SSRI and psychedelics: Difference between revisions

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'''Pre-2023 it was a commonly held belief by healthcare practitioners that there was a theoretical interaction between [[psychedelics]] and SSRIs that may cause [[serotonin]] syndrome, a potentially fatal reaction.''' However, the serotonin theory of action of antidepressants<ref>'''“No convincing evidence”'''. BMJ 2022; 378 doi: <nowiki>https://doi.org/10.1136/bmj.o1808</nowiki> (Published 20 July 2022) BMJ 2022;378:o1808</ref> and psychedelics is now under debate and there is now some empirical data to suggest that there is a weak interaction<ref>'''Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use'''. Natalie Gukasyan. Accessed on 14 Jun 2023 via : https://journals.sagepub.com/doi/10.1177/02698811231179910</ref> or even no interaction<ref>'''Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects.''' Clinical Pharmacology & TherapeuticsVolume 111, Issue 4 p. 886-895. Accessed via: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2487</ref><ref>'''Psilocybin for treatment resistant depression in patients taking a concomitant SSRI medication.''' Goodwin, G.M., Croal, M., Feifel, D. ''et al. Neuropsychopharmacol.'' (2023). https://www.nature.com/articles/s41386-023-01648-7</ref>.
'''SSRIs (Selective Serotonin Reuptake Inhibitors) and [[psychedelics]] do not have a strong enough interaction that could lead to serotonin syndrome<ref>'''Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects.''' Clinical Pharmacology & TherapeuticsVolume 111, Issue 4 p. 886-895. Accessed via: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2487</ref><ref>'''Psilocybin for treatment resistant depression in patients taking a concomitant SSRI medication.''' Goodwin, G.M., Croal, M., Feifel, D. ''et al. Neuropsychopharmacol.'' (2023). https://www.nature.com/articles/s41386-023-01648-7</ref>, a serious and potentially life-threatening condition.''' However, research has indicated that there is a mild interaction between psychedelics and antidepressants, such as SSRIs, which may reduce the effectiveness of the psychedelics<ref>'''Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use'''. Natalie Gukasyan. Accessed on 14 Jun 2023 via : https://journals.sagepub.com/doi/10.1177/02698811231179910</ref>.


=== SSRIs vs Psychedelics ===
=== SSRIs vs Psychedelics ===

Revision as of 05:58, 17 October 2023

SSRIs (Selective Serotonin Reuptake Inhibitors) and psychedelics do not have a strong enough interaction that could lead to serotonin syndrome[1][2], a serious and potentially life-threatening condition. However, research has indicated that there is a mild interaction between psychedelics and antidepressants, such as SSRIs, which may reduce the effectiveness of the psychedelics[3].

SSRIs vs Psychedelics

Much of the scientific data compares the efficacy of psychedelics versus the most popular antidepressant therapy, most of the time this is an SSRI such as citalopram. One of the most recent studies[4] has show a direct comparison of effects of both of the medicines:

Effect SSRI (Escitalopram) Psilocybin
Neuroticism −0.38 −0.63
Introversion - −0.38
Disagreeableness −0.26 −0.47
Impulsivity −0.35 −0.40
Absorption - 0.32
Conscientiousness - 0.30
Openness 0.28 0.23

Psilocybin was associated with a decrease in neuroticism (B = −0.47) and disagreeableness (B = −0.41) remaining decreased at month 6. Whereas is escitalopram with neuroticism (B = −0.46) remaining decreased at month 6.


References

  1. Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects. Clinical Pharmacology & TherapeuticsVolume 111, Issue 4 p. 886-895. Accessed via: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.2487
  2. Psilocybin for treatment resistant depression in patients taking a concomitant SSRI medication. Goodwin, G.M., Croal, M., Feifel, D. et al. Neuropsychopharmacol. (2023). https://www.nature.com/articles/s41386-023-01648-7
  3. Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use. Natalie Gukasyan. Accessed on 14 Jun 2023 via : https://journals.sagepub.com/doi/10.1177/02698811231179910
  4. Personality Change in a Trial of Psilocybin Therapy vs Escitalopram Treatment for Depression – CORRIGENDUM. Weiss, B., Ginige, I., Shannon, L., Giribaldi, B., Murphy-Beiner, A., Murphy, R., . . . Erritzoe, D. (2023). Psychological Medicine, 1-1. doi:10.1017/S0033291723002039

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