Ayahuasca and antidepressants: what the sources say

The interaction

• Serotonin syndrome with SSRIs and other serotonergic drugsSerious risk

  The MAO-inhibiting harmala alkaloids in ayahuasca combined with SSRI antidepressants may induce a serotonin syndrome with a potentially grave outcome. ICEERS states that combining MAOIs with SSRIs or other serotonergic medications is contraindicated. (Journal of Psychoactive Drugs, 1998; ICEERS, 2026)

• Why MAOI-containing brews carry more interaction riskSerious risk

  A review of serotonin toxicity notes that true serotonin toxicity typically occurs with overdose or when a drug that increases synaptic serotonin is combined with an MAOI; serotonergic drugs without MAOIs are low risk with psychedelics that also lack MAOIs. Warning signs needing immediate medical attention include myoclonus, extreme or fluctuating vital signs, agitation or coma, muscle rigidity, high fever and seizures. (Psychopharmacology (Berl), 2022)

• Other contraindicated medicines and supplementsSerious risk

  ICEERS lists antidepressants and other psychotropic medications, drugs metabolised by certain cytochrome enzymes, and any medication that interacts with MAO (including MAO inhibitors) as potentially contraindicated, and names St John's wort and Ginkgo biloba as contraindicated herbal supplements. It advises avoiding alcohol, stimulants, opioids and other drugs in the days or weeks before a session. (ICEERS, 2018)

• Stopping medication before a ceremonySerious risk

  ICEERS says contraindicated medications such as certain antidepressants may need to be stopped at least two weeks before a session, but only under strict medical supervision because abruptly stopping psychiatric medication can be dangerous. It also warns that stopping medication for a chronic illness to take ayahuasca can itself be dangerous. (ICEERS, 2018)

Ayahuasca and 5-MeO-DMT

• Combination with ayahuasca can be fatalSerious risk

  A published autopsy case attributed a death to hallucinogenic amine intoxication after 5-MeO-DMT was taken together with harmala alkaloids, and ICEERS reports a US death that seems to have followed an overdose of synthetic 5-MeO-DMT taken hours after ayahuasca. Retreats that offer toad medicine alongside ayahuasca therefore raise interaction concerns. (Journal of Analytical Toxicology, 2005; ICEERS, 2023)

What listed centres publish

Quoted from each centre's own site. None of this is medical advice: any change to medication belongs with your prescriber.

• Temple of the Way of Light · Near Iquitos, Loreto, Peru

  "All applicants complete a comprehensive medical form, which is reviewed by our medical support team." "Certain medications, especially SSRIs and MAOIs, are contraindicated with ayahuasca." Form screens for cardiovascular, liver or kidney disease, recent surgeries, psychiatric conditions and contraindicated medications. No ECG requirement stated.

• Arkana Spiritual Center · Near Libertad (Iquitos), Loreto; also Sacred Valley, Cusco, Peru

  FAQ: "we do not serve Ayahuasca to individuals diagnosed with" schizophrenia, bipolar disorder or borderline personality disorder; epilepsy, high blood pressure, heart conditions and diabetes require consultation. "All medications and supplements must be stopped unless explicitly approved by our medical intake coordinator." "Ayahuasca contains natural MAOIs (Monoamine Oxidase Inhibitors), which can interact dangerously with certain medications, including: Antidepressants (SSRIs, SNRIs, etc.)". "An onboarding medical call is conducted to identify any potential health conditions before your arrival." Defibrillators and CPR-trained staff stated. No ECG requirement stated.

• Nimea Kaya Healing Center · Near Pucallpa, Ucayali, Peru

  FAQ: "There are several types of medications that conflict with Ayahuasca. Please directly inquire with us regarding any medications you are taking". "All anti-depressant medications must be eliminated at least 3-6 weeks before the retreat begins." Medications must be declared in the application. No MAOI-specific statement, psychiatric exclusion criteria or ECG found on the pages read.

• Blue Morpho · Near Iquitos, Loreto; also Sacred Valley, Cusco, Peru

  FAQ: "Everyone completes a confidential medical screening as part of registration. Some health conditions - such as heart disease or mental health diagnoses - and certain medications may be contraindicated with ayahuasca." "Most medications and supplements must be paused before arrival, with the exception of birth control." No ECG or explicit MAOI/SSRI list found.

• Dreamglade · Moralillo, Iquitos-Nauta road, Loreto, Peru

  "Dreamglade requires every guest to complete a health and medication disclosure before being accepted." Lists SSRIs, SNRIs, MAOIs, tricyclics, stimulants, sedatives, heart and blood pressure medications and blood thinners as possibly unsafe; asks about heart, blood pressure or seizure conditions and "A personal or family history of psychosis, schizophrenia, or bipolar I." Written health intake completed "before any deposit is taken." No ECG stated.

• Etnikas · San Salvador, Sacred Valley, Cusco (also Manu programmes), Peru

  "Guests fill out a health form which is reviewed by our doctors and psychologist." "The doctor will conduct a physical medical examination before the ayahuasca ceremony to ensure the guests are able to participate." No MAOI/SSRI or ECG statement found on pages read.

• La Medicina · Near Tarapoto, San Martin, Peru

  FAQ: "For medications, particularly SSRIs, a discontinuation period longer than four weeks may be necessary (under the guidance of a licensed professional). Report all medication use during intake." "all medications and supplements ... are evaluated individually, so full disclosure in your intake form is crucial." No ECG or psychiatric exclusion criteria found.

• Nihue Rao Centro Espiritual · San Juan Bautista, near Iquitos, Loreto, Peru

  Not stated on the pages we read: the FAQ and retreat pages contain no statement on contraindicated medication, MAOIs, SSRIs or a medical questionnaire.

• Refugio Altiplano · Tamshiyacu River, near Iquitos, Loreto, Peru

  Medical advice page: "It is necessary that you let us know, in confidence, any known medical conditions and/or use of any medication, at the time of booking." Lists SSRIs ("We advise you to stop taking SSRI medications six weeks prior to a workshop"), MAO inhibitors and St. John's Wort as contraindicated. "If you have a heart condition or chronic high blood pressure you cannot be accepted." Notes risk for "those with a history of psychological problems." No ECG or formal questionnaire stated.

• SpiritQuest Shamanic Sanctuary · Rio Momon, near Iquitos, Loreto, Peru

  "a detailed written screening questionnaire to help us get acquainted with you and to assure your safety and suitability for our work." "We are selective when it comes to accepting applicants." No MAOI/SSRI or ECG statement found on pages read.

• Takiwasi Center · Tarapoto, San Martin, Peru

  Applicants send a Health Form, Motivation Letter and Registration Form; "Takiwasi's Medical Director, Dr. Jacques Mabit, will review your health form and motivation letter." "Consumption of marijuana or other drugs should be suspended as it is incompatible with the intake of master plants and ayahuasca." Participants starting allopathic or psychotherapeutic drugs after registering must notify the centre. No explicit MAOI/SSRI statement or ECG found on pages read.