Safety
Safety screening checklist
Things to tell any provider before a session. Bring this list to your intake.
This checklist is not complete and is not medical advice. Talk to your doctor or prescriber before any psychedelic session, especially if you take medication.
Medications to raise before any session
- Lithium. Oregon's required intake form asks whether you've taken lithium in the last 30 days, and the state says clients may be found ineligible if so. An analysis of 62 self-selected online reports involving lithium and classic psychedelics found that 47% mentioned seizures. This is not an estimate of seizure risk among all people who combine them. Discuss the risk with a qualified prescriber; never stop or change medication on your own.
- MAO inhibitors, tramadol and haloperidol are named as concerns in screening tools published by Oregon's Psilocybin Advisory Board.
- Antidepressants (SSRIs and others) combined with ayahuasca. Ayahuasca contains MAO-inhibiting compounds, and researchers have warned that combining it with SSRIs may cause serotonin syndrome.
- Any other prescription, over-the-counter medication or supplement. Bring the full list, including doses.
Health conditions to mention
- Heart conditions, irregular heartbeat or high blood pressure. These are listed as concerns in Oregon's screening tools for psilocybin.
- For ibogaine in particular: any heart condition. Reviews link ibogaine to dangerous heart rhythm problems (long QT) and sudden deaths, so an ECG and medical monitoring are essential.
- A personal history of psychosis. Oregon says clients diagnosed with active psychosis at any time may be found ineligible.
- Thoughts of harming yourself or others, now or in the past.
- Seizures or epilepsy, diabetes, kidney disease, pregnancy, and any mushroom allergy.
A good provider will
- Ask about all of the above in writing before your session.
- Tell you plainly if they think it isn't safe for you, and suggest you speak with your doctor.
- Never ask you to stop a prescribed medication on your own. Any change should be planned with the prescriber.
Sources
- Client Information Form - Oregon Health Authority
- Oregon Psilocybin Services, Access Psilocybin Services - Oregon Health Authority
- OPAB psilocybin recipient screening tools - Oregon Psilocybin Advisory Board
- Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures (Nayak et al., 2021) - Pharmacopsychiatry
- Ayahuasca preparations and serotonin reuptake inhibitors (Callaway & Grob, 1998) - Journal of Psychoactive Drugs
- The anti-addiction drug ibogaine and the heart: a delicate relation (Koenig & Hilber, 2015) - Molecules