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Please list all current medications.

Everything was going so smoothly, too, until you hit that section of the intake form. Now you’re questioning your readiness all over again.

Next thing you know, you’re halfway through a 2019 Reddit thread from u/ShroomDad73. Need we remind you upvotes don’t qualify as peer review? Thankfully, we know some people.

For today’s newsletter, we asked our network of licensed psilocybin facilitators: Can I do psilocybin therapy while taking antidepressants, or do I need to come off my meds first?

Here's how they handle this situation.

Look, you don't need an excuse to go to Aspen.

But if you did, a two-day psychedelic symposium would be a pretty good one.

The Aspen Psychedelic Symposium returns June 6-7 with panels on ibogaine for Parkinson's, Indigenous medicine protection, Medicaid coverage for psychedelic therapy, and much more.

If you’ve been cycling with us for a while, you’ll recognize plenty of the speakers. Consider this your chance to meet belly-to-belly with some of our most influential Psychonaut POV guests.

Oh, and those mountain views aren’t half bad, either.

If you’re on antidepressants, there’s a good chance your psilocybin experience won’t hit as hard. Erin Witter explains: “SSRIs and SNRIs can significantly blunt psilocybin's effects due to 5-HT2A receptor downregulation. Many people on these medications report a muted or absent experience.”

But there are workarounds. Clayton Ickes lays it out: “You can stay on your antidepressants, but they have a chance of reducing the efficacy of psilocybin. If [discontinuing your medication] is not possible, we can use a higher dose of psilocybin to counteract any potential blunting.”

Blunting effects vary from person to person, so Char McKendrick adds a mid-session option: “Facilitators may plan for this in dosing, sometimes with the option of a booster dose if appropriate.”  But adjusting the psilocybin is the easy part. Adjusting your antidepressants is where it gets complicated.

The reason most people want to come off their medication is that they think a stronger experience means a better one. Kate Schroeder says otherwise: “Preparation, screening, and support matter far more than chasing a particular intensity of experience.” A subtle acute experience can still be transformative.

In fact, a calmer nervous system going in may be advantageous. Benjamin Hawes adds something most people don't expect: “Some studies suggest that certain antidepressants may positively affect therapy due to the reduced anxiety during the journey.” Michelle Harrell sees it in practice: “Many clients complete psilocybin sessions while still on antidepressants and experience meaningful results.”

At the end of the day, safety is the priority. Michelle Ertl is unambiguous: “SSRIs should never be stopped suddenly. If you have difficulties tapering, it is better to resume your medication than risk being in an unstable place headed into a psilocybin journey.”

None of this gets figured out in a vacuum. It’s not supposed to. Sage Dutra is clear: “Nobody should make changes to their medication without professional guidance.”

That conversation can include both your facilitator and your prescriber. Kate describes what gets discussed: “Together, we consider factors like your current stability, your intentions for the work, and whether your system is resourced enough to tolerate a shift.” It’s a plan built around your history, current status, and intentions.

There is no one right answer here. Michelle E. sees it play out differently with every client: “Some clients who already want to get off SSRIs use this as an opportunity to taper off of their medication. For others, tapering isn't the best approach.” With such a personal decision, it helps to have qualified advisors in your corner.

Be warned. Some self-styled psychedelic gurus will have opinions about your prescription. Strong ones. “Spiritual” ones.

You heard it here first, Cyclists. If anyone demands you come off your medication before working with them, that’s a major red flag.

(Caveat: We’re talking about psilocybin and antidepressants specifically. There are drug interactions between other pharmaceuticals and psychedelics that pose real risk.)

What often gets overlooked is that tapering off antidepressants too quickly is dangerous itself. It can destabilize a nervous system that was functioning fine before anyone rocked the boat.

Besides, stopping your meds a week before your journey doesn’t even have the desired effect. The blunting lasts longer than that.

So, you do you. Just please don’t take advice from someone who puts drugs on a moral hierarchy.

Thanks to Sheri W. from Victoria, BC 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.