Meta Information
ID:psilocybin-therapy
Name:Psilocybin Therapy
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-07-02T07:03:07Z
Model
phase-b-newfiles-claude-opus-4.8
Interactions
Target id:
/intervention/lithium-orotate
Target name:
Lithium
Severity:
major
Interaction type:
contraindication
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Combining lithium with a classic psychedelic like psilocybin is associated with a high rate of seizures and unpredictable neurological effects.
Actionable advice:
Psilocybin should not be combined with lithium; lithium should be discontinued under medical supervision well before any psychedelic session.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Strikingly, 47% of 62 lithium plus psychedelic reports involved seizures... we provisionally conclude that psychedelic use may pose a significant seizure risk for patients on lithium.
Label source:
Nayak et al. (2021), PMID 34348413.
Action type:
avoid
Target id:
/class/maois
Target name:
MAO inhibitors
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
MAO inhibitors block serotonin breakdown and can dangerously potentiate psilocybin, risking serotonin toxicity and hypertensive effects.
Actionable advice:
Psilocybin should not be combined with MAO inhibitors without expert supervision.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
MAOIs raise synaptic serotonin and potentiate serotonergic psychedelics; risk of serotonin toxicity. Mechanistic caution.
Label source:
Class inference
Action type:
avoid
Target id:
/class/serotonergic-agents
Target name:
SSRIs / SNRIs / serotonergic drugs
Severity:
moderate
Interaction type:
adverse
Nature:
relative
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Serotonergic antidepressants can both blunt psilocybin's effects and, in theory, add to serotonergic load.
Actionable advice:
It is important to talk to the supervising clinician about antidepressant timing before psilocybin therapy.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Chronic SSRIs downregulate 5-HT2A receptors (blunting effect) and add serotonergic tone; managed by tapering under supervision. Mechanistic.
Label source:
Class inference
Action type:
monitor
Target id:
/class/antipsychotics
Target name:
Antipsychotics
Severity:
major
Interaction type:
diminishing
Nature:
relative
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Most antipsychotics block the 5-HT2A receptor that psilocybin acts on, negating its effects.
Actionable advice:
Antipsychotics will blunt or abolish psilocybin's effects; not used together in therapy.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
5-HT2A-antagonist antipsychotics block psilocin's primary target. Mechanistic.
Label source:
Class inference
Action type:
informational_none
Target id:
/condition/schizophrenia-psychosis
Target name:
Schizophrenia / psychosis history
Severity:
major
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Psilocybin can trigger or worsen psychosis in people with a personal or family history of psychotic disorders.
Actionable advice:
Psilocybin should be avoided with a personal or strong family history of a psychotic disorder.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Psychedelics can precipitate/worsen psychosis in vulnerable individuals. Well-documented contraindication.
Label source:
Class inference
Action type:
avoid
Target id:
/condition/bipolar-disorder
Target name:
Bipolar disorder
Severity:
major
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Psilocybin can precipitate manic episodes or mood instability in bipolar disorder.
Actionable advice:
Psilocybin should be avoided in bipolar disorder unless in a closely supervised research setting.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Classic psychedelics can precipitate mania in bipolar disorder. Well-documented caution.
Label source:
Class inference
Action type:
avoid