Which medications are unsafe with ayahuasca?
Antidepressants, tramadol, stimulants and some supplements can react dangerously with ayahuasca. A reference list, and what to do if you take one.
If you take any medication, you need to know what is safe and what is not. This is not something to guess about: the wrong combination can cause a serious medical emergency.
Below is a reference list. If you take anything on it, please don’t skip ahead. Read it, then talk to us before you book.
Never stop or change a prescribed medication on your own. Any change has to be planned with the doctor who prescribed it.
This list also applies to Satori, the third ceremony in both our ayahuasca and psilocybin retreats, because it also contains an MAO inhibitor. More in what is Satori.
Why ayahuasca interacts with so many medicines
Ayahuasca contains MAO inhibitors, which stop the body from breaking down serotonin and other neurotransmitters. Add a medicine that raises serotonin, and it can build up to dangerous levels. This is called serotonin syndrome: fast heart rate, high blood pressure, tremor, muscle rigidity, fever and confusion, and in severe cases seizures. Other combinations can cause a dangerous spike in blood pressure.
Do not combine
Antidepressants: SSRIs
Sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), fluoxetine (Prozac), citalopram (Celexa), fluvoxamine (Luvox).
They raise serotonin. Together with an MAO inhibitor, the risk of serotonin syndrome is high. If you and your doctor decide to stop one, it has to be tapered, never stopped abruptly, and you need a clear gap afterward. Fluoxetine stays in the body much longer than the others, so its gap is longer.
Antidepressants: SNRIs
Venlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq). Same risk as SSRIs, plus effects on heart rhythm and blood pressure.
Tricyclic antidepressants
Amitriptyline, nortriptyline, imipramine, doxepin, clomipramine. Risk of serotonin syndrome and of heart rhythm problems.
MAOI antidepressants
Phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), selegiline. This doubles the same mechanism: serious risk of a hypertensive crisis and of serotonin syndrome.
Tramadol and some other opioids
Tramadol, meperidine, methadone and tapentadol raise serotonin. With ayahuasca they carry a risk of serotonin syndrome and seizures.
St. John’s wort and other serotonergic supplements
St. John’s wort, 5-HTP, SAMe and tryptophan behave like antidepressants in this context.
High risk: talk to us first
Stimulants
Methylphenidate (Ritalin, Concerta), amphetamines (Adderall, Vyvanse), phentermine and other weight-loss drugs. They raise heart rate and blood pressure, and the combination can be dangerous.
Some blood pressure medicines
Methyldopa and reserpine in particular. They may need to be changed with your cardiologist’s help.
Linezolid
An antibiotic with MAO-inhibiting effects. Wait until the infection is treated and the course is finished.
Migraine medicines
Triptans (sumatriptan and others) act on serotonin.
Cold and cough medicines
Decongestants with pseudoephedrine or phenylephrine can raise blood pressure. Cough syrups with dextromethorphan (DXM) are serotonergic. Some antihistamines, such as chlorpheniramine, are too.
Cancer treatment
Some chemotherapy and targeted drugs interact with MAO inhibitors. Chemotherapy or radiation in the past four weeks is a reason to wait.
Needs individual review
- Lithium and other mood stabilizers
- Antipsychotics
- Benzodiazepines and sleeping pills
- Diabetes medication, because of fasting on ceremony days
- Blood thinners, thyroid medication and others
Tell us about all of them, including over-the-counter medicines, supplements and herbs such as kava, kratom, ginseng, rhodiola, ephedra or yohimbe.
Usually fine
Paracetamol (acetaminophen) and ibuprofen in normal doses, basic vitamins and minerals. Still, list them.
How the review works with us
- Register and tell us about every medication, supplement and condition.
- Screening call. We go over your health and history with you.
- If something is on the list, we talk about whether the retreat is safe for you, and whether a change planned with your own doctor would make it possible. Sometimes the answer is to wait, or to choose a different retreat.
- Before you arrive, we confirm that the plan was followed and that you are safe to take part.
Nothing is confirmed until this review is done.
If you are unsure
Don’t guess, and don’t “see what happens”. Send us your full list. We will tell you whether it is a clear no, a possible yes with planning, or something to review with your doctor.
The full list of conditions and medicines is on our medical information page. When you are ready, book a call and we will go over it together.
This article is general information, not medical advice.
