Cautions and Warnings
PSILOCYBIN IS NOT FOR EVERYONE
There are many factors to consider before trying this treatment for your migraine disease.
- Psilocybin is illegal in most places.
- Do not use psilocybin if you are pregnant.
- Do not use psilocybin if you suffer from or are prone to some types of mental illness.
- Psilocybin may interact with other medications you are taking.
- What can I expect when I take psilocybin?
The fact that PSILOCYBIN IS ILLEGAL in most places should be considered prior to deciding to use them as a treatment.
Hallucinogenic tryptamines are currently illegal in most places. However the law on these substances are rapidly changing. In many places state and local laws are not in line with federal laws regarding these substances. Please learn the laws that impact your jurisdiction and circumstances and consider risks associated before trying these treatments.
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Do not use hallucinogenic tryptamines if you are pregnant; they can cause miscarriage.
Do not take hallucinogenic tryptamines if you are pregnant or think you might be pregnant.
Do not use hallucinogenic tryptamines if you suffer from or are prone to some types of mental illness.
People diagnosed in the past or present with a psychotic disorder, or people with biological parents or siblings diagnosed with a psychotic disorder should not take psychedelics, including LSD, psilocybin, DMT and LSA. Psychotic disorders include schizophrenia, delusional disorder, affective (mood-related) psychosis and others. Psychedelics may exacerbate symptoms of psychosis or trigger psychosis in people who were psychotic in the past, or with immediate family members who were or are psychotic.Taking psilocybin during or immediately after a period of emotional upheaval, such as a relationship breakup or the death of a loved one, may intensify negative emotions, even to a proportion that feels “out of control.”Psilocybin should only be taken when one feels confident and secure in his or her ability to handle a psychedelic experience and is confident in the stability of one’s mind set.
Psilocybin may interact with other medications.
Every doctor, every pharmacist, will warn about drug interactions…some chemicals simply do not play well with others in the body. Sometimes, one drug will block the actions of another. Sometimes, one drug will strengthen or change the actions of another, or the two together will cause something else entirely to happen.The bad news for people with headache disorders: many medications commonly used to treat these disorders will block the effectiveness of tryptamines.There are other drugs and substances that make the tryptamines work too well…that is, they enhance the psychedelic side effects of tryptamines, and make for some unwanted surprises.Based on the reports of people that have used these treatments and expectations based on research and theory, there is a list of drugs likely to interfere with the treatment.Experience has shown this treatment works best when drugs that interfere are avoided for long enough to be cleared from the body. We call this period “detox,” short for “detoxification,” though technically, this is not the proper term. Many use some of these drugs for other conditions, and should talk with their doctors before stopping or changing any medications; some headache medications must be withdrawn from slowly with a prescribed schedule so, again, see your doctor first.Any medication change should only be done under the direct supervision of your health care provider.
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SURE BLOCKERS (Medications that may potentially block psilocybin effectiveness)
Perhaps the most common culprits for failure are the triptans, since they unfortunately are the most popular abortive treatments for migraine attacks. Sumatriptan (Imitrex) can stop an attack quickly, and it’s possible it foils the tryptamine treatment more often than any other blocker. Other triptans are used less often, and there are fewer experiences, but for the sake of caution, these should also be avoided.
- Sumatriptan (Imitrex®)
- Zolmatriptan (Zomig®)
- Rizatriptan (Maxalt®)
- Naratriptan (Amerge®)
- Frovatriptan (Frova®)
- Almotriptan (Axert®)
- Eletriptan (Relpax®)
Anti-convulsants (Anti-seizure medications)
These medications work on different receptors from tryptamines, but there is strong evidence that they are interconnected and that these medications can block the effects of psilocybin.
- Topiramate (Topamax®)
- Sodium valproate (Depakote®)
- Carbamazepine (Tegretol®)
- Gabapentin (Neurontin®)
- Pregabalin (Lyrica®)
- Zonisamide (Zonegran®)
The molecules of these substances are very similar in shape to the tryptamines. This means they fill the same neuroreceptors as tryptamines, and interfere with this method. These include but are not:
- Dihydroergotamine (DHE) (nasal sprays [Migranal®] and injections)
- Methysergide (Sansert®) (unavailable at this time)
- Ergotamine (Ergomar®)
Selective serotonin re-uptake inhibitors (SSRIs)
SSRIs, or selective serotonin re-uptake inhibitors, widely used to treat mood and other psychological disorders may be blockers, as they are involved with serotonin. The SSRIs include:
- Fluoxetine (Prozac®)
- Citalopram (Celexa®)
- Escitalopram (Lexapro®)
- Paroxetine (Paxil®)
- Sertraline (Zoloft®)
Selective serotonin and norepinephrine re-uptake inhibitors (SNRIs)
- Venlafaxin (Effexor®)
- Desvenlafaxin (Pristiq®)
- Duloxetine (Cymbalta®)
- Amitriptyline (Elavil®)
- Imipramine (Tofranil®)
- Nortriptyline (Pamelor®)
ENHANCERS (Medications that may increase effects of psilocybin)
There are some medications that can increase the psychedelic effects of psilocybin. These should be avoided if at all possible. Not only will the resulting effects be impossible to know beforehand but it will be very difficult to determine the best dose for you in the future. It is not a way to use less medicine. It’s a way to not know how much medicine will work for you in the future.
It is very difficult to assess Lithium’s interaction with psilocybin. Lithium can either block the actions of psilocybin or can increase the effects. Much depends upon how long a person has been on lithium and at what dosage. Each person and situation is different so there is no real accurate way of knowing how each individual may react.
Anecdotal reports suggest that lithium can greatly potentiate the effects of LSD or mushrooms, and that it can produce very unpleasant feelings.
The combination of lithium and tryptamines may even produce episodes that seem like, and perhaps are, epileptic seizures. If people are taking lithium for treating migraine and it is not working, they may want to talk with their doctor about not taking it any more before trying mushrooms or LSD. If people are taking lithium for bipolar affective disorder, they probably should continue taking lithium, and they should avoid taking psilocybin for migraine.
Monoamine oxidase inhibitors (MAOIs) are prescribed for depression and sometimes other conditions. They can block the action of enzymes that can break down some tryptamines, and as such may act to intensify the action of a given dose of tryptamine, especially when first taking tryptamines. However, after continued use (as perhaps after a month or more), MAOIs will tend to reduce the psychedelic effects of mushrooms and LSD. It is not known if long term use of MAOIs will interfere with tryptamine treatment of headache disorders, but it is possible.
- Selegiline (Zelapar®)
- Isocarboxazid (Marplan®)
- Tranylcypromine (Parnate®)
- Phenelzine (Nardil®)
- Selegiline (Eldepryl®, Emsam®)
SUSPECTED BLOCKERS (anecdotes support that these will block the effects of psilocybin)
Steroids can be very effective at completely stopping migraine attacks while they are being used.
There are many reports that corticosteroids will block psilocybin. Depending on the steroid and its delivery system (pills, injections,patches,creams etc) it is necessary to be off these drugs for a minimum of 5 days to give the treatment any chance of working.
- Prednisolone (Orapred®)
- Methylprednisolone (Medrol®)
Verapamil and other calcium channel blockers (Calcium channel blockers)
Verapamil is a blood-pressure drug often prescribed for the long-term, preventive treatment of migraine. Most reports seem to indicate verapamil and other calcium channel blockers will interfere with the treatment, though a few say they successfully used tryptamines while on verapamil, and some reports seem to indicate that it impeded but didn’t completely block the treatment. Verapamil is known by the brand names Isoptin, Verelan, Verelan PM, Calan, Bosoptin and Covera-HS.
Opiates and Opioids
Opiates usually have little to no effect on migraines for most, but some say they work for them. Regardless, opiate and opioid painkillers seem to interfere with migraine treatment with hallucinogenic tryptamines. There are many in use; here is an incomplete list:
- Pethidine (Demerol®)
- Oxycodone (Roxicodone®, Percocet®, Oxcontin®)
- Hydrocodone (Vicodin®)
- Fentanyl (Duragesic®, Subsys®, Actiq®)
- Buprenorphine (Suboxone®)
- Tramadol (Ultram®, Ultracet®)
- Hydromorphone (Dilaudid®)
NON-BLOCKERS (Medications and supplements that may not block psilocybin effectiveness)
There are substances which will probably not interfere with the actions of psilocybin:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Aspirin (ASA)
- Ibuprofen (Advil)
- Paracetamol/Acetaminophen (Tylenol)
There are a lot of other medications that may not block the action of psilocybin, but it would be impossible for us to list them all. Please talk to your doctor before trying this treatment to ensure it is appropriate for your medical situation.
What can I expect when I take psilocybin?
The experience (The psilocybin experience) or What happens after ingestion
When people think of tryptamines such as psilocybin or LSD, they think of the psychedelic trip as the main effect of the substance. Since we are here to talk about treatments for migraines, we will consider migraine relief as the main, medicinal effect; the psychedelic experience we’ll call side effects. These side effects can be significant, and you should be prepared.
The goal is to take an amount that will treat migraines without causing extreme side effects. But psilocybin, LSA and the other tryptamines are powerful psychoactive drugs, and it’s wise to be prepared for a psychedelic experience. It can be hard to know how potent a natural substance is and it can be hard to predict the effects from taking a given amount. It is better to prepare for a trip and not take one than it is to suddenly blast off without a seat belt.
There are two important factors: set and setting. Set is the mindset, mood and expectations of the person taking the substance. Setting is the physical environment and situation in which the substance is taken.
Generally, the psychedelic effects can be expected to be felt 20 minutes to two hours after ingestion. Once ingested, patience is important. A common mistake is to think the mushrooms are having too little effect or the dose was too small; more mushrooms are taken only to discover the effects were merely delayed, and the dose and its effects are more than wanted or expected.
Of course, the dose should be taken at a time and place that will provide the best set and setting for a psychedelic experience. Depending on the dose, the psychedelic effects will continue for two to six hours, ramping up slowly, and decreasing even more slowly.
Psilocybin should be taken only in a place where one feels secure and with people they can trust.
Set (Setting yourself up for success with psilocybin dosing)
This is about mental preparation and knowledge. If you feel confident in yourself and secure in your knowledge of the effects of the drug, you know the effects will end, there is no physical danger, and no lasting damage.
You will know that what your senses are telling you and what your mind is experiencing is not you at all and is not permanent, but only a drug that will wear off soon. We fear the unknown the most, and knowing what to expect can ease your mind.
There are times – certain sets of mind, when psychedelics should not be taken, times of emotional stress, grief or insecurity.
A safe and familiar setting is best. You want as few surprises as possible. Arrange things so there is nothing important to be done, no authority figures to meet, no strangers to worry about. Many people like to dose on weekends, when there is plenty of time and privacy for the experience.
For most people, their own living room will be ideal – comfortable, safe and familiar. All your favorite toys are there, there’s food and drink in the kitchen and you know where the bathroom is.
Have a sober spouse or trusted friend there with you to run interference and help keep things calm.
Enjoy yourself. Get out your favorite music, or an upbeat movie you like. Settle into your favorite chair. Smile at your friends. Notice how sounds and sights become more vibrant and interesting, somehow. Music is richer and sweeter, colors are brighter. And jokes of any age or quality are downright hilarious.
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