Harm Reduction
Contraindication
What is a contraindication?
A contraindication is any condition, factor, or circumstance that serves as a reason to withhold a certain medical treatment, substance, or practice because it could be harmful. In pharmacology, contraindications are categorized as:
- Absolute contraindications: The substance must NOT be used under any circumstances (e.g., psilocybin with lithium)
- Relative contraindications: The substance may be used with caution, weighing risks against potential benefits
Contraindications can be based on existing medical conditions, concurrent medications, pregnancy, family history, or psychological state.
Why it matters for microdosing
Understanding contraindications is one of the most critical aspects of safe microdosing. Key contraindications for psilocybin and other classical psychedelics include:
- Lithium and other mood stabilizers — documented risk of seizures when combined with psychedelics
- SSRIs and SNRIs — can reduce efficacy and, in rare cases, contribute to serotonin syndrome
- Personal or family history of psychosis or schizophrenia — psychedelics may trigger or worsen psychotic episodes
- Severe cardiovascular conditions — psilocybin can temporarily affect heart rate and blood pressure
- Pregnancy and breastfeeding — insufficient safety data
How it works in practice
Before starting any microdosing protocol, you should:
- Review your current medications — especially psychiatric medications, MAOIs, and heart medications
- Assess your mental health history — including family history of psychotic disorders
- Consult a healthcare professional — ideally one familiar with psychedelic medicine
- Research interactions — use reliable pharmacological resources, not just anecdotal reports
What to watch out for
- "Natural means safe" fallacy — psilocybin mushrooms are natural, but still have real pharmacological interactions
- Self-discontinuation of prescribed medication — never stop psychiatric medication to microdose without medical guidance
- Incomplete self-assessment — be honest with yourself about your medical and psychological history