Can You Drink Ayahuasca on Antidepressants? The Answer Nobody Gives You

If you are reading this, there is a fair chance you already know the answer you want.

You are on something. Maybe it is an antidepressant you have taken for eight years and stopped thinking about. Maybe it is a mood stabilizer. Maybe it is nothing more than a blood pressure tablet and a thyroid script, and you are hoping none of it counts.

And somewhere in the back of your mind there is a quiet calculation running. How much of this do I actually need to mention?

I understand that calculation better than you might think, and I will come to why.

What follows is the answer we give on the phone, several times a week, to people asking exactly what you are asking. It is longer than the answer you will find anywhere else, and it is specific, because the true answer to this question is not one answer. It depends on which medicine, which drug, and which body.

Nothing in here is invented. Every claim about how these medicines behave in the body is drawn from published pharmacology, and I have named the sources at the end so you can check me. You should check me. That is rather the point of the article.

The question nobody asked me

I want to start with my own story, because I am not writing this from a safe distance.

When I sat in my first ceremony, I was on antidepressants.

Nobody asked.

Not on a form. Not on a call. Not at the door.

By then I had been through years of psychologists, psychiatrists, the medications, Zoloft and Lexapro, the breathwork, the yoga, the meditation. You name it, I had tried it and nothing had held for long. I was 41. I had already attempted to take my own life. Then I heard about the plants on a podcast, driving to a meeting, and something in me said quietly that this might be the missing link.

So I went looking. And I landed in the hands of a man who did not have the training he said he had.

The address arrived by email the day before, from a third party. I turned up and there were 45 people in the room. Everything about it felt wrong before anything had even started.

What followed was one of the most terrifying nights of my life.

For a long time I told that story as a story about a bad facilitator, and it is. But there is a second half to it that I did not understand until years later, once I had done the training and learned what actually interacts with what.

I was carrying an antidepressant in my body that night.

I will never know how much of what happened to me was the man, how much was the room, and how much was the chemistry nobody had bothered to ask about. That question does not have an answer now. It never will.

What I do know is that I got lucky. Other people, on other scripts, in other rooms just like that one, have not.

That is the whole reason this article exists.

The call that showed me how rare a good question is

A while ago a woman rang us about a retreat. We ended up talking for an hour and a half.

Some of that was us. Every call we take runs through the same ground, because it has to. Your cardiovascular system. Your mental health history, and your family's. Every medication you are taking, prescribed or otherwise. We ask it on the call, we ask it again on the forms, and we ask it again before you arrive. Not because we forget, but because people remember things the second and third time that they did not think to mention the first.

But a good portion of that hour and a half was her.

She wanted to know about the medication she takes for rheumatoid arthritis, and what it actually interacts with. Whether we titrate the dose across ceremonies. What the mechanism was, not just the rule.

I have taken a lot of these calls. Very few people ask what she asked.

At the end of it I told her something I meant. Her questions were the right questions, and I hoped she would ask every one of them again, whether she came to us or went somewhere else entirely. Because most of the places she rang were never going to volunteer any of it.

So let me put on the page what I told her.

First, understand that these are two different conversations

Most people write to us about ayahuasca and assume the medication rules are one set of rules.

They are not. Ayahuasca and Huachuma work on the body in completely different ways, and on this question in particular they are not close.

Ayahuasca does not forgive medication

Here is the part almost nobody explains.

Ayahuasca is not one plant. The vine and the leaf do different jobs. The vine, Banisteriopsis caapi, works by shutting down an enzyme in your body called monoamine oxidase.

That enzyme has a day job. It clears excess serotonin out of your system, and it breaks down a substance called tyramine, which is part of how your body regulates blood pressure.

Now switch that enzyme off, and think about what is left running.

If there is a serotonin drug in your body, an SSRI, an SNRI, a tricyclic, nothing is clearing the excess any more. That is the setup for serotonin syndrome. Fever, confusion, sweating, muscle rigidity, seizures, organ dysfunction, a heart rate and blood pressure that will not hold steady. It kills people.

And if there is anything in your body that pushes blood pressure up, nothing is holding the brake. That is the setup for a hypertensive crisis. A sudden spike, and at the far end of it, stroke or haemorrhage.

Now here is the part that catches people out.

It is almost never the antidepressant that surprises us on a call. People know about that one. It is the ordinary things.

Pseudoephedrine. Decongestants. Cold and flu tablets. Antihistamines and allergy medication. Asthma inhalers. Ritalin, Adderall, phentermine. Certain blood pressure medications. Venlafaxine.

Every one of those sits on the documented list of things that can produce a hypertensive crisis in combination with an MAO inhibitor.

Picture how that actually happens. Someone has flown to Peru. They have saved for this, taken the leave, told their family. Three days out they get a head cold and they are terrified of missing the ceremony. So they take a cold and flu tablet, because it is a cold and flu tablet.

They would never think to mention it. Nobody asked.

You will occasionally hear the argument that the risk here is overstated, because the compounds in the vine are a reversible kind of MAO inhibitor and documented cases of serious harm are rare. That is true as far as it goes. Researchers do point to that reversibility to explain why, despite ayahuasca spreading across the world and a great many participants almost certainly sitting down with an SSRI still in their system, the literature holds very few clear cases.

I would ask you to sit with what that argument is actually saying.

It is saying that a great many people have taken the risk and most of them got away with it.

Rare is not safe. And it is a very strange thing to volunteer for.

Huachuma is a different animal, and here is why

Huachuma sits differently, and the reason is worth understanding rather than taking on faith.

The first proper study of how mescaline moves through the human body was published last year. Researchers tracked 105 dosing sessions across 49 people. What they found is that Huachuma barely gets processed at all.

About half of it is converted on first pass into a compound that does nothing. The rest comes out in your urine unchanged. Nearly the entire dose is gone from your body inside a day.

That matters more than it sounds. Most pharmaceuticals are broken down in the liver, and the liver is where the great majority of drug interactions happen, drugs queuing for the same enzyme and interfering with each other. Huachuma largely skips that queue. It passes through and leaves through the kidneys, mostly intact.

That is not folklore. That is measurable. And it is why this medicine sits alongside more of ordinary life than ayahuasca does.

Thyroid medication, most blood pressure medication, medications like Olumiant for rheumatoid arthritis. These are generally not a problem with Huachuma. We still check every one of them individually, but the honest starting position is different.

It is also why we ask about your kidneys. The researchers on that study flagged it directly. If your kidney function is impaired, the way this medicine leaves your body changes. Almost nobody in this world asks that question. We ask it, and we ask it because of that paper.

None of which makes Huachuma a free pass.

The serotonin drugs still matter. SSRIs, MAOIs, opiates, antipsychotics, Ritalin and the like. That interaction is real, and our requirement there is 14 days clear. Anything recreational, or any other ceremony, is 30 days out. And if you are on none of that, the preparation is seven days, and it is purely about food. Red meat, pork, spices. That is all.

We are not physicians and we do not pretend to be. What we do is tell you plainly what interacts, and then send you to your doctor to have an honest conversation about it. Tell them what you actually intend to do. We have found most doctors are far more helpful about that than people expect.

The one that is missing from almost every list

If you take one thing from this article, take this.

Lithium.

In 2024 a team of researchers published a systematic review of drug interactions involving classic psychedelics. They found 47 case reports of lithium taken in combination with them.

Roughly half of those involved seizures or status epilepticus.

Half.

Nothing else in that review comes close. SSRIs combined with psychedelics did not produce seizures at anything like that rate. The reviewers put lithium in a category of its own.

Now think about who is on lithium. It is one of the most commonly prescribed medications for bipolar disorder. Which means the people most likely to be carrying it are often the same people whose diagnosis already sits outside what this work can safely hold.

Go and look at the medication lists published by retreat centres. Count how many of them name lithium.

The trap inside the thirty day rule

Here is something that will tell you whether the people you are speaking to have done their homework or copied someone else's website.

Most washout periods you will see quoted are 14 days or 30 days. Fourteen days is the standard clinical separation between an MAO inhibitor and a serotonin drug. It is in the product labelling of most SSRIs. As a general rule it is sound.

But there is one drug that breaks it, and it happens to be one of the most prescribed antidepressants on earth.

Fluoxetine. Prozac.

Fluoxetine has an unusually long half life, and its active metabolite lasts longer still. The standard clinical guidance for fluoxetine before an MAO inhibitor is a washout of at least five weeks.

Not fourteen days. Not thirty days. Five weeks.

Which means somebody coming off Prozac, who has done everything right by a thirty day rule they were given in good faith, can walk into a ceremony with active drug still in their system.

If you are on fluoxetine and someone tells you a month is plenty, you have learned something about them.

If you are reading this with a specific medication in mind, that is the conversation to have on a call rather than in an article.

The part of this conversation almost nobody has

Everything above assumes that the easy part is stopping the medication.

It is not. And this is where I think our industry does its quietest damage.

Coming off an antidepressant is a clinical event in its own right. If you have been taking one for more than about six weeks and you stop abruptly, you can develop what is called antidepressant discontinuation syndrome. Nausea, flu like symptoms, insomnia. For some people those symptoms run for months, not days.

The risk is higher if you stop suddenly rather than tapering, if you have been on it for years, or if you are on a high dose. Most of it can be reduced by tapering gradually, over weeks to months, with a doctor watching.

And underneath all of that sits the obvious thing. There was a reason you started taking it.

So when a retreat tells someone to simply be off their medication a fortnight before they arrive, understand exactly what has happened. They have not created a safety protocol. They have handed you the hardest and most medically significant part of the process to manage alone, unsupervised, on a deadline set by their calendar.

That is not care. That is a liability moving from their side of the table to yours.

Which is why our answer is sometimes that this is not the right season for you. That the conversation with your doctor about tapering may need to run over months. And that the retreat can wait, because it will still be there.

I know that is not what anyone wants to hear when they have finally worked up the courage to make the call. But you have my word that I would rather disappoint you than have you dismantle something that is holding you together, in order to make a date.

What we do with our own family

I will give you the clearest example I have.

My wife Grace works alongside me. She is on medication for high blood pressure.

With ayahuasca, the safety window is 30 days off medication. For someone on blood pressure medication, a month without it is not a small thing. So when Grace sits, she is monitored, we have staff on site checking her, and sometimes she simply cannot complete a full cycle.

We apply that to my wife.

I mention it not because it is admirable but because it is the only test that means anything. Ask whoever you are speaking to what happens when the rule is inconvenient for someone they love.

"If you are looking for a place that is safe and you are well looked after, contact Rodolfo and his lovely wife Grace."

Josh Wilkins, Google review

There is a second reason to tell the truth about your medication

This one is not about danger, and it rarely gets mentioned.

Research has documented that people on SSRIs and SNRIs often experience a blunted response to these medicines, during and for some time after taking them. The effects are attenuated. For some people, very little happens at all.

So picture the person who decides to under declare on the screening call, gets through, and travels.

They arrive. They prepare. They sit down. And they feel almost nothing.

Then they fly home and conclude one of two things. Either the medicine does not work, or something is uniquely broken in them.

Neither is true. They were carrying something in their body that was always going to stand in the way, and they did not tell anyone, because they were frightened of being told no.

I would rather tell you no today than have you spend that money, that leave, and that hope on an experience that could never reach you.

How to tell whether you are being properly screened

You do not need to be a pharmacologist. You only need to notice how the conversation goes.

Green flags, the signs that someone is actually looking after you:

They ask about medication before you raise it, and they ask more than once. On the call, on the forms, and again before you arrive.

They ask about your family history, not only yours. Standard practice in psychedelic clinical research is to exclude people with a personal or family history of bipolar disorder or schizophrenia spectrum illness. If nobody has asked about your family, nobody is following the standard.

They ask about your heart. Blood pressure, bypasses, any cardiovascular diagnosis. These medicines reliably lift heart rate and blood pressure. In a healthy person that settles by itself. In the wrong body it does not.

They know which drug breaks the rule, and why. Ask what happens with fluoxetine specifically.

They send you to your doctor, and they tell you to be honest with them.

They are willing to say no, and they will tell you what percentage of people they turn away.

Red flags, the things that should make you slow down:

Nobody asks about medication at all. Walk away. This is not a small oversight, it is the whole thing.

The screening happens by email and by tick box, and you never speak to a human being.

They tell you to stop your antidepressant a fortnight before you come, and nothing else. No doctor, no taper, no follow up.

You mention a psychiatric diagnosis and the energy in the conversation does not change.

Their medication list does not mention lithium.

They say yes quickly.

That last one deserves its own sentence. We say no to roughly 80% of the people who call us, either because the intention is not right or because there is a health condition that makes ceremony dangerous. A quick yes is not a compliment. It is information about how the place is run.

Frequently asked questions

Can I drink ayahuasca while taking antidepressants?

No. Ayahuasca works by inhibiting monoamine oxidase, the enzyme that clears excess serotonin and helps regulate blood pressure. Combining that with an SSRI, SNRI or tricyclic creates the conditions for serotonin syndrome, which can be fatal. The medication needs to be fully cleared beforehand, and that is a decision to make with your doctor, not with a retreat.

How long do I need to be off my antidepressant?

The standard clinical separation is at least 14 days, and we require 30 days before ayahuasca. Fluoxetine, sold as Prozac, is the exception. Because of its long half life and its active metabolite, standard guidance is a washout of at least five weeks. Anyone quoting you a single number for every drug has not looked closely enough.

Can I take Huachuma while on medication?

It depends entirely on which medication. Mescaline is unusual in that it is barely metabolised. Around half converts on first pass into an inactive compound and the rest is excreted largely unchanged through the kidneys within about a day, so it does not compete with most medications the way other substances do. Thyroid, most blood pressure and many arthritis medications are generally not a problem. SSRIs, MAOIs, opiates, antipsychotics and stimulants such as Ritalin are, and require 14 days clear. Every case is reviewed individually.

What medical conditions rule out plant medicine ceremony?

Cardiovascular disease of any kind. Bipolar disorder, schizophrenia and related conditions involving psychosis, paranoia or hallucinations, including where these appear in your immediate family. Impaired kidney function. Anyone taking lithium. There are others, which is what the call is for.

Why is lithium so dangerous with plant medicine?

A 2024 systematic review of drug interactions involving classic psychedelics identified 47 case reports of lithium taken in combination with them, and roughly half involved seizures or status epilepticus. No other medication in that review carried comparable risk.

Is it safe to simply stop my medication before a retreat?

Stopping an antidepressant abruptly can cause discontinuation syndrome, with symptoms that can persist for months, and it carries a risk of relapse. It should be done gradually and with medical supervision. If a retreat tells you to come off your medication without involving your doctor, that tells you what you need to know about them.

This article is educational and is not medical advice. Decisions about prescribed medication belong to you and your doctor.

A quiet invitation

If you have read this far, you were probably hoping for permission.

I know that feeling. You have finally decided to do something about your life, and here is another door with a lock on it.

But I would ask you to consider that the screening is not the obstacle standing between you and the work. It is the work beginning. Somebody taking the time to find out exactly who you are and what you are carrying, before you ever lie down, is not gatekeeping. It is the first real evidence you will get about whether you are in safe hands.

So the question is not really whether you can do this on your medication. The question is whether the person you are asking cares enough to find out properly, and whether they are willing to lose your booking over the answer.

If you would like to have that conversation with people who will, it starts with a call. Bring everything. The scripts, the diagnoses, the things you were hoping not to have to mention.

It would be an honor to serve you.

Book a Conversation

Sources

Everything in this article about how these medicines behave in the body comes from published research. Check it for yourself.

Vizeli et al. (2025), Pharmacokinetics, Pharmacodynamics, and Urinary Recovery of Oral Mescaline Hydrochloride in Healthy Participants, Clinical Pharmacokinetics. Read it here

Halman et al. (2024), Drug-drug interactions involving classic psychedelics: A systematic review, Journal of Psychopharmacology. Read it here

Callaway and Grob (1998), Ayahuasca preparations and serotonin reuptake inhibitors: a potential combination for severe adverse interactions, Journal of Psychoactive Drugs. Read it here

Monoamine Oxidase Inhibitors, StatPearls, National Center for Biotechnology Information. Read it here

Cardiovascular safety of psychedelic medicine: current status and future directions. Read it here

Going Off Antidepressants, Harvard Health Publishing. Read it here