For the past couple of years psilocybin — the active ingredient in magic mushrooms and truffles — has been held up as the great hope in mental health treatment. Raised high on the shoulders of scientific study and research, this substance previously lumped together with dangerous drugs like heroin and cocaine, is having a long overdue image makeover. 

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A Bitter Irony For Those With Depression

It really can’t come fast enough. Not only is it pretty nuts that a substance rated the least dangerous recreational drug (with the very legal alcohol rating at least 10x more likely to land you in a pickle!) is still prohibited, there are millions of people across the globe who could benefit from the magic of psilocybin. 

So far, this wonder compound has been seen to treat conditions ranging from depression, PTSD, anxiety, addiction, and eating disorders. It’s really quite exciting. However, up until recently there’s been bitter irony attached to this burgeoning success story. For a long time the accepted knowledge was that the desired effects of psilocybin would be dampened by usage of traditional antidepressant and anxiety medications. The main focus was Selective serotonin reuptake inhibitors or ‘SSRIs’. 

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Think about it… those who most desire the help psilocybin provides thwarted by the medications they are currently on now. Talk about unfair!

The Problems With SSRIs

And, there are many reasons why someone might wish to come off traditional pharmaceutical medications. Of course they work for many people. But for many people they don’t. It could be that they have no or very little effect. That they create an emotional numbness that cannot be endured. That the many side effects are too much to handle. Or, even that the user does not want to put unnatural chemicals in their body. 

However much some of their users may struggle with them, for many it’s either meds — or suffer the most crippling version of their depression or anxiety. This risks their own safety, as well as their relationships with loved ones, and professional commitments. 

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Both psilocybin and SSRIs interact with the neurotransmitter serotonin, but in very different ways. SSRIs trap serotonin in the brain, and can often blunt emotional response. In contrast, psilocybin binds to and stimulates receptors, actually increasing emotional connection. 

Previously, it was recommended that a user of SSRIs should wean themselves off before beginning to medicate with psilocybin. For many users this is a problem as they will experience substantial physical and mental withdrawal, as well as a return of the symptoms of their condition. It’s a lot to ask, especially when the treatment you want is illegal or difficult to access in many places. 

New Studies Show You Can Combine SSRIs and Psilocybin

So it’s with supreme excitement we can report that two recents studies, that were published within weeks of each other at the end of 2021, indicate that this is actually not the case. You can combine SSRIs and psilocybin without negative effects on either substance! 

Firstly by biotechnology company MindMed, who in November 2021 released data which showed how psilocybin and SSRIs interact in humans. The study, carried out by University Hospital Basel, found that participants who were using the SSRI escitalopram still experienced the positive mood effects of psilocybin. They also had a reduced potential for the negative effects psilocybin can cause such as anxiety, when compared with the placebo group. 

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In the study, some participants were given either 10mg of escitalopram daily for seven days, then 20mg daily for the next seven days, including the day of psilocybin administration. The others, two weeks of a placebo until psilocybin administration. 

Answering Key Questions

The study’s Principal Investigator, Dr. Matthias Liechti explained the questions they hoped to answer with their research:

“First, for safety reasons, should a patient stop using antidepressants before receiving psilocybin? Second, if there’s no safety risk, will the antidepressant reduce the patient’s response to psilocybin?”

And, they were able to answer them:

“These results indicate that psilocybin may be dosed during escitalopram treatment without apparent impact on the effect of psilocybin. Thus, the study answers the first question and provides a positive indication for the second.” (Dr. Liechti) 

A good first step, with a pressing incentive to do more study, as Dr. Miri Halperin Wernli, MindMed’s Executive President outlined;

“If the results are confirmed in subsequent studies, with other substances and in patients rather than healthy individuals, antidepressants may no longer need to be stopped for psilocybin treatment,” 

Compass Pathways Find The Same Result

Oh, and wouldn’t you know it? Within a few weeks Compass Pathways released their own data, with more of that desired proof…

In Compass Pathways’ study comparable results were found in the participants who were still on a regime of SSRIs, and those who had stopped their regime prior to the study, when they were given COMP360.  COMP360 is a novel psilocybin extraction created by Compass Pathways specifically for therapeutic use. 

Chief Medical Officer of Compass Pathways, Guy Goodwin, stated:

“The results of this study challenge the widely-held belief that the use of SSRI medication together with psilocybin could interfere with psilocybin’s therapeutic effect. Our findings provide a strong signal that COMP360 psilocybin therapy could be an adjunctive treatment to SSRI antidepressant as well as a monotherapy.”

A ‘monotherapy’ is a one drug treatment. So what he’s saying is that psilocybin could be used both as a singular treatment (as we knew) and together with SSRIs. 

Magic Mushroom Myth Busting!

Phew! Quite some myth-busting going on. It’s great news for those currently on SSRIs who want to undergo psilocybin treatments — often those the most in need. 

Watch this space for more positive findings!

And in the meantime, remember to always speak to your doctor if you are planning to make a change to your medications or wellness routine.