The psychedelic compound in magic mushrooms, psilocybin, has recently been ‘fast-tracked’ by the United States FDA for approval in treating depressive disorders. More specifically, the therapy has been indicated for both Treatment-Resistant Depression (TRD) and Major Depression (MDD).
This has prompted interest in the chemical from those who currently suffer from all forms of depression; front-line therapies for the disorders currently employ antidepressant pharmaceuticals, along with behavioral therapies. Unfortunately, antidepressants blunt and diminish the effects of psilocybin—understandably, you may be wondering how to safely combine the two.
Antidepressants and magic mushrooms
Most antidepressants significantly diminish the psilocybin experience, from microdosing to macrodosing. Not only is this a bummer in general, but it can also be dangerous when individuals try to increase their dose of psilocybin to overcompensate for the effect. For others that are desperate for real transformation, the outcome of a disappointing trip can be equally as detrimental to the psyche.
The boogeyman of drug prohibition has also created the specter of Serotonin Syndrome—a legitimate and dangerous event to be sure, but incredibly rare among users of ‘classical psychedelics’. These include magic mushrooms and LSD, compounds that operate directly on your serotonin system. The syndrome and its associated complications are much more common among users of MAOIs, which are inherent in the mixture of plants that comprise ayahuasca.
While the prospect of a blunted trip isn’t dangerous in and of itself, the possibility is nonetheless a barrier to those who may most benefit from psilocybin therapy. For those that are stable and determined to make the most of their psychedelic experiences, tapering off of antidepressants is an approach that’s frequently considered.
Tapering antidepressants for psychedelic therapy
Antidepressants are prescribed for a reason, and tapering your dose will come with inevitable outcomes. Before making any changes to your medication regimen, a thoughtful reflection on whether it’s truly a good time to undertake such a process is necessary. Crisis, major life changes, and instability should be general indicators that now is not a good time for drastic measures.
Ideally, you’ll have your prescriber on-board and notified. Along with brain zaps and general discomfort, tapering can also increase suicidal ideation—discounting the potential benefit of psilocybin, safety is always of paramount importance. Reduction of dosing as not a strict science: a fast taper limits your unmedicated timeframe, but may introduce strong and unwanted side-effects.
Tapering off of antidepressants slowly is often recommended, minimizing side-effects and allowing for time to reflect on the changes in mindset that accompany the process. This isn’t a one-way process—if you feel, at any time, that your mental stability is at risk, reassume your regular dose and delay your psychedelic experience.
After fully tapering to baseline over weeks or months, it is best to allow for a further 2-4 weeks to fully eliminate the compound from your system. At this point, you’ll be ready to experience the full, mystical and transformative experience that you seek. Afterwards, medication should be resumed, but the dosage can be discussed with your prescriber to account for any changes in mindset.