Si vous êtes au Canada ou tout autre pays où l'usage des psychédéliques est dépénalisé, quand vous décidez de voyager en prenant un produit psychoactif, la première question à se poser c'est de savoir si ce produit est compatible avec les médicaments que vous prenez quotidiennement ou que vous avez pu prendre au cours des dernières semaines. La réponse peut être vitale.
Pourtant, ne connaissant ni la composition exacte ni la pureté du produit absorbé, pas simple à savoir. De plus, dans un contexte de prohibition et de prolifération des produits, les interactions entre molécules sont peu étudiée, mal connues. Enfin, pour corser le tout, nous avons chacun un métabolismes qui nous est propre.
Voici donc quelques informations que j'ai pu trouver au fil des forums afin de réduire les risques et d'anticiper les problèmes. Je n'en garantis pas l'exactitude. Je ne suis pas pharmacien, je n'ai pas tout essayé. Soyez prudents, en cas de doute, ne prenez aucun risque, n'hésitez pas à vous renseigner auprès d'un médecin ou pharmacien.
Sur smartphone, pour une mise en page correcte des tableaux, affichez la version web du site, ou lire en mode paysage.
Interaction de médicaments sur des psychédéliques.
Ci dessous un extrait d'un tableau provenant de l'hopital de Bâle, qui pratique en Suisse des thérapies psychédéliques depuis quelques années déjà. Sources
Version 6, 29.11.2023, University Hospital Basel, Prof. Matthias E. Liechti & Dr. Yasmin Schmid
PRODUCT | MDMA | LSD | PSILOCYBIN |
Sex | Dosing dependent on sex: • women: xxx mg • men: xxx+25% mg • or use weight adjustment) | No adjustment by sex | No adjustment by sex |
Age | Adjust in elderly persons: • > 75 yr: xxx mg | No adjustment to age | No adjustment to age |
2D6 poor metabolizer / strong CYP2D6 inhibitor | Reduce dose by 0-25% | Reduce dose by 0-25% | NA |
Problems urinating | Tamsulosin on treatment day, NA | Tamsulosin on treatment day, NA | Tamsulosin on treatment day, NA |
Problems sleeping before session | Benzodiazepine/analogs, daridorexant, diphenhydramine | Benzodiazepine/analogs, daridorexant, diphenhydramine | Benzodiazepine/analogs, daridorexant, diphenhydramine |
Nausea, Vomiting | Domperidone (e.g. Motilium® 10mg max. 30mg / 24h), AVOID metoclopramide | Domperidone (Motilium ®), AVOID metoclopramide | Domperidone (Motilium ®)), AVOID metoclopramide |
Migraine | 1. Domperidone, Coffee, Paracetamol, NSAR 2. Triptan (if 1 is not working) | 1. Domperidone, Coffee, Paracetamol, NSAR 2. Triptan (if 1 is not working) | 1. Domperidone, Coffee, Paracetamol, NSAR 2. Triptan (if 1 is not working) |
SSRIs, SNRIs | - Pause for 4 elimination half-lives; 5-7 days for most SSRIs, 2 weeks for fluoxetine (otherwise reduced effect of MDMA but no adverse effects) | -Maintain, optional on treatment day, NA | - Maintain, optional on treatment day |
Mirtazapine | Maintain | Pause 5-7 days before, NA | Pause 5-7 days before, NA |
Trazodone | Maintain | Pause 1-2 days, NA | Pause 1-2 days, NA |
Bupropion | -Maintain, reduces cardiostimulation and prolongs effect of MDMA (bupropion is inhibiting CYP2D6) -Consider MDMA dose reduction (see above) | -Maintain, NA -Consider LSD dose reduction since bupropion also acts as a CYP2D6 inhibitor (see above, NA) | Maintain, NA |
MAOI | Stop 14 days before | NA | NA |
Lithium | maintain or pause 3-7 days, NA | -maintain or pause 3-7 days, NA -possibly increased risk of seizures | -maintain or pause 3-7 days, NA -possibly increased risk of seizures |
Antipsychotics | May pause 2-5 days in particular D2 antagonists | Pause at least 7 days (reduced effect) | Pause at least 7 days (reduced overall effect but potentially more anxiety/bad drug effects with D2 antagonists) |
Pregabalin | Maintain, NA | Maintain, NA | Maintain, NA |
Antiepileptics | Maintain, NA | Maintain, NA | Maintain, NA |
Opioids | Maintain | Maintain | Maintain |
Benzodiazepines | Maintain, if possible reduce dose | Maintain, if possible reduce dose | Maintain, if possible reduce dose |
Disulfiram | Pause for 3 days | Pause for 3 days | Pause for 3 days |
Naltrexone | Pause for 1-3 days | Pause for 1-3 days | Pause for 1-3 days |
Methylphenidate | Pause on treatment day | Pause on treatment day | Pause on treatment day |
(Lis)dexamphetamine | Pause on treatment day | Pause on treatment day | Pause on treatment day |
Client’s Therapy | MDMA | Tryptamines and lysergamines (psilocybin, N,N-DMT, 5-MEO, LSD) | Ayahuasca (contains MAOI) |
SSRI serotonin reuptake inhibitor ·citalopram (Celexa) ·fluoxetine (Prozac) ·paroxetine (Paxil) ·sertraline (Zoloft) SNRI serotonin norepinephrine reuptake inhibitor ·desvenlafaxine(Pristiq) ·duloxetine (Cymbalta) ·venlafaxine (Effexor) | Interaction: muted effect1-5 Approach may range from a short break in therapy to a full taper and wash-out | Interaction with LSD: muted effect1 Interaction with psilocybin: muted effect6 Approach may range from a short break in therapy to a full taper and wash-out N,N-DMT and DMT no reported interactions | CONTRAINDICATED Interaction: risk of serotonin syndrome ranging from mild confusion to death15 Clear from system for at least 2 weeks (fluoxetine longer) |
DNRI dopamine norepinephrine reuptake inhibitor ·bupropion (Wellbutrin) | MDMA Pharmacokinetic Interaction: increased subjective effects and longer duration7 | No theoretical risk | Interaction: increased risk of side effects including hypertensive reactions16; clear from system for at least 2 weeks |
St John’s Wort Weak monoamine oxidase-A and -B inhibitor, equal serotonin, dopamine and norepinephrine inhibitor | Insufficient evidence; potential risk of serotonin syndrome | Insufficient evidence; potential risk may range from muted effect to serotonin syndrome | Interaction: risk of serotonin syndrome; clear from system for at least 2 weeks |
TCA tricyclic antidepressant ·Amitriptyline (Elavil) ·Clomipramine (Anafranil) ·Desipramine (Norpramin) ·Imipramine (Tofranil) ·Nortriptyline (Pamelor) | Interaction: muted effect1 Approach may range from a short break in therapy to a full taper and wash-out | LSD interaction: increased subjective effects of LSD10 Unknown interaction with other tryptamines but may range from muted effect to increased subjective effects Approach may range from a short break in therapy to a full taper and wash-out | Interaction: risk of serotonin syndrome with clomipramine and imipramine17 Taper and clear clomipramine and imipramine from system for at least 2 weeks prior to therapy |
MAO-A Inhibitors monoamine oxidase inhibitor ·Phenelzine (Nardil) ·Isocarboxazid (Parnate) ·Tranylcypromine (Marplan) ·Moclobemide ·Linezolid (Zyvox), antibiotic | CONTRAINDICATED Interaction: possible serotonin syndrome, hypertensive crisis and death8,9 Taper and clear MAO-A from system for at least 2 weeks prior to therapy | 5-MEO-DMT interaction: risk of serotonin syndrome11, seizure2 or increased effects and prolonged exposure11 Taper and clear MAO-A from system for at least 2 weeks prior to therapy LSD interaction: may result in muted effect of LSD10 Psilocybin and N,N-DMT: prolonged and intensified effect | Interaction: risk of serotonin syndrome and hypertensive episodes Taper and clear MAO-A from system for at least 2 weeks prior to therapy |
Lithium | Interaction: possible seizure; both MDMA and lithium decrease seizure threshold Clear lithium from system for at least 5 days prior to therapy | LSD interaction: Multiple reports of seizure and hospitalizations13,14 psilocybin interaction: Increased effect of lithium10 Clear lithium from system for at least 5 days prior to therapy | Interaction: risk of serotonin syndrome Clear lithium from system for at least 5 days prior to therapy |
Interactions entre drogues et certains traitements. Le tableau de Tripsit.
https://archive.org/download/1551215518285-0/1551215518285-0.png
Un résumé du tableau de Tripsit, en français, produit par le Corevih
