Psychedelic retreats · 10 cited sources
Psilocybin safety: screening, drug interactions, contraindications
What the two state programs and published research say. sunny.day is a travel site: we do not screen anyone, and nothing here is medical advice or a promise about any outcome. Tell the facilitator about every medication you take, and do not stop or change a prescribed medication to qualify for a session without talking to the person who prescribed it.
Screening is part of the law
- Oregon: every client must complete a preparation session with a licensed facilitator first. A client may be found ineligible if they are experiencing ideation of harm to self or others, have taken lithium within 30 days, or have been diagnosed with active psychosis at any time. [Oregon Health Authority]
- Colorado: before or during the preparation session the facilitator must do a comprehensive screening, including a medical-history safety assessment (4 CCR 755-1, Rule 6.16). [4 CCR 755-1]
- Colorado: a facilitator licensee may not serve a participant who takes lithium or antipsychotic medication unless that person has a referral, medical clearance, or a documented risk review with a licensed medical or behavioral health provider (4 CCR 755-1, Rule 2.2(A)(6)-(7)). A facilitator may decline anyone for any health or safety reason. [4 CCR 755-1]
Drug interactions
- Lithium: in an analysis of 62 online reports of classic psychedelics taken with lithium, 47% involved seizures and 39% involved medical attention. The authors provisionally conclude psychedelic use may pose a significant seizure risk for people on lithium. [Nayak et al., Pharmacopsychiatry 2021]
- SSRIs and SNRIs: in a survey of 611 reports, the probability of weaker than expected psilocybin effects was 0.47 with an SSRI and 0.55 with an SNRI, and the dampening may last up to 3 months after stopping. In a controlled study of healthy volunteers, escitalopram pretreatment reduced bad drug effects, anxiety and cardiovascular effects of psilocybin without changing its positive mood effects. [Gukasyan et al., J Psychopharmacol 2023] [Becker et al., Clin Pharmacol Ther 2022]
- MAOIs: a systematic review lists MAOIs among the serotonergic medications with potential interactions, and found only five publications on psilocybin interactions of any kind. MAO-A is one of the enzymes that breaks down psilocin, so an MAOI may change how the body processes it. Thin evidence is a reason to ask a prescriber, not a reason to assume it is fine. [Sarparast et al., Psychopharmacology 2022] [Thomann et al., Front Pharmacol 2024]
Contraindications research screens for
- Safety guidelines from Johns Hopkins researchers exclude people with a personal or family history of psychotic disorders or other severe psychiatric disorders. [Johnson et al., J Psychopharmacol 2008]
- Hallucinogens can moderately raise pulse and blood pressure. Research protocols review an ECG at screening and monitor pulse and blood pressure during sessions. [Johnson et al., full text]
If something goes wrong
- In an emergency call 911. For a mental health crisis call or text 988, the Suicide & Crisis Lifeline, which Oregon Health Authority lists on its access page. [Oregon Health Authority]
- Poison Help: 1-800-222-1222 reaches your local US poison center. [America's Poison Centers]
sunny.day does not sell, book or take payment for sessions at these centers. Contact a center directly.
This is travel information, not medical or legal advice. Safety, screening and drug interactions →
Legal basis: Colorado.
- Colorado voters passed Proposition 122, the Natural Medicine Health Act of 2022 (C.R.S. title 12, article 170). It sets up regulated access for adults 21 and older to natural medicine, which the Act defines to include psilocybin and psilocyn, at licensed healing centers. (source)
- Senate Bill 23-290 created the Natural Medicine Division in the Department of Revenue, which licenses healing centers. Facilitators are licensed separately by the Division of Professions and Occupations. (source)
Federal law. Psilocybin and psilocyn are listed in Schedule I of the federal controlled substance regulations (21 CFR 1308.11(d)). The state programs on this page operate under state law. (source)