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Welcome to Tricycle Day. We're the psychedelics newsletter that finally achieved emptiness. (Gastric emptiness. Anyone got snacks?) 🪷  

When you ingest psilocybin, it passes through your stomach before it reaches your brain.

Your tummy, God bless it, doesn’t care about your intention. It thinks mushrooms are food. Which means a humbling amount of your spiritual journey comes down to a fleshy bag of enzymes. 

But lately a lot of y’all’s enzymes are working differently, thanks to GLP-1s like Ozempic and Mounjaro.

So for today’s newsletter, we asked our network of licensed psilocybin facilitators: What should someone on a GLP-1 drug know before working with psilocybin?

Here’s what they had to say.

Humans have been using psychedelics for millennia.

While the Horizons conference hasn’t been around that long, it is one of the longest-running in the field.

On October 15-17, Horizons returns to New York Academy of Medicine for its 19th edition, with a roster of heavy-hitter speakers at the center of psychedelic science, medicine, policy, and culture.

We’re especially excited for day one. The Psychedelic Healthcare Forum, co-presented with Psychedelic Alpha, is a full day of briefings and dialogues for entrepreneurs, execs, and investors.

We’ll be there. Come find us.

First, it helps to understand how GLP-1s work at all. Anna Desmarais explains that “they can significantly delay the onset of psilocybin because GLP-1s slow down the process of gastric emptying. In other words, it takes longer for the psilocybin to digest and convert to the active compound, psilocin.”

Sure, you can plan around a slower onset. The other interactions… not so much. Kate Schroeder describes how the side effects might overlap: “GI symptoms—including nausea, fullness, constipation and sometimes vomiting—are common with GLP-1 medications, while nausea and vomiting can also occur with psilocybin.” 

Whatever you do, just don’t let your slo-mo gut get the best of you. Masha Steiner-Renoir spells it out: “A delayed onset doesn't mean the psilocybin isn't working, so don't rush to take more.” A GLP-1 can also “prolong the experience,” she warns, so give yourself extra runway on both ends.

So, one approach is to take a break from the GLP-1 altogether. Benjamin Dancer has had success with a full taper: “My clients have had no problem tapering off the GLP-1 prior to the journey, then going back on after. This taper method ensures there is no interaction with the psilocybin.”

Anna thinks that may be overkill: “Most of my clients will hold a minimum of one weekly injection before a session, but usually 2-3 just to be safe. It's not necessary to have a complete washout of the drug.” 

Given the lack of consensus, it’s probably not wise to make this choice alone. Kate offers a grounded take: “I wouldn't recommend independently stopping or changing a prescribed GLP-1 simply to prepare for psilocybin. That decision belongs with the prescribing clinician.” Indeed, your facilitator is not your endocrinologist.

Keep in mind, these (pharmacological) things are rarely black and white. As Monica Ramunda points out, “the exact effect varies by person, medication, dose, and how long they've been taking it.” Not to mention any other medications you may be on.

Kate illustrates the point: “Someone who has just increased their GLP-1 dose and is struggling with nausea is in a very different situation from someone who has been stable on the same medication for months.”

Now you can see why screening is so important. Terry Turner describes what happens in the state-regulated programs: “If a person is taking Ozempic, this item would probably be flagged and be cause for a medical consultation with one's personal physician or a consulting MD.” Outside these programs, it’s up to you to raise the flag yourself.

Since the facilitators have handily covered the warnings and precautions, let’s take the other side.

Could these medicines ever complement each other?

For instance, say you’re microdosing Ozempic to quiet “food noise.” Well, here’s something that might surprise you. Many people find that psychedelics help them make healthier choices, too. We wrote a whole article on why that is.

The area of overlap between GLP-1s and psychedelics where we have the most questions, though, is addiction.

Semaglutide is currently in alcohol use disorder trials. Psilocybin has been in those for years. (It's also helped smokers quit.)

So what happens if you're doubling down to tackle the root cause? If the GLP-1's working, you might go searching in your mushroom journey for an urge that’s no longer noisy. Nobody's studied that interaction yet.

Dang, what a strange time to be a craving.

Thanks to Sidney Y. from Marysville, WA for submitting this week’s question. 🫠

Reply to this email to shoot your shot. If it’s a juicy one, we may select it for a future issue.

That’s all for today, Cyclists! Whenever you’re ready, here’s how we can help.

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DISCLAIMER: This newsletter is for educational and informational purposes only and is not intended as a substitute for professional medical advice. The use, possession, and distribution of psychedelic drugs are illegal in most countries and may result in criminal prosecution.