Antidepressants and Psychedelics with Clinical Pharmacist Ben Malcolm, PharmD


Dr. Ben Malcolm completed a Doctorate in Pharmacy and a Masters in Public Health, prior to post-graduate training and board-certification in psychiatric pharmacy. He currently holds a position in academia teaching psychiatric pharmacy, as well as providing consulting services for those seeking information about psychedelics at SpiritPharmacist.com.

In this episode, Dr. Malcolm discusses how antidepressants react with MDMA, psilocybin, DMT, 5-MeO-DMT, ayahuasca and ketamine. He also explains the risk profiles for interactions between psychedelics and medications such as benzodiazepines, sleep medication, antipsychotics and lithium.

In This Episode

• Why combining antidepressants with ayahuasca has a high physical risk profile
• How antidepressants can diminish the effect of MDMA and why it is advised to not take a high dose of MDMA to attempt to workaround that effect
• What serotonin syndrome is and how to avoid it
• How one’s use of antipsychotics or lithium may be an indicator of possible contraindicated condition to psychedelic use


“[A]ntidepressants like the SSRIs or SNRIs, in the long-term, create changes that makes the brain more resistant to using a psychedelic like MDMA” [9:14]

“Most available and most antidepressant-friendly is […] ketamine” [20:00]

“With microdoses, you’re talking about using very very small doses, and you’re probably not talking about using something like MDMA that depletes serotonin. You’re probably talking about using psilocybin or LSD, and so for those, the drugs have great physical safety profiles in very very large doses. So if you’re thinking if there’s going to be some horrible interaction risk that kind of pops out of the closet with psilocybin or LSD with my antidepressant? Probably not.” [46:00]


* The Psychedelic Medicine Podcast has allowed the Psychedelic Medicine Association to post episodes as an educational resource, and in return the PMA is hosting the podcast show notes.