The Good, The Bad, and the Soul: Drug Interactions and Ayahuasca with Ben Malcolm
Psychedelics are known for having relatively low physiological risk, compared to most other powerful substances. But risk is always present, and some psychedelics have a greater risk from certain drug combinations – Ben Malcolm talks us through the topic.
Ben Malcolm, known as Spirit Pharmacist, is a Board Certified Psychiatric Pharmacist who provides online education and consultation services that focus on how medications interact with psychedelics.
In this interview, which you can find in full below, Ben gives Lorna a thorough yet concise presentation on this under-researched yet vital area of interest for the many people wishing to drink ayahuasca but worrying about the pharmaceuticals they are taking.
Ben’s entry into the world of psychedelic pharmacology began at an ayahuasca conference, when Ben realized that people were rarely speaking about the spiritual side of pharmacology. He started his website, Spirit Pharmacist, to raise awareness of the spiritual dimension of drugs.
While some substances are more likely to produce spiritual experiences than others, Ben explains that any experience on a substance could be spiritual, just as any sober moment in life has the potential to be spiritual.
When it comes to drug interactions and ayahuasca, Ben points out that ayahuasca does have more risk of harm than the classic psychedelics like LSD and psilocybin, due to the strength of the monoamine oxidase inhibitors (MAOIs) in the brew. Therefore it’s more important to be wary of what medications you’re taking.
The main risk with ayahuasca, according to Ben, is serotonin syndrome. This is when serotonin levels in your body become so high that it starts to damage your organs and cause serious physiological changes. It can lead to hospitalization and even death in rare circumstances.
Ayahuasca contains powerful MAOIs that stop serotonin being broken down by the body, meaning that serotonin levels can rise quite high. When combined with other medications similar to the MAOIs in ayahuasca, serotonin levels can theoretically reach dangerous levels.
Ben suggests that the evidence so far points towards certain safe behaviors: such as screening ceremony participants for prior health issues, planning ceremonies well, and avoiding mixing different substances and medications where possible.
It’s true that many people may combine medications with ayahuasca and not have a bad time – but Ben says that doesn’t mean there isn’t risk, and when the interaction does become dangerous, it can be very serious.
As for the question of what is safe and what isn’t in combination with ayahuasca, Ben states that anything that boosts serotonin, dopamine or norepinephrine levels in the brain has the potential to interact dangerously with ayahuasca. When asking yourself if you should combine a substance with ayahuasca, Ben suggests considering what you want from the experience, and remembering that ayahuasca can offer plenty of spiritual power on its own.
If you decide to wean off a medication before an ayahuasca ceremony, Ben offers this helpful technique: look up the half-life of your medication, and then stop taking it five times that length of time before your ceremony. So if your medication’s half-life is 12 hours, you need to stop taking it 5×12=60 hours before your ceremony to make sure there is barely any left in your body.
An important caveat to weaning yourself off medications is that certain medications may require very specific weaning regimens. Especially if you’re on antidepressants – many of these drugs require a long and careful weaning process, otherwise you could experience severe withdrawal effects including suicidal ideation.
If you’re on antidepressants, make sure to check with your healthcare provider before weaning off them, and weigh up the relative risks of taking ayahuasca while on your medications against the risks of weaning off a medication.
When it comes to microdosing ayahuasca, Ben suggests caution despite the low doses – since we don’t yet know the level at which MAOI medications might interact dangerously with low doses of ayahuasca vine.
About Ben Malcolm
Board Certified Psychiatric Pharmacist Dr. Ben Malcolm teaches psychopharmacology and clinical psychiatric pharmacy, practices as a clinical specialist in psychiatric pharmacy, and performs clinical research on psychoactive drugs. Ben envisions a society in which psychedelics are available in a number of safe and supported settings for purposes of psychospiritual well-being, personal development, ceremonial sacraments, and treatment of mental illness. He provides consultation and education-based services focused on the interface of medication to treat mental illness and psychedelics. He also supports persons in tapering mental health medications, facilitators in screening processes, and healing centers in design of protocols that optimize safety and minimize risks of psychedelic use.
Where to Find Ben
Get the Free Gift Antidepressant and Psychedelic Drug Interaction Chart – An up-to-date and evidence-based chart detailing the drug interaction potential and minimum discontinuation times for safe and beneficial psychedelic experiences. Download here.
Special Offer! Get 20% off Ben’s Psychedelic School course with the discount code “ENTHEO20” at checkout.
