Helpful Tips on Tapering Off of Antidepressants
How Long Do I Need to Discontinue Use?
Understanding what should be naturally expected from our body’s present conditions is step number one. Conscious and safe preparation for the psychedelic experience in step number two for ensuring you preserve your physical and mental health.
Before diving into some relevant and typically effective options for getting the most out of your magic mushrooms, please be advised that cessation of any medical treatment like antidepressants, should always be discussed with your psychiatrist beforehand.
Antidepressant dosage reduction or termination should always be done under the supervised care and direction of a medical professional and should never be abruptly withdrawn. Abrupt discontinuation of antidepressant medications can worsen mental health conditions and cause emotional instability and volatility.
Having said that, we understand it can be intimidating to approach your doctor with psychedelic-related concerns. If you need some guidance, check out our article on how to speak with your doctor about psilocybin therapy. Now, let’s review what can be done to promote better absorption of psilocybin to hopefully yield more adequately-weighted therapeutic psychedelic effects.
If you’re taking any of the SSRIs or SNRIs referenced in the first chart, including SPARI drugs like Vibryyd (Vilazodone) or Trintellix (Vortioxetine), with the exception of fluoxetine, consider tapering off of your meds no less than 2 weeks before your psychedelic journey. If you’re on fluoxetine, discontinuation of medication should occur at least 6 weeks prior to your journey. By the time you’re ready to embark on the trip, you should have ceased consumption of any SSRI drug.
Fortunately, there are no reports of reduced psychedelic effects on Wellbutrin, but some would advise tapering medication as a precaution, correlating the length of premeditated discontinuation to the potency of desired effects.
On a Mirtazapine medication, tapering should also allow for a 2 week period of discontinued use, prior to your trip. Mirtazapine could dull psychedelic experiences, similar to SSRIs and SNRIs, but its blunting mechanisms lie in a blockage of the 5HT2A receptor, rather than blocking the 5HT reuptake pump.
This same 2 week tapering regimen should be applied for those on Tricyclic antidepressants. Discontinuation before a psychedelic trip is advised due to the potential for experiencing intensified psychedelic effects and serotonin syndrome.
If on Trazodone, tapering and discontinuation should be in effect a minimum of 5 days before a trip to prevent blunting effects.
Buspirone consumers should also follow this 5-day minimum to avoid the same events.
MAOIs should be discontinued through tapering 2 weeks before a trip for these same reasons.
Helpful Tips on Tapering Off of Antidepressants
The best way to taper off, adjust, or eliminate any medication is with the supervision and guidance of your prescribing doctor or psychiatrist. However, we also recognize that many doctors are better at prescribing medications than they are at helping people taper. This often results in them recommending tapering regimens that are far too aggressive and lead to significant withdrawal symptoms.
For most people, these withdrawal symptoms are so disruptive and debilitating that it seems easier to continue to use a particular pharmaceutical drug in order to avoid the return of depressive symptoms. In an effort provide you with some general guidelines, we’ve outlined a tapering protocol established by Adele Framer, the founder of survivingantidepressants.org:
Since 2011, SurvivingAntidepressants.org has advocated a conservative 10% reduction per month of the most recent dose – an exponential taper, the size of each reduction becoming progressively smaller, approximating the hyperbolic method endorsed by recent research.40,72,73,98 These gradual tapers to minimize withdrawal symptoms typically require the creation of customized dosages and take many months to several years, depending on individual tolerance for dosage reduction.
Why reductions at monthly intervals? Although diagnostic criteria require withdrawal to appear within a week of dosage reduction, our members report it can take several weeks (or more) for them to appear.4,16,83 People may not recognize incipient symptoms themselves or it may take some time for symptoms to culminate. Pharmacokinetically, enough residual drug may be active to forestall withdrawal symptoms through the washout period.57,72,73,106,107
If the taper proceeds without significant problems, for most drugs, people generally reduce to less than 2.5% of the original dosage before stopping completely.72,73 Given the potential lag time in emergence of withdrawal side effects, the person should be monitored for at least 3 months after discontinuation, with low-dose reinstatement at the ready should subsequent withdrawal symptoms appear.
To reiterate, taper slowly and listen to your body at all times. It is common for withdrawal side effects to have a delayed onset up to 2 weeks. Often times a more conservative tapering process will be faster in the long run than forcing things and ending up in the start/stop cycle.
What About Medications Other Than Antidepressants?
When it comes to other psychotropic medications like benzodiazepines, stimulants, and opioids we suggest being free and clear of the medication prior to ceremony. However, unlike serotonergic medications, these drugs can be stopped in the immediate 1-7 days prior to the journey given their minimal halflife and lack of significant withdrawl symptoms.
In order to determine when use should be cessated, look up the halflife of the medication in question via Google. From there, you can plug your dosage into this handy drug half life calculator to determine how long it will take for the drug to be eliminated from your system.
Psychedelic therapeutics is a very fresh space in the American mental health industry, but the niche work of research enthusiasts dating back over 25 years, are now serving a large population of interested supporters.
That’s to say, although the drug interactions discussed in this analysis may precipitate feelings of angst, it’s this prefatory scientific research that has led to the admittedly rapid development of effective resolutions.
Of course, we cannot leave you without once again stating our firm advice against ceasing the use of any psychiatric medications without first getting explicit approval from your doctor. Embarking on a psychedelic journey can be a deeply life-changing experience, but this excitement should never shepherd impulsive decision-making that could lead to dangerous health complications.