SSRI and psychedelics
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[1] and psychedelics is now under debate and there is now some empirical data to suggest that there is a weak interaction[2] or even no interaction[3][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
- ↑ “No convincing evidence”. BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1808 (Published 20 July 2022) BMJ 2022;378:o1808
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 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