Ayahuasca + SSRIs
Ayahuasca + SSRIs: the short answerAyahuasca contains natural MAOIs, so drinking it while on an SSRI (or other serotonergic medication) risks serotonin syndrome — this is the interaction retreat centers screen for most carefully. Anyone combining them who becomes agitated, feverish, and rigid needs emergency care.
Why it’s dangerous
The ayahuasca vine contains harmala alkaloids (harmine, harmaline) that inhibit monoamine oxidase A — the same mechanism as prescription MAOIs. SSRIs block serotonin reuptake, so the brew's DMT plus the SSRI's stored serotonin cannot be cleared normally and serotonin toxicity can develop. Stopping an SSRI suddenly to attend a ceremony also carries its own withdrawal and relapse risks, so any change should be medically supervised.
What happens
- Serotonin syndrome: agitation, confusion, sweating, tremor
- High fever, muscle rigidity, and jerking
- Blood-pressure spikes and dangerous heart rhythms
- Overwhelmingly intense, frightening experiences
Warning signs
- Extreme distress, shaking, and sweating during or after the ceremony
- Hot skin and temperature above ~38.5°C/101°F
- Stiff muscles, twitching, or seizure
What to do
- Call emergency services for fever, rigidity, or severe agitation
- Move the person somewhere cool and calm while waiting
- Never stop an SSRI abruptly just to attend a ceremony — tapering needs medical guidance and takes weeks
- Disclose every medication to facilitators in advance; legitimate centers will turn people away for this combination