Psilocybin Interactions

A

  • Amitriptyline - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Alcohol (non-intoxicating levels) - the subjective effects of alcohol are opposed by psilocybin; the subjective effects of psilocybin vary but by majority are unchanged

B

  • Bupropion - loss of effect not predicted to occur

  • Buspirone - pretreatment reduced visionary restructuralization/visual perceptual changes; consider tapering and discontinuing at least 5 days prior

C

  • Chlorpheniramine - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Chlorpromazine - pretreatment decreased pupil dilation and visual perceptual distortion

  • Citalopram - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Clomipramine - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

D

  • Desipramine - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Desvenlafaxine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Duloxetine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

E

  • Escitalopram - potential loss of psychedelic effect; however, pretreatment with 10 mg/day for 7 days, followed by 20 mg/day for 7 days, and a single 20 mg dose 2 h before psilocybin reduced negative acute effects without reducing positive mood and mind-altering effects; reduced bad drug effects such as fear, talkativeness, openness, anxiety, ineffability, and global adverse effects; reduced elevations in blood pressure and pupillary dilation; consider tapering and discontinuing at least 2 weeks prior

  • Ergotamine - did not significantly alter subjective experiences

F

  • Fluoxetine - potential loss of psychedelic effect; consider tapering and discontinuing at least 6 weeks prior

  • Fluvoxamine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

H

  • Haloperidol - reduced oceanic boundlessness, derealization, and depersonalization phenomena; increased anxiety; increased “dread of ego dissolution”

I

  • Imipramine - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Isocarboxazid - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

K

  • Ketanserin - pretreatment blocked psilocybin effects on delayed response task and Altered State of Consciousness Rating scale; pretreatment blocked subjective effects of psilocybin

L

  • Levomilnacipran - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

M

  • Mirtazapine - loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Moclobemide - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

N

  • Nortriptyline - potential intensified psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

P

  • Paroxetine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Phenelzine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

R

  • Risperidone - pretreatment weakened effects in a dose-dependent manner; reduced all parameters of the Altered States of Consciousness scale; reduced the extent of delayed reaction time

S

  • Selegiline - potential intensified psychedelic effect; potential low risk of physical toxicity; consider tapering and discontinuing at least 2 weeks prior

  • Sertraline - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

T

  • Trazodone - loss of psychedelic effect; consider tapering and discontinuing at least 5 days prior

  • Tranylcypromine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

V

  • Venlafaxine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Vilazodone - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

  • Vortioxetine - potential loss of psychedelic effect; consider tapering and discontinuing at least 2 weeks prior

LSD

DMT