Building a community database: psilocybin + medications interactions
523 replies · Harm Reduction
The medical literature on psilocybin drug interactions is thin. Clinical trials exclude most polypharmacy. So we have to compile what we know from experience. Let's share what we actually know, with the caveat that n=1 experiences are not medical evidence.
Lamotrigine (Lamictal): Multiple reports suggest it blunts or eliminates psilocybin effects. Mechanism seems to be lamotrigine's sodium channel stabilization reducing cortical excitability. No reports of danger — just reduced efficacy.
Lithium: This is the real danger interaction. Several published case reports of seizures and cardiac events in people combining lithium with psychedelics. If you are on lithium, do not combine with psilocybin. This is one of the very few absolute contraindications.
SSRIs: Most people report significantly reduced psilocybin effects while on SSRIs. Safe in terms of serotonin syndrome risk (the chemistry doesn't support that concern with psilocybin). Just less effective. Many taper their SSRI before a session — please do this with medical support.
520 more replies — forum posting coming soon.