The risks of taking psychedelics are not as high as once thought, but that definitely doesn't mean they are risk-free. There are some elements that significantly increase the risk of physical or psychological harm, and I will address the main elements here.
Drug interactions
Interactions are the term we use for medications that don't go well together for various reasons. Since the list of medications that exist in the world is almost endless, it's important to do your own research. These are the main categories that are known to have interactions:
- SSRI/SNRI (antidepressants): Can be fatal when combined with ayahuasca. Markedly attenuates the effects of psilocybin, LSD, and MDMA for most people. Read more details about interactions with antidepressants here .
- MAO inhibitors, monoamine oxidase inhibitors (antidepressants): Can be fatal in combination with MDMA and ayahuasca. No known interaction with LSD/psilocybin, but caution should be exercised here. Read more details about interactions with antidepressants here (MAO inhibitors on page 2) .
- Benzodiazepines (anxiety-reducing): Significantly reduce the effects of psychedelics and are often called "trip killers", but are not dangerous. Read more details about interactions with benzos here .
Mental disorders
Although psychedelics have shown preliminary results for treating a range of mental disorders, some groups are excluded from the studies. Classic psychedelics (such as LSD, psilocybin, ayahuasca/DMT) carry a risk of temporary worsening of symptoms, especially in disorders at the more out-of-touch end of the spectrum (schizophrenia, psychosis, bipolar disorder, borderline). Psychedelics were first called psychomimetics and appear to work by temporarily expanding one's perception of reality. If part of the challenge one already has is stabilizing thought patterns and a shared perception of reality, one can see why this could have negative consequences for this group.
In addition, it is not recommended to use psychedelics (both classic and MDMA) if you are suicidal.
Activities
Some activities significantly increase the risk of mental and physical harm. Driving a car or boat is of course very dangerous, both under the influence of MDMA and psychedelics. In a moment you may feel capable of driving, but a few minutes later the experience can change completely. Candles and open flames can be dangerous in combination with psychedelics, as your ability to assess risk may be reduced. Activities that increase body temperature (dancing in a hot room, sauna, hot tub, etc.) can be particularly harmful in combination with MDMA, as your body temperature increases and your ability to regulate it is reduced under the influence.
Please contact us if you have questions about the risks of psychedelics and MDMA.