{"id":12701,"date":"2023-11-16T18:36:53","date_gmt":"2023-11-16T17:36:53","guid":{"rendered":"https:\/\/evolute-institute.com\/?p=12701"},"modified":"2025-07-31T13:12:20","modified_gmt":"2025-07-31T11:12:20","slug":"psilosybiini-ja-sen-mahdolliset-vuorovaikutukset-masennuslaakkeiden-ja-muiden-psyykenlaakkeiden-kanssa-2","status":"publish","type":"post","link":"https:\/\/evolute-institute.com\/fi\/psychedelics\/psilocybin-and-its-potential-interactions-with-antidepressants-and-other-psychiatric-drugs\/","title":{"rendered":"Psykedeelien turvallisuus - Perimm\u00e4inen opas psilosybiinist\u00e4 ja sen mahdollisista yhteisvaikutuksista masennusl\u00e4\u00e4kkeiden ja muiden psykiatristen l\u00e4\u00e4kkeiden kanssa."},"content":{"rendered":"\t\t
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\n\t\t\t\t\t\t\tDmitrij Achelrod PhD\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<\/a>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\tDr. Dmitrij Achelrod (PhD) is passionate about advancing human and planetary well-being. With an extensive background in healthcare and data science, Dmitrij has pioneered AI-powered solutions at high-growth tech startups, served on advisory boards in digital therapeutics companies, and co-founded Evolute Institute to cultivate wisdom in leadership circles.\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\tDmitrij Achelrod PhD\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t<\/a>\n\t\t\t\t\n\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\tDr. Dmitrij Achelrod (PhD) is passionate about advancing human and planetary well-being. With an extensive background in healthcare and data science, Dmitrij has pioneered AI-powered solutions at high-growth tech startups, served on advisory boards in digital therapeutics companies, and co-founded Evolute Institute to cultivate wisdom in leadership circles.\t\t\t\t\t<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Psilocybin and its natural source, over 200 species of psilocybin mushrooms and truffles, have gained the limelight not only of those seeking deep introspective experiences but also of the psychiatric community given their fascinating effects on the human psyche and their unprecedented potential for treating a wide range of psychiatric disorders.<\/span>1<\/sup><\/a><\/span> In particular, psilocybin has been investigated and shown to be effective in treating (treatment-resistant) depression, PTSD, anxiety disorders. Psilocybin\u2019s effects are being investigated in many more disorders, such as autism, anorexia nervosa etc. However, as with any substance that alters brain chemistry, it’s crucial to understand how psilocybin interacts with psychiatric medications, such as antidepressants (SSRIs, SNRIs) or antipsychotics. What are potentially dangerous complications by combining psilocybin with antidepressants or other psychiatric drugs? How will it affect the subjective psychedelic experience? This expert article by Dmitrij Achelrod (PhD) delves into the complex interactions between psilocybin and various classes of psychiatric drugs, offering insights for those considering psilocybin in a retreat setting.<\/p>

Please note that the Evolute Institute does not provide medical recommendations. Always consult with a licensed medical professional before taking psychedelics, especially before combining psychedelics with your psychiatric medications. However, in the name of risk prevention and education, to the best of our knowledge (November 2023), we highlight the most common classes of psychiatric medications (and some psychoactive substances) and their potential interactions with psilocybin. Our conclusion of the review of literature must not be applied to other psychedelics, in particular MDMA<\/span>2<\/sup><\/a><\/span><\/a> and ayahuasca<\/span>3<\/sup><\/a><\/span><\/a>, as they have different routes of mechanisms and chemical compositions to psilocybin, with many more potential interactions.<\/p>

1. Psilocybin – how does it work in the brain?<\/b><\/h2>

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Psilocybin (for the more nerdy ones amongst us: 4-phosphoryloxy-N,N-dimethyltryptamine) is a psychoactive tryptamine that gets converted in the body to psilocin, which then can pass the blood-brain barrier. The pathway of action is psilocin activating a subtype of certain serotonin receptors in our brain. Serotonin\u2019s chemical name is 5-hydroxtryptamine (5-HT) and the specific intracellular receptors that psilocin binds to are called 5-HT2A receptors.<\/span>4<\/sup><\/a><\/span><\/a> Serotonin is a very important neurotransmitter that is responsible not only for regulating mood, but also other vital function such as bowel movement and the dilatation and constriction of our blood vessels. The activation of these receptors leads to a cascade of changes in brain chemistry and ultimately in excitatory brain activity.<\/span>6<\/sup><\/a><\/span><\/a> The greater the percentage of 5HT2A receptors in the brain activated by psilocybin, the stronger the (subjectively perceived) effect of the psychedelic.<\/span>7<\/sup><\/a><\/span><\/a><\/p>

1.1 How does psilocybin travel through the body?\u00a0<\/b><\/h3>

When evaluating the potential of a substance to interact with other drugs, it is important to look at how the body absorbs, distributes, breaks down, and excretes the drug (known as pharmacokinetics). Compared to other psychoactive compounds, like MDMA or ayahuasca, psilocybin is less likely to lead to pharmacokinetic drug-drug interactions because its metabolic pathway mainly involves UGT1A10 (in the small intestine) and UGT1A9 (in the blood circulation)<\/span>8<\/sup><\/a><\/span><\/a> – two pathways that few other drugs act upon.<\/span>9<\/sup><\/a><\/span><\/a> Still, medications that can inhibit or induce these enzymes should be discontinued or tapered prior to administration of psilocybin. Some examples of UGT1A10\/1A9 inhibitors are diclofenac (a non-steroidal anti-inflammatory drug) and probenecid (a uric acid reducer).<\/span>10<\/sup><\/a><\/span><\/a> In addition, psilocybin is not excreted by the kidneys, making it less dangerous for people with renal impairment.<\/span>11<\/sup><\/a><\/span><\/a><\/p>

Taken in isolation, psilocybin is a very safe substance in terms of toxicity for the liver, central nervous system, or the heart.<\/span>12<\/sup><\/a><\/span>,<\/span>13<\/sup><\/a><\/span><\/a> In fact, even compared to socially accepted substances like alcohol and tobacco, psilocybin is one of the safest psychoactive substances we know of that people take in non-medical settings.<\/span>14<\/sup><\/a><\/span><\/a><\/p>

The only important remaining point then is that psilocybin acts on the serotonin system. The main issue is that several psychiatric drugs also directly influence the serotonin system, so the probability of some sort of drug-drug interaction when taken together with psilocybin can be heightened. In the following sections, we are going to explore specifically what this could mean for specific classes of psychiatric drugs.<\/p>

2. Psilocybin and SSRIs (Selective Serotonin Reuptake Inhibitors)<\/b><\/h2>

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2.1 How do SSRIs work?\u00a0<\/b><\/h3>

SSRIs, or Selective Serotonin Reuptake Inhibitors, are a class of drugs primarily used as antidepressants in the treatment of major depressive disorder and anxiety disorders. They are some of the most commonly prescribed antidepressants due to their relative safety and lower side effect profile compared to older antidepressants.<\/span>15<\/sup><\/a><\/span><\/a>You might have come across the following names, dependent if you live in the USA or in Europe:<\/p>