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roxykell t1_itseew2 wrote

There’s a lack of research on psychedelics and mental illness, and even less understanding of their interactions with drugs like SSRIs etc.

But there’s a vested interested in psych use to improve mental health, thus how do you provide advice while also being cautious of the potential for aggravation of any mental illness? Or do you caution against trying them at all?

I have dabbled in the mixing of psychs with SSRIs, more for curiosity, and haven’t had issues. I was lucky to have experienced friends that offered what they knew, but it’s still always a gamble.

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psychsafetyalliance OP t1_itsiazu wrote

Absolutely. While it absolutely makes sense that the clinical trials are proceeding cautiously, with very strict parameters on who they treat and how they treat them and only changing a few variables at a time, there is a lot of eagerness by the innumerable folks who have not found relief through traditional psychiatry to DIY these protocols now. It's hard not to want to jump in when you've been experiencing so much unrelieved suffering, and you're seeing all these exciting headlines in mainstream news outlets.

For the interactions with SSRIs, there's this handy chart that summarizes some of the (known) issues, along with relevant citations. If you are able to identify a psychedelic-friendly psychiatrist in your area, it's worth it to talk through contraindications and any proposed change or taper to your medications with them. It could prevent further exacerbation of whatever mental health challenges you may have, such as triggering (potentially fatal) Serotonin Storm Syndrome.

As a general rule of thumb, we encourage anyone who is seeking treatment to seek as much professional assistance as they can find while on this path. It's a bit of a wild west out there right now in terms of identifying competent integration specialists who can truly help you on your path - not all of them are adhering to safe sourcing or testing strategies (here's a recent horror story about someone being given meth instead of MDMA for their underground therapy session). Having a professional, licensed person to guide you on your path in preparing and integrating the experience can help you identify any potential issues that may be difficult to identify without that outside set of eyes. We always advise, regardless of known underlying mental health conditions, to start with a low dose, and go slow, with any doses, and slowly titrate up to the desired dose to match your intention over the course of many sessions. This takes time, but will help you carefully evaluate your body's response and find a dose that minimizes negative effects while maximizing benefits. We've got our Safer Psychonaut Dosing Protocol here to minimize risk, and a set & setting checklist to help people create as safe a container as they can for their experience.

And finally: for folks with a genetic predisposition to schizophrenia-type disorders, there is a small but nonzero risk of triggering psychotic episodes, especially at higher doses. We encourage folks with this predisposition to have especial caution when thinking about LSD, psilocybin, and their analogues.

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Vessix t1_ittolzs wrote

>Having a professional, licensed person to guide you on your path in preparing and integrating the experience can help you identify any potential issues that may be difficult to identify without that outside set of eyes

A license in what, though? I got my masters at a state university, about to work as an unlicensed therapist eligible for LCSW that I'll have in about 2 years. Within the scope of social work it's pretty much perfectly against ethical standards to suggest treatments that don't have scientific evidence base. Given the unfortunate lack of research in psychedelic tx options I sort of hesitate to suggest just any "licensed" professional. A licensed health coach isn't going to be a super safe option to guide someone utilizing psychedelic drugs to address serious mental health issues, for example. I genuinely want to know, who can? It takes thousands of hours of supervised practice for a genuine clinical mental health license, but none of those professions can act outside the law or outside the scope of existing research without risking said license.

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