New research suggests that the use of certain antidepressants, particularly SSRIs and SNRIs, may attenuate the acute subjective effects of psilocybin in some people. The survey results appearing in Journal of Psychopharmacologyshowing that this inhibitory effect on psilocybin may persist for a considerable period of time even after antidepressant discontinuation.
Psilocybin is a naturally occurring psychedelic compound found in certain types of “magic” mushrooms. Previous studies have shown that psilocybin-supported therapy can provide rapid and potent antidepressant effects. However, it is unclear how psilocybin interacts with antidepressants and other psychotropic medications commonly prescribed to patients with depression and other mental health conditions.
“There are mixed data on the effects of antidepressant use on psychedelic effects,” said study author Natalie Gukasyan.@N_Gukasyan), Assistant Professor and Medical Director of the Center for Psychedelic and Consciousness Research at Johns Hopkins University.
“In short, some of the existing data suggest that antidepressants may attenuate the effects of psychedelics, and that this blunting effect may persist even after the drug is completely out of the body. This could affect many people taking antidepressants, and if psilocybin is approved to treat major depressive disorder and other conditions, it will eventually may be asked for.”
“Currently, the standard for many clinical trials with psilocybin and other psychedelics is to taper off antidepressants prior to dosing,” Gukasyan explained. “This can be difficult for some patients, especially those with severe disease. Patients may avoid the delay and discomfort associated with tapering off.”
“On the other hand, psychedelic supportive therapy is a resource and time intensive intervention. We need as much information as possible to know how, which could mean using higher doses of psychedelics for these patients or waiting longer after stopping the medication. I have.”
The researchers conducted a large retrospective research study to investigate these interactions. This study collected anonymous responses from individuals who used psilocybin while taking antidepressants or within two years after stopping antidepressant treatment. The survey was conducted online, and participants were recruited through psychedelic and mental health-related forums, social media platforms, and online communities. The final sample he included 2,625 participants.
Participants were asked to provide information about their experience with psilocybin while taking antidepressants, including type of antidepressant, duration of antidepressant use, dosage form and dose of psilocybin, and effects experienced. rice field. The researchers also collected data on participants’ reports of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin levels.
Research results suggest that concomitant use of antidepressants, especially SSRIs and SNRIs, with psilocybin (the active compound in magic mushrooms) may attenuate the effects of psilocybin in some people. However, this effect was only observed in about half of the participants.
“About half of people taking SSRIs or SNRIs reported that when they took psilocybin with their antidepressants, the drug worked less than expected,” Gukasyan told PsyPost. “Based on anecdotal reports, we expected this number to be higher.”
The researchers also found that after cessation of SSRIs or SNRIs, the likelihood of psilocybin’s effects diminishing over time, although this reduction may still be significant up to 1-3 months after cessation. also found. This finding was not strongly influenced by fluoxetine, a long half-life SSRI. This suggests that the reduced efficacy of psilocybin is likely due to long-term brain changes rather than the immediate effects of antidepressants.
“Commonly used antidepressants (SSRIs, SNRIs, etc.) may reduce the effects of psychedelic drugs, and this effect may persist for 1-3 months after antidepressant discontinuation. Yes,” Gukasyan explained to PsyPost. “Antidepressants whose mechanism does not involve serotonin, such as bupropion (wellbutrin), are less pronounced.”
“The duration of these effects suggests that this change is mediated by something other than serum drug levels. It may take months or more to return to higher levels after stopping the medication.”
In clinical trials, participants taking serotonergic antidepressants are not usually given psilocybin because of concerns about reduced efficacy and possible adverse interactions such as serotonin syndrome. However, this study found no clear evidence that high doses or long-term use of antidepressants lead to a significant reduction in psilocybin efficacy.
“We also expected that people taking long-term antidepressants were more likely to be less effective with psilocybin, but the opposite was true. We found that people who reported taking antidepressants were less likely than those who were taking antidepressants, and only for short periods of time,” Gukasyan said. “This may be related to sampling issues (i.e., not enough respondents had information about psychedelic use immediately after drug discontinuation).”
Adverse events resulting from the combination of psilocybin and antidepressants were rare in this study.
However, future studies with larger samples and controlled doses are needed to confirm the results. Surveys of individuals who attended legal psilocybin retreats and who took psilocybin during or after antidepressant discontinuation may provide valuable additional data.
“These data were collected retrospectively, meaning that people were asked to recall psychedelic experiences that may have occurred years ago, thus biasing their recollections of the effects of the drug. There could be,” Gukasyan pointed out. “Another big caveat is that lower-than-expected drug efficacy does not necessarily mean lower therapeutic value. Recent cases reported in American Journal of Psychiatry In this study, one patient was given psilocybin while taking high doses of trazodone, and although there was no significant acute drug effect, there was still significant improvement in subsequent depression. ”
the study, “Attenuation of effect of psilocybin mushroom during and after SSRI/SNRI antidepressant useThe authors are Natalie Gukasyan, Roland R. Griffiths, David B. Yeaden, Dennis G. Antoine II, and Sandeep M. Nayak.
