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SSRI and psychedelics: Difference between revisions

SSRI and psychedelics: Difference between revisions

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'''SSRIs (Selective Serotonin Reuptake Inhibitors) and [[psychedelics]] can be safely administered together<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>.''' In fact, there is a US patent which was granted for medical professionals to initiate patients on SSRIs and psilocybin for depression<ref>'''United States Patent and Trademark Office, Patent no.11801256 B2.''' Accessed on 2 November 2023 via:https://image-ppubs.uspto.gov/dirsearch-public/print/downloadPdf/11801256</ref>. However, given this, there is some research that has indicated that there is a mild interaction between psychedelics and SSRIs. Some studies have indicated a slight impairment of psilocybin’s antidepressant effects<ref>'''Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression''', Journal of Psychopharmacology, David Erritzoe, Tommaso Barba, Meg J Spriggs, Fernando E Rosas, David J Nutt and Robin Carhart-Harris. Accessed on 26 March 2024 via: https://journals.sagepub.com/doi/pdf/10.1177/02698811241237870</ref>, potentially by reducing the subjective effects of the psychedelics<ref>'''Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use'''. Natalie Gukasyan, Roland R. Griffiths, David B. Yaden, Denis G. Antoine, Sandeep M. Nayak. School of Medicine. Journal of Psychopharmacology. Published - Jul 2023 accessed 5 Dec via:https://pure.johnshopkins.edu/en/publications/attenuation-of-psilocybin-mushroom-effects-during-and-after-ssris</ref><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>. The long term antidepressant effects remain the same however, patients who take an SSRI have significantly less intense subjective experience in the domains of mystical-type experiences, challenging experiences and emotional breakthroughs during a psychedelic experience<ref>'''Interactions between classic psychedelics and serotonergic antidepressants''': Effects on the acute psychedelic subjective experience, well-being and depressive symptoms from a prospective survey study. Published: January 27, 202. Jessica Barbut Siva, Tommaso Barba, David Erritzoe <nowiki>https://doi.org/10.1177/0269881123122421</nowiki></ref>.
'''Antidepressant medications have typically required a washout period prior to dosing with both drugs due to concerns about serotonin syndrome; however, this is unlikely to be a risk of psilocybin though it may be for MDMA<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>.''' In fact, there is a US patent which was granted for medical professionals to initiate patients on SSRIs and psilocybin for depression<ref>'''United States Patent and Trademark Office, Patent no.11801256 B2.''' Accessed on 2 November 2023 via:https://image-ppubs.uspto.gov/dirsearch-public/print/downloadPdf/11801256</ref>. However, given this, there is some research that has indicated that there is a mild interaction between psychedelics and SSRIs. Some studies have indicated a slight impairment of psilocybin’s antidepressant effects<ref>'''Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression''', Journal of Psychopharmacology, David Erritzoe, Tommaso Barba, Meg J Spriggs, Fernando E Rosas, David J Nutt and Robin Carhart-Harris. Accessed on 26 March 2024 via: https://journals.sagepub.com/doi/pdf/10.1177/02698811241237870</ref>, potentially by reducing the subjective effects of the psychedelics<ref>'''Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use'''. Natalie Gukasyan, Roland R. Griffiths, David B. Yaden, Denis G. Antoine, Sandeep M. Nayak. School of Medicine. Journal of Psychopharmacology. Published - Jul 2023 accessed 5 Dec via:https://pure.johnshopkins.edu/en/publications/attenuation-of-psilocybin-mushroom-effects-during-and-after-ssris</ref><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>. The long term antidepressant effects remain the same however, patients who take an SSRI have significantly less intense subjective experience in the domains of mystical-type experiences, challenging experiences and emotional breakthroughs during a psychedelic experience<ref>'''Interactions between classic psychedelics and serotonergic antidepressants''': Effects on the acute psychedelic subjective experience, well-being and depressive symptoms from a prospective survey study. Published: January 27, 202. Jessica Barbut Siva, Tommaso Barba, David Erritzoe <nowiki>https://doi.org/10.1177/0269881123122421</nowiki></ref>.


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

Revision as of 00:44, 3 May 2024

Antidepressant medications have typically required a washout period prior to dosing with both drugs due to concerns about serotonin syndrome; however, this is unlikely to be a risk of psilocybin though it may be for MDMA[1]. In fact, there is a US patent which was granted for medical professionals to initiate patients on SSRIs and psilocybin for depression[2]. However, given this, there is some research that has indicated that there is a mild interaction between psychedelics and SSRIs. Some studies have indicated a slight impairment of psilocybin’s antidepressant effects[3], potentially by reducing the subjective effects of the psychedelics[4][5]. The long term antidepressant effects remain the same however, patients who take an SSRI have significantly less intense subjective experience in the domains of mystical-type experiences, challenging experiences and emotional breakthroughs during a psychedelic experience[6].

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[7] 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. ↑ 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
  2. ↑ United States Patent and Trademark Office, Patent no.11801256 B2. Accessed on 2 November 2023 via:https://image-ppubs.uspto.gov/dirsearch-public/print/downloadPdf/11801256
  3. ↑ Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression, Journal of Psychopharmacology, David Erritzoe, Tommaso Barba, Meg J Spriggs, Fernando E Rosas, David J Nutt and Robin Carhart-Harris. Accessed on 26 March 2024 via: https://journals.sagepub.com/doi/pdf/10.1177/02698811241237870
  4. ↑ Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use. Natalie Gukasyan, Roland R. Griffiths, David B. Yaden, Denis G. Antoine, Sandeep M. Nayak. School of Medicine. Journal of Psychopharmacology. Published - Jul 2023 accessed 5 Dec via:https://pure.johnshopkins.edu/en/publications/attenuation-of-psilocybin-mushroom-effects-during-and-after-ssris
  5. ↑ 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
  6. ↑ Interactions between classic psychedelics and serotonergic antidepressants: Effects on the acute psychedelic subjective experience, well-being and depressive symptoms from a prospective survey study. Published: January 27, 202. Jessica Barbut Siva, Tommaso Barba, David Erritzoe https://doi.org/10.1177/0269881123122421
  7. ↑ 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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