Combinations - Contraindications between psilocybin + lexapro, benzo, trazadone

Discussion in 'Magic Mushrooms (Psilocybe & Amanita)' started by Christopher M Stepien, Apr 19, 2018.

  1. Christopher M Stepien

    Christopher M Stepien Newbie

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    Hi there,

    Based on the Johns Hopkins study involving psilocybin and existential anxiety around cancer, I'm researching for my father.

    Pop takes:
    I haven't found any good resources for contraindications with psilocybin and would like to know if anyone can give me their thoughts on what combinations of these medications?

    I appreciate your time.

    Chris
     
  2. Shampoo

    Shampoo entity of sorts Staff Member

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    Hi Chris,

    from a pharmacological perspective there are a few things to consider here -

    The Amlodipine and Valsartan are both blood pressure medications. While there is no direct interaction between these and psilocybin, psilocybin does case an increase in blood pressure. It is transient and not dangerous, but something to consider in this case.

    Temazepam will likely dull the effects of any psychedelic. Do you know dosage this is?

    Trazadone and Lexapro are the real problems here, not from a danger perspective but from a pharmacological one. Lexapro (Escitalopram) is an SSRI, meaning that it inhibits the uptake of serotonin and therefore there is more serotonin around, binding to the same serotonin receptors where psilocybin will target. This will also reduce the effects of the psilocybin. Many people report little to no response to psilocybin when on SSRI medications. Trazadone is also a SSRI but in addition to this it is a serotonin receptor antagonist (binding strongly to and inactivating the 5HT2A serotonin receptor, which is the primary target of psilocybin).

    Aside from the blood pressure issue I do not see this as a risky combination, but it is very unlikely that someone on these medications will see much in the way of effects from any psychedelic drug such as psilocybin.

    To be clear, this is not medical advice and I am not saying that this is 100% safe. This is merely data to help you make an informed decision.
     
  3. Christopher M Stepien

    Christopher M Stepien Newbie

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    Shampoo, thank you so much for your time and energy. The transient increase in BP and lack of response due to the SSRI was what I was thinking too.

    Again, I'm grateful.

    Chris
     
  4. Christopher M Stepien

    Christopher M Stepien Newbie

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    @Shampoo, got two more medications for you that I'm curious about in regards to the interaction with psilocybin.

    Tramadol (50 mg), which is benzenoid and acts as serotonin–norepinephrine reuptake inhibitor. Is this a similar effect as SSRIs?

    Clonezapam (0.5), which is another benzodiazapene like temazepam.

    Will both of these dull the effects?
     
  5. Josh Carlton

    Josh Carlton Titanium Member

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    Clonazepam will certainly dull the effects. As far as I know, most Benzodiazepines will either dull or completely stop the effects of psychedelics, depending on dose. All they really do when people end up in the hospital having a bad psychedelic trip is give people a shot of a benzo - I'd assume Diazepam, but I'm not sure.

    Some people report that Tramadol may decrease the effects of mushrooms. As I understand it, Tramadol is an opioid, but a rather atypical one in that, in addition to being an agonist at primarily the Mu Opioid Receptor, it also functions as an SNRI, and as a 5-HT2C antagonist. There are several things that could occur with Tramadol and mushrooms:
    -There is some debate on this, but some people seem to think that opioids reduce the effects of psychedelics. If they do, their impact on the trip is less significant than with benzos.
    -Tramadol's SNRI action may also lead to a slight reduction in the effects of the mushrooms.
    -Mushrooms act as an agonist at various serotonin receptors - it is thought that agonism at the 5-HT1A, 5-HT2A, 5-HT2C, and 5-HT7 receptors may be responsible for some of the psychedelic effects. Tramadol acts as an antagonist at the 5-HT2C receptor. I'm not sure if this would alter the effects of the mushrooms, or if it did, how significant it would be. But it might reduce some aspects of the mushroom experience.
    -Tramadol lowers the seizure threshold (makes seizures more likely). Psilocybin, while it won't cause seizures on its own, may also reduce the seizure threshold. However, you probably won't have to worry about this because Clonazepam and Temazepam both raise the seizure threshold thanks to their GABAergic activity. In fact, Clonazepam is sometimes used as an epilepsy medication. So this should not be an issue, but I just want to put it out there for completeness.
    -Risk of Serotonin Syndrome is raised. While I'm not sure how likely it is, Serotonin Syndrome is a possibility. I've heard a few reports of Serotonin toxicity occurring from high doses of LSD while on Tramadol. I think the risk is less with mushrooms, but I think it is possible. I'm not sure if or how taking SSRIs as well would change this. Benzos are used to treat some symptoms of Serotonin Syndrome, but don't solve the problem that causes those symptoms. So the risk of this is low, and if it did occur, it probably wouldn't be bad. But it is a consideration.


    Given the arsenal of medications your father is on, I think it is likely that the effects of mushrooms will be significantly diminished. Have you considered how you might adjust the dosage for this?
     
    Last edited: Apr 24, 2018
  6. Shampoo

    Shampoo entity of sorts Staff Member

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  7. Christopher M Stepien

    Christopher M Stepien Newbie

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    Thank you @Josh Carlton and @Shampoo .

    I don't think this is worth the risk. I'm working to connect my father with an MD who specializes in benzo detox here in NJ. If he's really motivated to drop this anxiety, he'll take steps. I'll see you.

    TY so much.
     
  8. Christopher M Stepien

    Christopher M Stepien Newbie

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    @Shampoo and @Josh Carlton - I have a friend who is interested in psilocybin.

    He's consumed ayahuasca many times without issue.

    Here is his med list. Any help would be appreciated.

    1. Thyroid

      1. Levothyroxine
    2. Weightloss

      1. Victoza - needs are novofine

      2. Phentermine

      3. Contrave

      4. Garcinia cambogia
    3. Nerve pain

      1. Gabapentin
    4. Constipation

      1. Diurex ultra

      2. colrite