Certain prescription medications and recreational drugs can change how microdosed psilocybin feels or behaves in the body. It is advisable to check with a clinician if you take regular medication.
AVOID
- MAOIs (e.g., phenelzine; some ayahuasca admixtures) — potentiation risk
- Lithium — case reports of seizures with full-dose psychedelics, including psilocybin.
- Serotonergic stimulants (MDMA, 2C-x compounds, NBOMes, methylone, and similar agents) — high serotonergic load and destabilisation risk
CAUTION OR AVOID
- Triptans (migraine) — serotonergic load
- Tramadol — serotonergic load + seizure-threshold concerns
- Linezolid — serotonergic load
- St John’s wort — serotonergic + induction effects
CAUTION
- SSRIs / SNRIs / TCAs / mirtazapine — may blunt effects; mild serotonergic risk
- Antipsychotics (quetiapine, risperidone) — likely to reduce/block effects
- Benzodiazepines — dulls effects; complicates interpretation
- Mood stabilisers / anti-epileptics (lamotrigine, valproate, carbamazepine) — may alter effects or mood stability
- Opioids (methadone, buprenorphine, codeine) — may affect mood stability / mask withdrawal signals
- Warfarin / anticoagulants — limited data
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