SSRI abstinence before taking a psychedelic?

[Praxis.]

My sister has been wanting to try psychedelics with me, specifically mushrooms, for a very long time. She has been taking 20mg of Citalopram daily for about a year, which is an SSRI. A few weeks ago she insisted on trying some LSD and ended up eating half a hit of some strong blotter. As expected, she didn't feel anything other than placebo effects and she went to bed after about 3-4 hours.

Anyways, she really wants to try mushrooms and I would like to share that experience with her--but considering that she takes SSRIs I'm not sure how to approach this. I know I could try to give her an extra large dose in the hopes she'll experience some effects, but that seems potentially dangerous to me and conversely could be a waste of a lot of mushrooms.

I was wondering how long people generally have to abstain from taking an SSRI before dosing a psychedelic? She's been on it for a year and I understand the risks of abruptly stopping medication, but if she could ween herself off of it over the course of a week or two I think she would be willing to do that.

As a note, I've made it very clear to her that SSRI's and psychedelics just don't mix and that the withdrawal symptoms could potentially contribute to a very uncomfortable trip--this would be her decision, I'm in no way trying to convince her to stop taking her medication.

I'm also aware of the other thread that's very similar, but I was hoping for some more specific information.

Thanks in advance.

 

[Pandora]

Interesting topic. Obviously, I cannot offer medical advice, but these are my thoughts/opinions:

1.) If she is on the SSRI for severe or potentially dangerous depression, and is not yet feeling a LOT better, maybe should not detox (even partially) at this point.

2.) Most SSRI's take WEEKS to let their effects be known. I'm guessing it takes that long to flush out of the system too.

Hope things work out for her.

 

[drfaust]

no medical advice here either!

How hip is her doctor? Most obvious nos are maois. Another probable no is getting off or stopping the meds. I think, according to the literature, that stopping the meds abruptly is a risk.

Is there is a chance that simply taking mushrooms and nothing else whilst on the ssri is okay? I'd research that question.

You could ask her doctor?

 

[Praxis.]

1.) If she is on the SSRI for severe or potentially dangerous depression, and is not yet feeling a LOT better, maybe should not detox (even partially) at this point.

2.) Most SSRI's take WEEKS to let their effects be known. I'm guessing it takes that long to flush out of the system too.

She takes it for anxiety, which apparently wasn't super serious initially. She originally only took like 10 or 15mg but for whatever reason her dosage was just upped to 20mg. Now when she isn't taking Citalopram she gets very anxious and is prone to panic attacks. In my opinion, it sounds like she had mild anxiety that could have easily been treated another way, but after a year or so of taking SSRIs she's become dependent and her anxiety worsens significantly when she isn't on them.

I had a good friend who had been prescribed various SSRIs for most of his life (he's since been able to get off of them) and psychedelics never worked for him unless he stopped taking his meds for at least a full month, and even then he said the effects were pretty diminished. My sister has only been taking Citalopram for a year, so I wasn't sure if she could get away with abstaining for only a week or two--I know she wouldn't be comfortable being off of them for any longer than that, and this period of time would include the period of gradual weening. Because of this, I'm thinking it seems pretty unlikely that she'll be able to partake.

How hip is her doctor? Most obvious nos are maois. Another probable no is getting off or stopping the meds. I think, according to the literature, that stopping the meds abruptly is a risk.

Is there is a chance that simply taking mushrooms and nothing else whilst on the ssri is okay? I'd research that question.

You could ask her doctor?

Yeah I definitely wouldn't be giving her any MAOIs. She's only really seriously interested in mushrooms. There is a supposed risk of serotonin syndrome when you combine SSRIs with a tryptamine, but AFAIK people who have combined the two haven't reported any serious adverse reactions. If she were to temporarily stop taking her meds, she would do so gradually and not abruptly. My concern is that since SSRIs significantly inhibit psychedelic effects, I don't want to take the risk of giving her a huge dose of mushrooms and I also don't want to waste them when I know full well she won't feel anything--so if she wants to take mushrooms, realistically that means getting off her meds for a period of time until psychedelics will work; and I'm just wondering how long that period of time should be.

 

[drfaust]

I would not necessarily extrapolate from your friend's experience and infer that for everyone SSRIs will diminish the experience of psychedelics. I have not found that to be the case when I took fluoxetine. But YMMV.

A safe path might be a mild dose whilst still on the SSRI?

I don't think I'd go in for tapering unless her doctor recommends it.

 

[Praxis.]

She took ~75-100 mics of LSD about 3 weeks ago while she was on her meds and nothing happened. We were smoking quite a lot of cannabis as well, which significantly potentiates the effects of LSD (for me at least). During the first 45 minutes or so she said she thought she felt a little something, but she also said it felt like she was psyching herself into feeling it. Shortly after that she reported that she didn't feel anything, and was able to fall asleep about 3-4 hours after ingestion.

Perhaps we could do a test run with a small dose of mushrooms and see if her experience is any different. I'd be really surprised though.

 

[DMTripper]

She would need to be off ssri's for two weeks for shrooms to work properly.
And if she's still on ssri's after a year then she should focus her life on the cause of her depression. Ssri's are not going to fix here if they haven't already.
I know smoking cannabis makes me very depressed. Fine while high but not good afterwards. So I tend to smoke all the time until it stops working and I'm just depressed all the time.

Eating ssri's for a long period is no good. I have a friend that has been using ssri's for years and now he's suffering memory loss and the med's don't work anymore and he's trying to get off them and is having a very bad time. Horrible stuff in the long run.

 

[drfaust]

She would need to be off ssri's for two weeks for shrooms to work properly.
And if she's still on ssri's after a year then she should focus her life on the cause of her depression. Ssri's are not going to fix here if they haven't already.
I know smoking cannabis makes me very depressed. Fine while high but not good afterwards. So I tend to smoke all the time until it stops working and I'm just depressed all the time.

Eating ssri's for a long period is no good. I have a friend that has been using ssri's for years and now he's suffering memory loss and the med's don't work anymore and he's trying to get off them and is having a very bad time. Horrible stuff in the long run.

I'm sorry about your friend. But I don't think you can extrapolate from his experience to give advice to others. What evidence do you have that taking ssris for a long period is no good? Do you have studies that show that?

I'm curious in general how people can take any number of alternative forms of either acute or chronic drugs and then, without research or knowledge, declare ssris to be "horrible stuff." They may or may not be effective or helpful to you, but for many they are. In fact, they can be very useful and very helpful for many people.

Also, the amount of time off of any chronic drug before its immediate effects wane depends on its half-life.

 

[null24]

In my opinion, which is based upon my experience with them, SSRIs are psychic poison. I know some people benefit greatly from them, but others shoot people in movie theaters. I know from my experience that there are far more effective depression and anxiety relief tools out there. Some are good food, exercise and the good human companionship. Another benefit of not taking pills for a condition that is neither life threatening nor chronically debilitating, or for one that is, but by consciously using methods akin to the ones i just listed, is that by doing so and not just using another person's opinion and some little pills and instead getting to know myself, I've become far more aware of what stimulates my depression and what i need to both avoid and treat it. I have a mighty big chip on my shoulder for the psychopharmacological industry, i feel they play with and destroy lives for profit while ignoring and denying people the simple information and support that would make their lives not only tolerable, but successful. Hold on a sec while i climb off this soapbox, it's taller than i am.... Ooof! There.

Now, that being said, and not that you would do so just because i didn't say so, but i feel i have to include the disclaimer to not advise her to come right off them. That's part of the deal, they make one reliant upon them and exacerbate the symptoms they are supposed to address. They don't heal, they hinder and addict and I'm pretty sure there is high risk of a rebound type effect. From what i understand, once one has gone through the acclimation period with them, the SSRIs become one's surrogate neurochemistry, and yanking them is yanking one's well being, quite literally. I'm sure the prescribers have a different term for it, but when i was on heroin and couldn't come off without getting sick, i don't know, addiction seemed like a pretty good term for it to me and those same doctors called me a junky. Wait, am i still up here?

Has your sister looked into 5htp? Doesn't do much for me, and both it and St John's wort another natural supplement cause create the same dangerous rage inducing levels of serotonin in my organic endogenous neurochemical plant. How about some of the things i mentioned, i swear to you and to her,that if she jumps on a bike and pedals that sucker for a good five miles or more, and comes home and puts a good source IDF l of body/brain nutrition into herself, she will neither be depressed not anxious. Tell you what, if she still has anxiety, the both of you are invited to cuss me out to relieve it. But you won't, she'd be to full of endorphin and other feel goods. And if she's too out of shape to exercise like that, well, my point is made.

So maybe she should work on slowly titrating of the anti-enlightenment psychedelic nullifier pills, while starting to try out some holistic methods that will connect and tune up her mind body connection, giving her greater self awareness and the ability to recognize exactly how, when and what she feels in her head and get to know her what her REAL medicine is. That way, when she does liberate herself from psychological bondage, those things will be in place. Seriously man, this goes for everyone, and I'm not just talking out of my ass like usual; if these simple things work for me and keep me breathing, as a double suicide attempt survivor, they'll work for anyone.

And then once she's healthy, she can begin taking the ONE medicine.

Peace to you both, i hope things work, and thank you for this post OP and replies everyone. So many of my friends are off the list because of those damn pills and can't take advantage of the extracts I've offered. It's sad.

 

[Alloklais]

I'd like to offer a few thoughts on this based on personal experience, and I hope some of this information will be helpful to those reading this thread:

After months of debilitating and chronic depression, brought on mostly by long-term, severe work stress, I started taking 50 mg of Setraline (Zoloft) in May, 2013. About three weeks later I started feeling "normal", snuck up like a thief in the night. "Hey, I feel... okay. Whoa. This is what okay feels like...nice." No more volatility or feelings of absolute resignation. But became plagued by yawns and a leaden feeling, couldn't shake off being tired all the time, six cups of coffee to get to 3:00 PM.

Under doctor's direction, immediately started tapering dose down to 25 mg/daily. About this time, I started using cannabis again after more than a decade. I also started staying up often to watch the sunrise, even during the week (apparently sleep deprivation is a treatment for depression, according to my doctor, but I did this on my own, intuitively?) The combination worked. The cannabis also triggered my renewed interest in psychedelics from my youth and on-going intellectual and spiritual explorations.

Knowing I wanted to revisit my first psychedelic break-through from nearly thirty years earlier, as it has been the ridgepole for much of my reading, thinking and self-exploration these last thirty years, I knew I had to get off the SSRIs. I started eating more healthy, exercising, and have tapered down to 12.5 mg daily. And I use less cannabis now, and do not stay up as late as often.

That said, I had tapered down to about 7 mg of Setraline daily, (I was skipping days in a set pattern, day on, day off, to reduce the serum levels) but had done so too fast, as all the emotional volatility came back, upending the even keel.

I started up 12.5 mg/daily again, and when I got back to a steady baseline a couple weeks later, along with the healthy diet and regular exercise, I started my first psychedelic tryptamine research with 5-MEO-MiPT , 5-MEO-DiPT, and 4-ACO-DMT. After reagent testing I've always done the test 1 mg dosages to check for allergic reactions, and then have slowly titrated up, following Shulgin's / community consensus dosage descriptions from light up to medium. I'd say I've reacquainted myself fairly well with the psychedelic spaces in a comfortable way.

I cannot detect that my experiences have been any less with the 12.5 mg/daily of Setraline, though I've stayed away from heroic doses. I am both eager and patient to get grounded and SSRI free so I can eventually incorporate MAOIs and have a full Ayahuasca experience. But not until then.

I think its difficult when young because of the impetuous nature of being young.

Praxis, I would encourage your sister to explore the lesson of patience first, and really work at weening off the SSRIs under her doctor's supervision. I think the drive to be healthy and well needs to be stronger than the desire to use psychedelics. I've accepted for myself that should I not be able to get totally off the SSRIs, the risk to incorporate MAOIs far outweighs the benefits. Not totally understanding the mechanisms involved and risk of a fatal or debilitating serotonin syndrome incident, that would be just devastating.

A last thought: I wonder if the pervasive use of SSRIs is a man-made evolutionary adaption to the stresses of modern life? My doctor and I have discussed this at length (he's a pretty cool guy, real involved in integrative medicine, promotes meditation, but definitely a traditional M.D. as well). Agreed, Big Pharma promotes the use of anti-depressants - to the detriment of many, even to the length of their abuse - but this substance certainly for me was a life saver in a gale, having fallen off the boat into some pretty violent swells. Being engaged in the modern world makes demands I don't think my parents' generation had had in the 1950's - though I am aware of tales of Mother's Little Helper. If the need wasn't there, then SSRIs, or other substances of abuse wouldn't be so prevalent. I agree with Johann Hari author of Chasing the Scream, that addiction is result of the context, our collective cages, not the substance itself, nor even our personal psychology and physiology. It's a deeper societal change that shows support, community and love over alienation that reduces addiction, be it opiods, stimulants, or for those who abuse psychedelics for pure escapism/entertainment only or SSRIs.

With much respect

 

[drfaust]

A last thought: I wonder if the pervasive use of SSRIs is a man-made evolutionary adaption to the stresses of modern life? My doctor and I have discussed this at length (he's a pretty cool guy, real involved in integrative medicine, promotes meditation, but definitely a traditional M.D. as well). Agreed, Big Pharma promotes the use of anti-depressants - to the detriment of many, even to the length of their abuse - but this substance certainly for me was a life saver in a gale, having fallen off the boat into some pretty violent swells. Being engaged in the modern world makes demands I don't think my parents' generation had had in the 1950's - though I am aware of tales of Mother's Little Helper. If the need wasn't there, then SSRIs, or other substances of abuse wouldn't be so prevalent. I agree with Johann Hari author of Chasing the Scream, that addiction is result of the context, our collective cages, not the substance itself, nor even our personal psychology and physiology. It's a deeper societal change that shows support, community and love over alienation that reduces addiction, be it opiods, stimulants, or for those who abuse psychedelics for pure escapism/entertainment only or SSRIs.

Thanks so much for that thoughtful and, to me, helpful post. I think SSRIs are very interesting and very helpful. I see them as a, now dated and very common, means of modulating the 5HT axis through the chronic administration of a reuptake-inhibitor. From what I understand, most of the research in that area is now dated and most of these drugs are now generic.

It is interesting to see the parallels with a 5HT agonist such as psilocybin. They both seem to affect the Executive function of the brain. They both probably calm and introduce some flexibility into the Executive or Ego functions of the brain. SSRIs do so through chronic administration and they do have some side effects. However, I think of them as quite benign and possibly helpful for some people.

The 5HT axis is fascinating and between the selective agonists, the reuptake inhibitors, and the reuptake enhancers, an interesting set of effects and/or benefits to these drugs has been shown.

None of these drugs is a panacea, and they do have risks. In my experience, I've found psilocybin interesting and helpful. I've also experimented with fluoxetine for a few months. It felt like a mild mushroom trip, interestingly, and it did introduce more flexibility into my thinking many years ago.

The positive effects persisted after I tapered off of it. I suppose I integrated what it had to "teach me". My GP gave it to me and said "try this as an experiment." He had samples so I never paid for it. He is also, or was, pretty open minded as a doctor.

I don't see a dramatic difference between acute 5HT agonists and chronic reuptake inhibitors, except in acute effect. I'd find it very narrow minded if I idealized the acute agonists (DMT) and completely wrote off reuptake inhibitors, or demonized them as "zombie drugs".

If anything, much research has focused on whether SSRI's are no better than placebo. In my experience they definitely had an effect, and an enhancing one at that.

I also don't want to minimize the mental suffering that many people go through and the difficult reactions that many people have to any of these drugs. We are all of us quite unique and we will have many different reactions. The advantage of an acute drug is its transient effects in that regard.

 

[Alloklais]

A last thought: I wonder if the pervasive use of SSRIs is a man-made evolutionary adaption to the stresses of modern life?

The 5HT axis is fascinating and between the selective agonists, the reuptake inhibitors, and the reuptake enhancers, an interesting set of effects and/or benefits to these drugs has been shown.
..........
I don't see a dramatic difference between acute 5HT agonists and chronic reuptake inhibitors, except in acute effect. I'd find it very narrow minded if I idealized the acute agonists (DMT) and completely wrote off reuptake inhibitors, or demonized them as "zombie drugs".
..........
We are all of us quite unique and we will have many different reactions. The advantage of an acute drug is its transient effects in that regard.

I wonder if I had dosed with LSD and with the right guide I would have saved myself these years of Setraline use? I just listened to a great GnosticMedia.com interview with David Nichols, first time I've heard him at length. From what I remember, disclaimer: I may be conflating this info with something else, that I mis-remembering, like an Art Bell show.... I think Nichols related a story about a seemingly miraculous cure / positive medical outcome / response to a psychedelic trip, which demonstrated some of his ideas about the plasticity of our bodies / brains, and the complex dance of gene's expressing themselves, I think signaled through the different metabolites that are released. This is the level of the psychedelic experience I want to understand more. The science part.

What then to me becomes the next most interesting, that the transient effects of an acute drug - one that is tied into the psychedelic experience - may cause a person to make a serious life change.

Exploring the healing properties of psychedelics, to me that falls onto acute, transitory experience. And if those were means to dependable, positive medical outcomes, then perhaps low dosing SSRIs would not be needed. When I asked my doctor "When do I stop taking these?" "Easy, when you have the guts to." (Don't know if he knew he was being ironic, or if he was really up on the latest psychedelic research related to the floura and fauna in our guts) Even though my doctor says there is no shame in them, I'm adverse to that long term path, and for myself draw a distinction: a permanent state of Dependence on an agent not produced naturally in the body, definitely not preferred. Then we're maybe strolling not so far from THX1138.

It's been more than twenty years but a favorite book was Zen and the Brain, James H. Austin, MD. He narrates his journey and exploration through a very committed and serious Zen practice, and correlating the mind states of the Zen practice to the physiology of the brain, its processes, agents and parts. And what might be happening during a peak experience. As I recall it can get a bit technical, nearly out of reach for me, but overall accessible, with some recurring themes on LSD/psychedelics. I highly recommend it.

Sorry, I did not mean to Hijack the thread, but the Nichols always seems to be an excellent reminder, at least for me, what the foundations are below the materials and sacraments we use.

With much respect.