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One issue is that SSRI treatment has to be stopped before starting psychedelic therapy (interactions). This means tapering off until you're not being treated an
by stef25 3y ago
One issue is that SSRI treatment has to be stopped before starting psychedelic therapy (interactions). This means tapering off until you're not being treated anymore, which takes weeks if not months, can be difficult and put the patient in a less than ideal state of mind, possibly even worse than when they started off.
And this is a very bad state of mind to be in when starting psychedelics. I wonder how people usually deal with that.
- icepat 3y agoWhile nobody should do this, the interaction risk between an SSRI and a classical psychedelic is low. The primary concerns are serotonin syndrome, which requires a dose far outside the level that a responsible practitioner would administer. That said, this does mean that if an error is made, the consequence is far more severe (ie: miligrams as opposed to micrograms in dosing LSD). I have heard second-hand reports of users who tapered their SSRI treatment, and on first exposure to psychedelics, had a severe negative response (to the point of re-traumatisation). So you're correct, this is exceptionally difficult to do correctly.
- stef25 3y agoYeah, which is why maybe these treatments are ok for people with relatively "mild" symptoms / disorders (like the guy in the article with "lingering ptsd"), people who aren't being aggressively treated with SSRIs. That's the sad thing about those pills I guess, it's that you stay on them or you get better.
- icepat 3y agoIn my experience with SSRI drugs, they mask the issue by blunting the emotional response itself. Much like removing a broken leg under aesthetic, rather than setting it and casting it.
- travisjungroth 3y agoAyahuasca is a classical psychedelic and the interaction risk with SSRIs is extremely high.
- icepat 3y agoAyahuasca contains monoamine oxidase inhibitors compounds too, those are the cause of the interaction. Dimethyltryptamine itself does not carry the same interaction risk. It's a mix of monoamine oxidase inhibitors and dimethyltryptamine to prevent the stomach acid decomposing active drug.
- travisjungroth 3y agoI’m just clarifying because you said it was low risk and there’s at least one case of it being high risk.
- icepat 3y agoI'm meaning the drugs themselves, rather than drug mixtures. But this is correct, and a unique case given that it is a drug mixture. You have the same problem if you ate St. Johns Wort.
- lukas099 3y agoMaybe psychedelics will end up being indicated as a first line of defense, before SSRIs are prescribed.
- efields 3y agoMy own success with battling depression had so much to do with controlling the adhd that we've talked about tapering off the SSRI's. I wouldn't be surprised if they become dramatically less prescribed over time. Mindfulness, communication, learning how to rest and better time management techniques have more than likely done more for my mental health than the SSRIs. I'd love to taper off with them one day but we'll see. Which pharmaceutical is going to back this clinical trial though??
- stef25 3y ago> Mindfulness, communication, learning how to rest and better time management techniques Doubtful that these things will cure depression though
- efields 3y agoWhat does cure mean? You just stop feeling sad? What does that mean? What happens when you're sad again after your depression is cured? What may have lead to depression? What may prevent it from coming back? What if certain things about your brain are gonna just be like that for life and you're the only one who has the burden of dealing with it? How will you? What if what you're striving for in life is realistically _unattainable_ and something about your brain thinks it is so you try really hard to fight reality and get depressed? You have to unlearn bad habits your brain picked up over time that it merely thought were good survival skills at the moment. SSRI or psychedelics alone will not fully help a person. They can be a step in the right direction. The body keeps the score.
- InSteady 3y agoNot sure if this is where GP got them, but these are techniques straight out of Dialectical Behavioral Therapy, one of the most broadly successful evidence-based clinical therapy frameworks. Don't undersell the value of learning how to rest. It is more complex and has far more healing power than the understated phrasing implies. A lot of important processes in the body only take place when the parasympathetic nervous system is active (including proper digestion, which is where all of our neurotransmitters come from either directly or by way of precursor molecules). This is likely a big part of why chronic stress is so strongly correlated with poor health.