SSRI and psychedelics

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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. In fact, there is a US patent which was granted for medical professionals to initiate patients on SSRIs and psilocybin for depression[3]. However, given this there is some research that has indicated that there is a mild interaction between psychedelics and antidepressants, such as SSRIs, which may reduce the effectiveness of the psychedelics[4].

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[5] 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. 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
  4. 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
  5. 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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