{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:38:14Z","timestamp":1793450294083,"version":"4.5.0"},"reference-count":70,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"EU Horizon","award":["2023-510488-36-01"],"award-info":[{"award-number":["2023-510488-36-01"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Classic psychedelics are increasingly studied as potential treatments for different psychiatric disorders. Current research protocols often require patients to discontinue antidepressants (ADs) for at least 2\u2009weeks before psychedelic administration to decrease the risk of serotonin syndrome and limit their effect on efficacy and the acute subjective effects of psychedelics. Moreover, the discontinuation of ADs represents a significant burden to patients that could also worsen their depression status and increase suicidal ideation. Together, this suggests that the general recommendation for AD discontinuation might be unnecessary and even detrimental to the therapeutic efficacy of psychedelics. In this scoping review, we summarise the existing literature on the concomitant use of conventional ADs with classic psychedelics in humans with the aims to assess safety, tolerability, efficacy, and subjective effects. Following PRISMA-ScR guidelines, we searched MEDLINE, Embase, and Scopus databases to retrieve relevant literature from inception to March 3, 2025. Data were systematically charted from included studies. We included 18 studies and found that the concomitant use of ADs and classic psychedelics is generally safe and tolerable, with no increased risk of serotonin syndrome, particularly for psilocybin. Some studies reported significant improvements in depression and other mental health symptoms. While some evidence indicates a potential attenuation of acute subjective psychedelic effects, this was not observed in all studies. Accordingly, we conclude that the use of ADs can be maintained to enhance patient access to psychedelic treatments and avoid the risk of AD discontinuation syndrome. Finally, this review highlights limitations and several knowledge gaps in the current literature that need to be addressed in future randomized double-blind, placebo-controlled trials.<\/jats:p>","DOI":"10.1177\/02698811251368360","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T10:58:32Z","timestamp":1757674712000},"page":"1072-1088","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Concomitant use of antidepressants and classic psychedelics: A scoping review"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-1098","authenticated-orcid":false,"given":"Stephan C.","family":"Tap","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Groningen University Medical Centre, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelan","family":"Thomas","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Touro University California, Vallejo, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"P\u00e1len\u00ed\u010dek","sequence":"additional","affiliation":[{"name":"Psychedelic Research Centre, National Institute of Mental Health, Klecany, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5439-4637","authenticated-orcid":false,"given":"Dea S.","family":"Stenb\u00e6k","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Copenhagen, Denmark"},{"name":"Neurobiology Research Unit, Copenhagen University Hospital, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-3007","authenticated-orcid":false,"given":"Albino J.","family":"Oliveira-Maia","sequence":"additional","affiliation":[{"name":"Champalimaud Research and Clinical Centre, Champalimaud Foundation, Lisbon, Portugal. NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas, NMS, FCM, Universidade NOVA de Lisboa, Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens H.","family":"van Dalfsen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Groningen University Medical Centre, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Schoevers","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Groningen University Medical Centre, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2022.03.004"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13249"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231224217"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2021.1957183"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2024.2368617"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.2487"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.3618"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra073096"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0893-133X(95)00145-4"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0166-4328(96)00102-7"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.1998.10399712"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1021\/acschemneuro.2c00718"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2032994"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.08.027"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.3285"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2022.2079108"},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt19601123"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1394962"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2016.10.005"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811241237870"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-025-02091-6"},{"key":"e_1_3_2_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000370338"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2005.11.016"},{"key":"e_1_3_2_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2206443"},{"key":"e_1_3_2_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-023-01648-7"},{"issue":"3","key":"e_1_3_2_29_1","first-page":"306","article-title":"Blocking of LSD reaction by premedication with Niamid","volume":"7","author":"Grof S","year":"1965","unstructured":"Grof S, Dytrych Z (1965) Blocking of LSD reaction by premedication with Niamid. Activitas nervosa superior 7(3): 306\u2013306.","journal-title":"Activitas nervosa superior"},{"key":"e_1_3_2_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231179910"},{"key":"e_1_3_2_31_1","first-page":"1","article-title":"The psychedelic renaissance in clinical research: A bibliometric analysis of three decades of human studies with classical psychedelics","volume":"54","author":"Hadar A","year":"2022","unstructured":"Hadar A, David J, Shalit N, et al. (2022) The psychedelic renaissance in clinical research: A bibliometric analysis of three decades of human studies with classical psychedelics. Journal of Psychoactive Drugs 54: 1\u201310.","journal-title":"Journal of Psychoactive Drugs"},{"key":"e_1_3_2_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231211219"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881116677852"},{"key":"e_1_3_2_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231200019"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269881108093587"},{"key":"e_1_3_2_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-020-0843-0"},{"key":"e_1_3_2_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.08.046"},{"key":"e_1_3_2_38_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2106356"},{"key":"e_1_3_2_39_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00035"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2018.05.022"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-021-05876-x"},{"key":"e_1_3_2_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2024.10.009"},{"key":"e_1_3_2_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2018.10.107"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-023-01316-5"},{"key":"e_1_3_2_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01661-0"},{"key":"e_1_3_2_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x"},{"key":"e_1_3_2_47_1","doi-asserted-by":"publisher","DOI":"10.1124\/pr.115.011478"},{"issue":"2","key":"e_1_3_2_48_1","first-page":"567","article-title":"The subjective effects of psychedelics may not be necessary for their enduring therapeutic effects","volume":"4","author":"Olson DE","year":"2020","unstructured":"Olson DE (2020) The subjective effects of psychedelics may not be necessary for their enduring therapeutic effects. ACS Pharmacology & Translational Science 4(2): 567\u2013567.","journal-title":"ACS Pharmacology & Translational Science"},{"key":"e_1_3_2_49_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.biochem.1c00812"},{"key":"e_1_3_2_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-020-05464-5"},{"key":"e_1_3_2_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2023.07.011"},{"key":"e_1_3_2_52_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00167"},{"key":"e_1_3_2_53_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03685-9"},{"key":"e_1_3_2_54_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.14530"},{"key":"e_1_3_2_55_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2013.00045"},{"key":"e_1_3_2_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/0024-3205(64)90037-2"},{"key":"e_1_3_2_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2016.05.001"},{"key":"e_1_3_2_58_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20220835"},{"key":"e_1_3_2_59_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00405249"},{"key":"e_1_3_2_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-024-06585-x"},{"key":"e_1_3_2_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-022-06083-y"},{"key":"e_1_3_2_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(24)00333-X"},{"key":"e_1_3_2_63_1","doi-asserted-by":"publisher","DOI":"10.1177\/02698811231154852"},{"issue":"3","key":"e_1_3_2_64_1","first-page":"241","article-title":"Human hallucinogen interactions with drugs affecting serotonergic neurotransmission","volume":"7","author":"Strassman RJ","year":"1992","unstructured":"Strassman RJ (1992) Human hallucinogen interactions with drugs affecting serotonergic neurotransmission. Neuropsychopharmacology 7(3): 241\u2013243.","journal-title":"Neuropsychopharmacology"},{"key":"e_1_3_2_65_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_3_2_66_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.adf0435"},{"issue":"3","key":"e_1_3_2_67_1","first-page":"278","article-title":"Influence of MAO inhibitors on psilocybine induced psychosis","volume":"10","author":"Vojt\u0115chovsk\u00fd M","year":"1968","unstructured":"Vojt\u0115chovsk\u00fd M, Hort V, Safratov\u00e1 V (1968) Influence of MAO inhibitors on psilocybine induced psychosis. Activitas Nervosa Superior 10(3): 278\u2013279.","journal-title":"Activitas Nervosa Superior"},{"key":"e_1_3_2_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101809"},{"key":"e_1_3_2_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/s44159-024-00345-6"},{"key":"e_1_3_2_70_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsptsci.0c00194"},{"key":"e_1_3_2_71_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.5960"}],"container-title":["Journal of Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811251368360","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02698811251368360","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811251368360","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:12:24Z","timestamp":1777507944000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02698811251368360"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,12]]},"references-count":70,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/02698811251368360"],"URL":"https:\/\/doi.org\/10.1177\/02698811251368360","relation":{},"ISSN":["0269-8811","1461-7285"],"issn-type":[{"value":"0269-8811","type":"print"},{"value":"1461-7285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,12]]}}}