrawal. Serotonin syndrome risk." }, { name: "Duloxetine", brand: "Cymbalta", risk: "high", category: "SNRI", washout: "2-3 weeks", notes: "Affects serotonin and norepinephrine. Do not stop abruptly." }, { name: "Desvenlafaxine", brand: "Pristiq", risk: "high", category: "SNRI", washout: "2 weeks", notes: "Active metabolite of Effexor. Same concerns." }, { name: "Levomilnacipran", brand: "Fetzima", risk: "high", category: "SNRI", washout: "2 weeks", notes: "SNRI with serotonin activity." }, // Lithium - HIGH RISK { name: "Lithium", brand: "Lithobid/Eskalith", risk: "high", category: "Mood Stabilizer", washout: "Weeks (consult doctor)", notes: "Seizure risk. Multiple case reports of adverse events. Consult psychiatrist." }, // TCAs - MODERATE RISK { name: "Amitriptyline", brand: "Elavil", risk: "moderate", category: "Tricyclic", washout: "1-2 weeks", notes: "Cardiovascular concerns. Affects multiple systems." }, { name: "Imipramine", brand: "Tofranil", risk: "moderate", category: "Tricyclic", washout: "1-2 weeks", notes: "Cardiovascular effects. Consult doctor." }, { name: "Nortriptyline", brand: "Pamelor", risk: "moderate", category: "Tricyclic", washout: "1-2 weeks", notes: "Cardiovascular effects." }, { name: "Doxepin", brand: "Sinequan", risk: "moderate", category: "Tricyclic", washout: "1-2 weeks", notes: "Also used for insomnia." }, // Atypical Antidepressants - VARIED RISK { name: "Bupropion", brand: "Wellbutrin", risk: "low-moderate", category: "NDRI", washout: "3-5 days", notes: "Does not affect serotonin directly. May lower seizure threshold." }, { name: "Mirtazapine", brand: "Remeron", risk: "moderate", category: "NaSSA", washout: "2-3 weeks", notes: "Affects serotonin indirectly. Monitor closely." }, { name: "Trazodone", brand: "Desyrel", risk: "moderate-high", category: "SARI", washout: "1-2 weeks", notes: "Serotonin activity. Often used for sleep." }, { name: "Vilazodone", brand: "Viibryd", risk: "high", category: "SSRI+", washout: "2-3 weeks", notes: "SSRI plus 5-HT1A agonist. Treat as SSRI." }, { name: "Vortioxetine", brand: "Trintellix", risk: "high", category: "Multimodal", washout: "2-3 weeks", notes: "Multimodal serotonin modulator." }, // Stimulants - HIGH RISK { name: "Amphetamine", brand: "Adderall", risk: "high", category: "Stimulant", washout: "Skip dose day of", notes: "Cardiovascular strain. Anxiety amplification. Avoid combination." }, { name: "Lisdexamfetamine", brand: "Vyvanse", risk: "high", category: "Stimulant", washout: "Skip dose day of", notes: "Prolonged stimulation. Cardiovascular risk." }, { name: "Dextroamphetamine", brand: "Dexedrine", risk: "high", category: "Stimulant", washout: "Skip dose day of", notes: "Same concerns as Adderall." }, { name: "Methylphenidate", brand: "Ritalin/Concerta", risk: "low-moderate", category: "Stimulant", washout: "Skip dose day of", notes: "Lower risk than amphetamines but cardiovascular load." }, // Antipsychotics - MODERATE RISK { name: "Haloperidol", brand: "Haldol", risk: "moderate", category: "Antipsychotic", washout: "N/A", notes: "Blocks psychedelic effects. Used as trip-killer." }, { name: "Chlorpromazine", brand: "Thorazine", risk: "moderate", category: "Antipsychotic", washout: "N/A", notes: "Blocks psychedelic effects." }, { name: "Aripiprazole", brand: "Abilify", risk: "moderate", category: "Antipsychotic", washout: "2-3 weeks", notes: "Dampens effects. If prescribed, consult psychiatrist." }, { name: "Risperidone", brand: "Risperdal", risk: "moderate", category: "Antipsychotic", washout: "N/A", notes: "Blocks most effects." }, { name: "Olanzapine", brand: "Zyprexa", risk: "moderate", category: "Antipsychotic", washout: "N/A", notes: "Blocks most effects." }, { name: "Quetiapine", brand: "Seroquel", risk: "moderate", category: "Antipsychotic", washout: "N/A", notes: "Blocks most effects. Often used as trip-killer." }, // Benzodiazepines - LOW-MODERATE RISK { name: "Alprazolam", brand: "Xanax", risk: "low", category: "Benzodiazepine", washout: "Optional", notes: "Generally safe. Dulls experience. Used as trip-killer for difficult trips." }, { name: "Lorazepam", brand: "Ativan", risk: "low", category: "Benzodiazepine", washout: "Optional", notes: "Generally safe. Reduces anxiety and intensity." }, { name: "Diazepam", brand: "Valium", risk: "low", category: "Benzodiazepine", washout: "Optional", notes: "Generally safe. Good trip-killer option." }, { name: "Clonazepam", brand: "Klonopin", risk: "low", category: "Benzodiazepine", washout: "Optional", notes: "Dampens experience significantly." }, // Pain Medications { name: "Tramadol", brand: "Ultram", risk: "extreme", category: "Opioid/SNRI", washout: "3-4 days", notes: "HIGH serotonin syndrome risk. Has SSRI properties. Never combine." }, { name: "Oxycodone", brand: "OxyContin/Percocet", risk: "moderate", category: "Opioid", washout: "Skip dose", notes: "May reduce effects. Avoid mixing downers with psychedelics." }, { name: "Hydrocodone", brand: "Vicodin", risk: "moderate", category: "Opioid", washout: "Skip dose", notes: "Respiratory depression risk if overdosed." }, { name: "Morphine", brand: "MS Contin", risk: "moderate", category: "Opioid", washout: "Consult doctor", notes: "Avoid combination. Difficult to gauge effects." }, { name: "Codeine", brand: "Various", risk: "low-moderate", category: "Opioid", washout: "Skip dose", notes: "Milder opioid but still avoid combination." }, // Minimal Risk { name: "Amoxicillin", brand: "Amoxil", risk: "minimal", category: "Antibiotic", washout: "None needed", notes: "Generally safe combination." }, { name: "Azithromycin", brand: "Zithromax/Z-Pack", risk: "minimal", category: "Antibiotic", washout: "None needed", notes: "Generally safe." }, { name: "Linezolid", brand: "Zyvox", risk: "extreme", category: "Antibiotic (MAOI)", washout: "14 days", notes: "EXCEPTION: This antibiotic has MAOI properties. Never combine." }, { name: "Loratadine", brand: "Claritin", risk: "minimal", category: "Antihistamine", washout: "None needed", notes: "Safe. Non-drowsy." }, { name: "Cetirizine", brand: "Zyrtec", risk: "minimal", category: "Antihistamine", washout: "None needed", notes: "Safe. May cause some drowsiness." }, { name: "Diphenhydramine", brand: "Benadryl", risk: "low", category: "Antihistamine", washout: "None needed", notes: "Safe but causes drowsiness. May have anticholinergic effects." }, { name: "Omeprazole", brand: "Prilosec", risk: "minimal", category: "PPI", washout: "None needed", notes: "Safe for acid reflux." }, { name: "Pantoprazole", brand: "Protonix", risk: "minimal", category: "PPI", washout: "None needed", notes: "Safe." }, { name: "Levothyroxine", brand: "Synthroid", risk: "minimal", category: "Thyroid", washout: "None needed", notes: "Safe for thyroid replacement." }, { name: "Metformin", brand: "Glucophage", risk: "minimal", category: "Diabetes", washout: "None needed", notes: "Safe for diabetes management." }, { name: "Ibuprofen", brand: "Advil/Motrin", risk: "minimal", category: "NSAID", washout: "None needed", notes: "Safe. May help with physical discomfort." }, { name: "Acetaminophen", brand: "Tylenol", risk: "minimal", category: "Analgesic", washout: "None needed", notes: "Safe." }, { name: "Aspirin", brand: "Bayer", risk: "minimal", category: "NSAID", washout: "None needed", notes: "Safe in normal doses." }, ]; const searchInput = document.getElementById('medicationSearch'); const resultsDiv = document.getElementById('searchResults'); if (searchInput && resultsDiv) { searchInput.addEventListener('input', function() { const query = this.value.toLowerCase().trim(); if (query.length < 2) { resultsDiv.innerHTML = '

Type at least 2 characters to search...

'; return; } const matches = medications.filter(med => med.name.toLowerCase().includes(query) || med.brand.toLowerCase().includes(query) || med.category.toLowerCase().includes(query) ).slice(0, 8); if (matches.length === 0) { resultsDiv.innerHTML = '

⚠️ Medication not found in database. This does NOT mean it is safe. Always consult a healthcare professional.

'; return; } let html = ''; matches.forEach(med => { let riskColor, riskLabel, riskBg; switch(med.risk) { case 'extreme': riskColor = '#dc2626'; riskLabel = '❌ EXTREME RISK'; riskBg = '#fee2e2'; break; case 'high': riskColor = '#ea580c'; riskLabel = '⚠️ HIGH RISK'; riskBg = '#fed7aa'; break; case 'moderate': case 'moderate-high': riskColor = '#ca8a04'; riskLabel = '⚡ MODERATE RISK'; riskBg = '#fef3c7'; break; case 'low-moderate': riskColor = '#2563eb'; riskLabel = 'ℹ️ LOW-MODERATE'; riskBg = '#dbeafe'; break; case 'low': riskColor = '#2563eb'; riskLabel = 'ℹ️ LOW RISK'; riskBg = '#dbeafe'; break; case 'minimal': riskColor = '#16a34a'; riskLabel = '✓ MINIMAL RISK'; riskBg = '#dcfce7'; break; default: riskColor = '#666'; riskLabel = 'UNKNOWN'; riskBg = '#f5f5f5'; } html += '
'; html += '
'; html += '' + med.name + ''; html += '' + riskLabel + ''; html += '
'; html += '

Brand: ' + med.brand + ' | Category: ' + med.category + '

'; html += '

Washout Period: ' + med.washout + '

'; html += '

' + med.notes + '

'; html += '
'; }); resultsDiv.innerHTML = html; }); } })();

Quick Reference Severity Chart

Complete alphabetical listing of common medications and their psilocybin interaction severity:

Medication Brand Name(s) Risk Level Category Washout Key Concern
Phenelzine Nardil ❌ EXTREME MAOI 14+ days Fatal serotonin syndrome
Tranylcypromine Parnate ❌ EXTREME MAOI 14+ days Fatal serotonin syndrome
Tramadol Ultram ❌ EXTREME Opioid/SNRI 3-4 days SSRI properties cause serotonin syndrome
Linezolid Zyvox ❌ EXTREME Antibiotic (MAOI) 14 days Has MAOI properties
Fluoxetine Prozac ⚠️ HIGH SSRI 4-6 weeks Long half-life, serotonin syndrome
Sertraline Zoloft ⚠️ HIGH SSRI 2-3 weeks Serotonin syndrome risk
Escitalopram Lexapro ⚠️ HIGH SSRI 2-3 weeks Serotonin syndrome risk
Venlafaxine Effexor ⚠️ HIGH SNRI 7-14 days Difficult withdrawal, serotonin risk
Duloxetine Cymbalta ⚠️ HIGH SNRI 2-3 weeks Serotonin/norepinephrine activity
Lithium Lithobid ⚠️ HIGH Mood Stabilizer Weeks Seizure risk documented
Amphetamine salts Adderall ⚠️ HIGH Stimulant Skip dose Cardiovascular strain, anxiety
Amitriptyline Elavil ⚡ MODERATE Tricyclic 1-2 weeks Cardiovascular effects
Mirtazapine Remeron ⚡ MODERATE NaSSA 2-3 weeks Indirect serotonin effects
Quetiapine Seroquel ⚡ MODERATE Antipsychotic N/A Blocks psychedelic effects
Bupropion Wellbutrin ℹ️ LOW-MOD NDRI 3-5 days No serotonin effect, seizure threshold
Methylphenidate Ritalin/Concerta ℹ️ LOW-MOD Stimulant Skip dose Cardiovascular load
Alprazolam Xanax ℹ️ LOW Benzodiazepine Optional Safe, used as trip-killer
Diazepam Valium ℹ️ LOW Benzodiazepine Optional Safe, good trip-killer
Omeprazole Prilosec ✓ MINIMAL PPI None No interaction
Levothyroxine Synthroid ✓ MINIMAL Thyroid None No interaction
Ibuprofen Advil/Motrin ✓ MINIMAL NSAID None Safe for discomfort
Acetaminophen Tylenol ✓ MINIMAL Analgesic None Safe

⚠️ Important Disclaimer

This database is for educational purposes only. Drug interactions are complex and individual responses vary. Factors like age, weight, liver function, and other medications can affect interactions. ALWAYS consult a healthcare professional before making any decisions about medications. Never stop prescribed medications without medical supervision.

Serotonin Syndrome

What is Serotonin Syndrome?

Serotonin syndrome is:

  • Potentially fatal condition
  • Caused by excess serotonin
  • Can result from interactions
  • Requires immediate medical attention

Symptoms

Symptoms include:

  • Agitation
  • Confusion
  • Rapid heart rate
  • High blood pressure
  • Fever
  • Seizures
  • Can be fatal

When to Consult Healthcare Providers

Always Consult If:

Consult healthcare providers if:

  • Taking any medications
  • Uncertain about interactions
  • Have medical conditions
  • Need guidance

Best Practices

  • Never combine with MAOIs
  • Avoid SSRIs and antidepressants
  • Research all medications
  • Consult healthcare providers
  • When in doubt, don't use
  • Prioritize safety always

Conclusion

Medication interactions with psilocybin can be extremely dangerous or fatal. MAOIs, SSRIs, and other antidepressants pose serious risks. Understanding these interactions and consulting healthcare professionals is essential for safety.

Always research thoroughly, consult healthcare providers, and prioritize safety. When in doubt about any medication interaction, don't use psilocybin. Safety must always come first, and no experience is worth risking serious harm or death.