Safety / Tools

Pre-retreat screening checklist

The questions a careful programme asks before anyone takes a psychedelic or ketamine, and why each one matters, from the studies, drug labels and guidelines that raise it. Answer them honestly for yourself first.

Not medical advice, and not a substitute for a doctor's assessment. A yes is a reason for a conversation with a doctor, not a verdict. Sources checked 26 Oct 2026. Taking medication? Check it in the interaction checker.

Heart and blood pressure

Do you have heart disease, an irregular heartbeat, a long QT interval, or a history of heart attack or heart failure?
Ibogaine blocks a cardiac potassium channel and prolonged the QTc past 500 ms in half of one study's patients; the GITA guidelines exclude prolonged QTc, arrhythmias and heart failure. ICEERS says people with serious cardiovascular conditions should not take ayahuasca. (Addiction, 2022; Addiction Biology, 2014; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016; ICEERS, 2018)
Matters for: Ibogaine, Ayahuasca, Psilocybin, MDMA, Ketamine or esketamine
Do you have high blood pressure, or take medicine for it?
Psilocybin typically raises blood pressure and heart rate (NIDA). MDMA raised systolic pressure above 160 mmHg in 33% of 166 healthy study subjects, and the Spravato label says esketamine raises blood pressure at all recommended doses and should be delayed or weighed carefully if pressure is above 140/90. (National Institute on Drug Abuse (NIH); Psychiatry Research, 2024; Journal of Psychopharmacology, Vizeli P, Liechti ME, 2017; Janssen Pharmaceuticals, via DailyMed (US National Library of Medicine), 24 Sep 2026)
Matters for: Psilocybin, MDMA, Ketamine or esketamine, Ayahuasca
Have you ever had an aneurysm, an arteriovenous malformation or bleeding in the brain?
The Spravato label lists aneurysmal vascular disease, arteriovenous malformation and a history of intracerebral haemorrhage as contraindications. (Janssen Pharmaceuticals, via DailyMed (US National Library of Medicine), 24 Sep 2026)
Matters for: Ketamine or esketamine

Mental health

Have you, or a parent, brother or sister, ever had psychosis or schizophrenia?
Research safety guidelines exclude people with a personal or family history of psychotic disorders, and a systematic review advises people with such a history to avoid ayahuasca and other hallucinogens. Oregon bars anyone ever diagnosed with or treated for active psychosis. (Journal of Psychopharmacology, 2008; Therapeutic Advances in Psychopharmacology, 2017; Oregon Health Authority, Public Health Division, 2026; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Psilocybin, Ayahuasca, Ibogaine, Ketamine or esketamine
Have you been diagnosed with bipolar disorder, or had an episode of mania?
In a survey of 541 people with bipolar disorder who had used psilocybin, 32.2% described new or worse symptoms afterwards, mostly mania, sleep problems and anxiety. The GITA guidelines exclude bipolar disorder that has needed hospital care or medication from ibogaine treatment. (Journal of Psychopharmacology, 2023; Therapeutic Advances in Psychopharmacology, 2017; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Psilocybin, Ayahuasca, Ibogaine
Are you having thoughts of harming yourself or someone else?
Oregon rules out a session for anyone with current thoughts of harming themselves or others. In the largest psilocybin trial for treatment-resistant depression, suicidal ideation or behaviour or self-injury occurred in every dose group. If this is you now, call or text 988 in the US. (Oregon Health Authority, Public Health Division, 2026; New England Journal of Medicine, 2022)
Matters for: Psilocybin, Ketamine or esketamine, Ayahuasca, MDMA, Ibogaine

Medicines, alcohol and other drugs

Do you take any prescription medicine, supplement or other drug?
Several combinations are dangerous: SSRIs or other serotonergic drugs with ayahuasca, lithium with psilocybin, MAOIs with MDMA, and many drugs with ibogaine. Stopping a psychiatric medicine is itself risky and should only be done with the prescriber. (Journal of Psychoactive Drugs, 1998; Pharmacopsychiatry, 2021; Forensic Science International, Pilgrim JL, Gerostamoulos D, Woodford N, Drummer OH, 2012; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016; ICEERS, 2018)
Matters for: Ayahuasca, Psilocybin, MDMA, Ketamine or esketamine, Ibogaine
Have you taken lithium in the last 30 days?
Seizures were reported in 47% of 62 online reports of lithium taken with a classic psychedelic, and Oregon's licensed programme bars anyone who has taken lithium in the last 30 days from a session. (Pharmacopsychiatry, 2021; Oregon Health Authority, Public Health Division, 2026)
Matters for: Psilocybin
Do you drink heavily every day, or take benzodiazepines regularly?
Seizures from alcohol and benzodiazepine withdrawal contributed to deaths after ibogaine, and the GITA guidelines warn that stopping either suddenly or within 72 hours before treatment may cause life-threatening seizures. (Journal of Forensic Sciences, 2012; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Ibogaine
Do you use opioids, including methadone or buprenorphine?
The GITA guidelines warn that ibogaine resets opioid tolerance, so using the usual amount afterwards can be an overdose, and that methadone can itself prolong the QT interval. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Ibogaine

Pregnancy and breastfeeding

Are you pregnant, trying to become pregnant, or breastfeeding?
Oregon requires pregnant or breastfeeding clients to be told that the risks of psilocybin are unknown. The Spravato label says it is not recommended in pregnancy or while breastfeeding, and the GITA guidelines list pregnancy as an exclusion for ibogaine. (Oregon Health Authority, Public Health Division, 2026; Janssen Pharmaceuticals, via DailyMed (US National Library of Medicine), 24 Sep 2026; Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Psilocybin, Ketamine or esketamine, Ibogaine

Other conditions

Do you have epilepsy or a history of seizures?
The GITA guidelines list epilepsy as an exclusion for ibogaine and say seizures under ibogaine can trigger lethal heart rhythm problems. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Ibogaine
Do you have liver or kidney disease?
The GITA guidelines exclude patients with liver enzymes more than 2.5 times normal or impaired kidney function, because they may not break ibogaine down properly and could experience toxicity. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)
Matters for: Ibogaine

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Pre-retreat screening checklist

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