ANTIDEPRESSANTS OR MICRODOSING?

HOW DOES PSILOCYBIN WORK AGAINST DEPRESSION?

Various international studies show that psilocybin is a natural antidepressant and anxiolytic, and could potentially alleviate other psychiatric conditions. It appears to work by promoting neuroplasticity (the brain's ability to create new connections between neurons) freeing users from long-standing thought patterns that have been deeply rooted.

DEPRESSION

A depressed brain fosters rigid thought patterns that impact well-being. This can be seen as a “landscape” with deep pits that make it difficult for patients to “move between” different thoughts and perspectives.

PSILOCYBE

Therapy with psilocybin “flattens” the brain's landscape and “opens up” the rigidity of depressed areas to allow new thoughts and perspectives to emerge.

POST-TREATMENT

After treatment, a flatter landscape makes it easier for patients to experience healthier flexibility and diversity in their thought patterns.

(Images by Richard Daws, Kings College London)

WHAT DO ANTIDEPRESSANTS DO?

Pharmacological antidepressants can alleviate symptoms of moderate to severe depression. Unlike psilocybin, many antidepressants are addictive and discontinuing them results in severe withdrawal symptoms.

SNRIs (serotonin and norepinephrine reuptake inhibitors) help alleviate symptoms of depression, such as irritability and sadness, but some are also used for anxiety disorders and nerve pain.

SSRIs (selective serotonin reuptake inhibitors) are the most commonly prescribed antidepressants, they are relatively safe and generally cause fewer side effects than other types.

IS IT SAFE TO COMBINE THEM?

Both SSRIs/SNRIs and psilocybin act on serotonin receptors. It is common practice to tell patients to stop taking antidepressants before starting psychedelic therapy. But is it necessary? Various clinical trials suggest that it is not, and that psilocybin can be safe and beneficial for those already taking antidepressants. The only exception is lithium, this should NOT be combined with psilocybin.

Although antidepressants do not interfere with the potential therapeutic effect of psilocybin, SSRIs/SNRIs appear to weaken the effects of psilocybin compared to a non-serotonergic antidepressant. This dampening effect can last up to 3 months after discontinuation of the antidepressant.

CAN THEY BE REPLACED?

There is little clinical evidence on this matter, but there is an abundance of empirical data collected around the world. People often report that after a few months of microdosing, they can easily reduce to lower doses of their pharmaceutical antidepressants and anxiolytics, or stop them altogether.

An examination of a large international sample identified lower levels of anxiety and depression among the population using microdoses of psilocybin compared to control groups. Future research continues to determine the impact of this practice on aspects of cognition, mood, and well-being that microdosing can provide to its users.

If you are looking to stop your antidepressant, you can gradually decrease the dose while using microdosing with guidance from your psychiatrist.

PSILOCYBIN vs ANTIDEPRESSANTS

More clinical evidence is needed to accurately compare psilocybin with established antidepressants. However, a study from the Imperial College London compared psilocybin against Escitalopram SSRI and found that psilocybin yielded similar and even more favorable results than Escitalopram.