Help! Ayahuasca Ceremony very soon: Seeking advice on medication interactions.

[jaiefluke]

Hello, I have an Ayahuasca retreat coming up in less than a month, but have some concerns. They only asked if I was taking any antidepressants which I got off of years ago (cymbalta, which was its own hell), I proudly stated that I was not. They told me that was all for now and they'd contact me closer to the ceremony.

Now upon further researching I'm finding that it may not be safe to be on Suboxone and Aya? I also take a low dose of Clonazepam and 30 mg IR Adderall. I can just not take my Adderall without any issue, but I can't just cold turkey my Suboxone (16 mg daily for 9+ YRS, only recently got serious about getting off it I've gone down from 24 mg had a lengthy/heavy fentanyl and heroin addiction), and Clonazepam.
It's a low dose of the Clonazepam for serious panic disorder, PTSD, and some crippling phobias. I don't feel anything from it it just keeps me from breaking down. I haven't raised my dose at all since starting, have actually self lowered the dose.

I could half my sub dose and micro dose the Clonazepam for the 2 days and live. I could also take them both earlier in the morning so there's less in my system, but I'm looking for more real life experiences and knowledge in regards to the specific chemical interactions or lack thereof.
Honestly I'm heartbroken, because while I was ready for a terrible trip if that's what it would take for me to face my trauma, I don't want to risk anything bad happening. I'm not sure why they only asked about antidepressants if other things have interactions with it? I found an older post on here and tried to comment on it, but it doesn't have updates or actual experiences with combining these. I'm already planning to not take my Adderall to prevent serotonin syndrome.

This trip was something I really felt like I needed since I had an LSD trip that helped me to feel completely normal for almost a whole year, (it was a God dose I'm not comfortable recreating that somehow helped my chronic pain, immune flares, anxiety, & PTSD, I'm assuming due to ego desolation. I tried Ketamine infusions, they helped very temporarily, and at home Ketamine. I took the 1/2 acclimation dose and it didn't work out for me. If anyone has any information, or experiences I would REALLY appreciate it. I'm looking all over for some insight. Thank you!

 

[iom]

Hello @jaiefluke and welcome to Bluelight!

I think you'll be fine with your regular amounts of Suboxone/buprenorphine and clonezepam and that taking less than your normal doses will increase risk. Skipping the Adderall may be a good idea though.

The risk with Adderall isn't really serotonin syndrome but adrenergic crisis, and there are a lot of variables involved including when you take the Adderall, what you eat that day, what the brew actually contains, and what kind of dose you get.

Anti-depressant drugs probably produce the most common and serious reactions, hence the retreat organizers are screening for them. I'm not sure how to judge the retreat organizers for their lack of interest in other drug types that might interact, but to be fair the reversible and selective MAOIs in ayahuasca are pretty forgiving most of the time.

By contrast, most pharmaceutical MAOIs are irreversible and non-selective. Reversible means that the enzyme action is only blocked temporarily, for a few hours rather than permanently. (The body must regenerate the MAO enzyme over a period of weeks.) Selective means that ayahuasca alkaloids preferentially bind to MAO-A over MAO-B, so as long as the dose isn't too high, MAO-B will still be active and an adrenergic crisis is unlikely to occur. Hopefully that's clear?

I do suggest caution regarding your retreat because the quality and safety of these events tends to vary a lot, and when you are deep in the jungle in a foreign country, you are in a vulnerable position. I hope you have done what you can to vet the people behind the retreat to avoid unwanted or dangerous encounters. Tragically these occur with disturbing frequency given how widespread interest in ayahuasca tourism is today and how much money gets involved. Be safe!

 

[jaiefluke]

Thank you so much this is very helpful information. I appreciate you taking the time to explain all that in such great detail.
It is an ceremony that my older sister who is very risk avoidant, and also somewhat against drugs in general attended and strongly recommended for my struggles.
I read about people saying they had bad trips, or someone died, but I also figure there are a lot of other factors that go into each individual case, especially like you said unsafe practice, brewing process and strength, as well as other interactions and underlying health issues.
I'm sure there are so many things that cause higher risk of adverse reactions, I just wanted to mitigate them as much as possible.
That makes me feel better, and not so scared to go into the trip. Especially since being fearful could impact the overall experience.
I'm already prepared for whatever the experience has to offer in terms of lessons or insight, even if it's unpleasant, just really want to do my due diligence
I researched more with the information you provided, and it really helped make a lot more sense of how it actually interacts with the medications. I feel like there's so much conflicting info out there so I really appreciate the breakdown.

Thank you so much!!!