Can I Microdose If I'm Taking Antidepressants? (UPDATED)

A note to our readers: This article has been updated to reflect the new research findings as they relate to the use of psychedelic microdosing while on SSRIs.

"Can I Microdose If I'm Taking Antidepressants?" The short answer is, probably! But there are variables and nuances to consider.

The question of combining antidepressants and microdosing is a common one. A significant portion of individuals are attracted to the practice because of the reported benefits of microdosing in reducing symptoms of depression. Many are hoping to utilize microdosing to avoid, reduce, or stop taking antidepressant medications.

While an extensive dive into the science of why psychedelics are effective in the treatment of depressive symptoms is beyond the scope of this article, it is important to note that most psychedelic medicines work by binding to serotonin receptors in the brain and triggering a process of neuronal avalanching similar to a domino effect of intense neural network activity in the brain. This mechanism is similar to how many modern antidepressant pharmaceuticals, namely SSRIs, function by binding to these receptors.

There are two key questions to consider:

1) Is it Safe to combine psilocybin with antidepressants?

2) Do antidepressants reduce or block the effects of psilocybin?

Is it Safe To Microdose On Antidepressants?

As recently as 2023, there appeared to be a strong consensus amongst prominent microdosing (us included) experts that combining antidepressants with psilocybin or LSD microdosing carried potential serious risks associated with overstimulation of serotonin receptors. Theoretically, this makes a whole lot of sense.

Overstimulation of the serotonin receptors can be risky, and in extreme cases, serotonin overload can lead to a fatal condition called "serotonin syndrome". Therefore, it is generally not recommended to mix most psychedelic medicines with pharmaceutical antidepressants.

However, recent research appears to challenge this assumption. A small double-blind placebo-controlled study (the highest standard in research) found that combining an SSRI with psilocybin therapy did not result in any symptoms associated with serotonin overstimulation and appeared not to hinder the therapeutic effects of psilocybin.

It is important to highlight that the findings of a single small study using a single antidepressant (Lexapro) should not be heavily relied upon as proof that combining psychedelics and antidepressants is safe or effective. Additional research is needed to understand the implications and make confident recommendations.

With that said, this study and a couple of others since then have opened new possibilities for those seeking psychedelic therapies while on antidepressant medications.

Considering these findings and the fact that the serotonin boost from a true microdose is most likely not sufficient to cause serious risks, most microdosing experts are cautiously green-lighting microdosing for individuals on antidepressants as "potentially safe under supervision". This means that anyone on antidepressants exploring microdosing is strongly recommended to do so with consent from their prescribing psychiatrist and under the supervision of an informed and educated microdosing guide.

Do Antidepressants Reduce Microdosing Effects?

While microdosing on antidepressants is potentially safe, we know very little about their efficacy.

Empirical evidence in my professional practice suggests that the efficacy of microdosing while on antidepressants varies based on a variety of factors:

• Type of Antidepressant

• Length of use & Dosage

• Other factors like health history, substance use, and lifestyle factors

Simply put, there is no one-size-fits-all! It takes time, patience, commitment, and professional support to explore, experiment, and optimize the conditions that can potentially lead to benefits. And... there are no guarantees that it will work!

While some clients notice some benefits from microdosing while on certain classes of antidepressants, most choose to safely taper off (under medical supervision and expert care) before exploring microdosing.

CAUTION! DO NOT stop or reduce the use of any psychiatric medications without medical supervision! There are significant and life-threatening implications. Ask your prescribing doctor about safe ways to taper off.

You can also Apply for a Free Consultation with me to explore personalized support. I have supported dozens of clients in successfully tapering off SSRIs & SNRIs.

For your reference, I have outlined various classes of antidepressants below and potential risk factors to consider when combined with the most commonly microdosed substances of psilocybin and LSD:

Can I microdose on SSRIs?

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for depression among a variety of other mental health conditions. Prozac, Lexapro, and Zoloft belong to this category, amongst others.

Since this class of medications functions by modifying serotonin absorption in the brain, theoretically, the combination with psychedelics can run the risk of serotonin syndrome, although no reported cases were identified in our research. New research is beginning to emerge that challenges this understanding. Until we develop a better understanding of how this class of drugs interacts with psychedelics, it is recommended to avoid the combination or solely engage under professional care.

Can I microdose on SNRIs?

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) are a class of antidepressants that function by boosting both serotonin and norepinephrine levels in the brain. Similar to SSRIs, we do not yet fully understand how they interact with psychedelics. Cymbalta and Effexor XR are two examples of drugs in this class.

According to anecdotal reports, they are more likely to reduce the effects of psychedelics than to cause serious harm. If you are currently taking SNRIs and considering working with psychedelics, it is best to ensure you do so under professional care and guidance.

Can I microdose on MAOIs?

Monoamine Oxidase Inhibitors (MAOIs) are a class of drugs sometimes prescribed for depression. They increase the levels of monoamine neurotransmitters (dopamine, serotonin, and norepinephrine) by preventing their breakdown in the brain. Nardil and Parnate are two of the most commonly prescribed MAOIs.

Since MAOIs also function to alter serotonin levels in the brain, it is not recommended to combine them with large doses of psychedelics. Like SNRIs, combination with a microdose will most likely produce no tangible effects.

Can I microdose on NRIs or NDRIs?

Norepinephrine Reuptake Inhibitors (NRIs) and Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs) are a class of medications commonly prescribed for depression and anxiety. They function by increasing the levels of norepinephrine (+ dopamine in NDRIs) in the brain. Wellbutrin, Strattera, and Ritalin are common examples.

We do not know how NRIs and NDRIs interact with psychedelics. Psilocybin does not interact with norepinephrine and dopamine receptors while LSD does, therefore, theoretically, there can be different risk factors for combining this class of drugs with these two commonly used psychedelic substances. However, until we better understand the counter-interaction mechanisms for each, it is best to avoid combining psychedelics with this category of pharmaceuticals.

Can I microdose on TCAs or TeCAs?

Tricyclic Antidepressants (TCAs) and Tetracyclic Antidepressants (TeCAs) are older classes of antidepressants that are not commonly prescribed. They function by boosting the levels of serotonin and norepinephrine in the brain. Anafranil, Elavil, and Norpramin are the most commonly prescribed medications in this class.

In addition to increasing serotonin and norepinephrine levels, this class of drugs also impacts a wide range of activities in the brain and the cardiovascular system making them especially risky in combination with psychedelics. TCAs and TeCAs should not be combined with psychedelics.

Can I microdose on SMSs or SARIs?

Serotonin Modulators and Stimulators (SMSs) and Serotonin Antagonists and Reuptake Inhibitors (SARIs) are a class of antidepressants that work to increase serotonin levels in the body by both stimulating and inhibiting various serotonin receptors. Desyrel and Trintellix are examples of this class of drugs.

While SSRIs and SNRIs often interact with one or two serotonin receptors, SMSs and SARIs are designed to target as many as 15 different serotonin receptors making their counter-interactions unpredictable and risky. It is therefore not recommended to combine psychedelics with this class of drugs.

Can I microdose on Lithium?

Lithium is a salt and not categorized as an anti-depressant, however, it is sometimes prescribed for bipolar and major depressive disorders. We do not fully understand how Lithium works but there are reports of serious counter-interactions with psychedelics resulting in seizures.

Combining psychedelics with Lithium can have extremely dangerous consequences and must be avoided at all costs.

Can I microdose if I recently stopped taking antidepressants?

If you've recently stopped taking antidepressants, you might be wondering if you can benefit from microdosing. Depending on the type of antidepressant, dosage, and length of time on the medication, you will likely need a period of reset and detox to restore the serotonin receptors to a state where microdosing will be effective. While each case is unique, generally speaking, for every year on antidepressant medications, you will need to account for two months to restore the brain. There are, however integrative detox protocols that can accelerate this process.

Customized detox protocols, alternatives to many pharmaceuticals for mental health, and expert-crafted Personalized Microdosing Protocols for mental health and performance are available through Microdose Guru's vetted network of practitioners.

APPLY for a FREE CONSULTATION with our founder to explore how microdosing can support your mental health goals.

Conclusion

As outlined above, combining antidepressants with psychedelics can be risky, but in some cases, under appropriate medical and expert supervision, it can be done safely. More clinical research is needed to better understand how each of these drugs interacts with various psychedelic substances.

While we have some limited understanding of psychedelic interactions with antidepressants, nearly all of our insights are limited to larger doses of psychedelics. Microdosing practice due to its consistency of administration and low dosage is likely to have very distinct implications when combined with different classes of antidepressant drugs.

It is imperative to note that any changes to anti-depressant medication doses or combined with any mood-altering substances, whether microdose, minidose, or macrodose, must be done under the direct care of a licensed psychiatrist. Luckily, as the field of psychedelic therapy continues to grow, there are more and more psychiatrists with an open mind willing to work in conjunction with psychedelic medicines and allow their patients to safely explore these alternative options.