Medical guidelines

For the mass majority of people Ayahuasca is completely safe and very beneficial, there are rare occasions when it’s not so safe due to certain medical conditions and pharmaceutical medications. It is necessary that you agree to disclose, in confidence, any known medical conditions and/or use of any medication, at the time of booking. Certain drugs and medications have been found to be un-compatible with Ayahuasca. It is essential to stop taking the following substances at least 4 weeks prior to a retreat.  This will give your system sufficient time to remove them from your system, before the start date. Please consult your doctor if you are in any doubt: you certainly should not suddenly stop taking prescribed medications (including antidepressants) without consulting your doctor. We at Etnikas take your health and safety very seriously and we want to support you in your healing process. If during the booking process we decide it’s not safe for you to attend at that time we are more than happy to work with you in the hopes that you can attend another retreat down the road. It’s our deeply held belief that any medical diagnosis can be fully healed by taking one step at a time.

It is not safe to work with Ayahuasca if you take the following medications or have any of the following health conditions: 

• Any medication that contains Monoamine Oxidase Inhibitors (MAOI’s). These medications are known to cause dangerous side effects when taken in conjunction with Ayahuasca. It is critical that you stop taking these drugs and allow plenty of time for your system to be cleared of these substances.

• Any medication which has an effect on the serotonin system, including Selective Serotonin Reuptake Inhibitors (SSRIs) (i.e. antidepressants such as Wellbutrin, Prozac, Zoloft, Effexor, etc). Combining these medications with Ayahuasca can induce serotonin syndrome – far more severely than with foods containing tryptophan, and with potentially fatal results. We advise you to stop taking SSRI medications six weeks prior to a workshop to allow the system to clear in time; some of these drugs may cause side effects when you stop taking them, and you should allow plenty of time for these to subside. You should not abruptly stop taking them without discussing the matter with your doctor. Please note that the herbal antidepressant St. John’s Wort (Hypericum Perforatum) also must not be taken directly prior to working with Ayahuasca, although the system can clear this in 2 weeks before commencing a workshop.

• Other medications you must suspend taking are decongestants, cold medications, allergy medications, antihistamines, sedatives, tranquillizers, amphetamines (including Adderall), some hypertensive medications, sympathomimetic amines including pseudoephedrine and ephedrine, carbamazipine, methylphemidate (Ritalin), macromerine, phenelanine, tyrosine, tryptophan, asarone/calamus, asthma inhalers and diet pills.

• Although Ayahuasca has not been found to cause psychosis or other psychiatric disturbances, it can be difficult for those with a very extensive history of psychological problems. Please tell us, in confidence, about any history of mental health problems.

• If you have a heart condition or chronic high blood pressure you cannot be accepted on a workshop.

•  It is not safe to drink Ayahuasca when you are pregnant.

• Special note to diabetics: MAOIs may change the amount of insulin or oral anti-diabetic medication that you need. If you are diabetic, unfortunately we are unable to accept you onto the retreat at this time.

These drugs and medications are potentially dangerous with MAOIs:

•       Other MAOIs

•       SSRI’s (any selective serotonin reuptake inhibitor)

•       Antihypertensives (high blood pressure medicine)

•       Appetite suppressants (diet pills)

•       Medicine for asthma, bronchitis, or other breathing problems; antihistamines, medicines for colds, sinus problems, hay fever, or allergies (Actifed DM, Benadryl, Benylin, Chlor-Trimeton, Compoz. These include Bromarest-DM or -DX, Dimetane-DX cough syrup, Dristan Cold & Flu, Phenergan with Dextromethorphan, Robitussin-DM, Vicks formula 44-D several Tylenol cold, cough, and flu preparations, and many others — any drug with DM or Tuss in its name.)

•       CNS (central nervous system) depressants

•       Antipsychotics

•       Barbiturates

•       Alcohol

Illegal or recreational drugs that are very dangerous to combine with MAOIs:

•       Cocaine

•       Amphetamines (meth-, dex-, amphetamine)

•       MDMA (Ecstasy)

•       MDA

•       MDEA

•       PMA

•       Dextromethorphan (DXM)

Illegal or recreational drugs that may be dangerous to combine with MAOIs:

•       Opiates

•       Mescaline (any phenethylapsychoactiverates

Other psychoactive that should not be combined with MAOIs:

•       Kratom

•       Kava

Some specific pharmaceutical drugs that should not be combined with MAOIs (some are mild risks, others serious):

•       Actifed

•       Adderall

•       Alaproclate

•       Albuterol (Proventil, Ventolin)

•       Amantadine hydrochloride (Symmetrel)

•       Amineptine

•       Amitriptaline

•       Amoxapine (Asendin)

•       Atomoxedine

•       Befloxetone

•       Benadryl

•       Benylin

•       Benzedrine

•       Benzphetamine (Didrex)

•       Bicifadine

•       Brasofensine

•       Brofaromine

•       Bupropion (Wellbutrin)

•       Buspirone (BuSpar)

•       Butriptyline

•       Carbamazepine (Tegretol, Epitol

•       Chlorpheniramine

•       Chlor Trimeton

•       Cimoxetone

•       Citalopram

•       Clomipramine (Anafranil)

•       Codeine

•       Cyclobenzaprine (Flexeril)

•       Cyclizine (Marezine)

•       Dapoxotine

•       Desipramine (Pertofrane, Norpramin)

•       Desvenlafaxine

•       Dextroamphetamine (Dexedrine)

•       Dextromethorphan (DXM)

•       Dibenzepin

•       Dienolide kavapyrone desmethoxyyangonin

•       Diethylpropion

•       Disopyramide (Norpace)

•       Disulfiram (Antabuse)

•       Dopamine (Intropin)

•       Dosulepin

•       Doxepin (Sinequan)

•       Duloxetine

•       Emsam

•       Ephedrine

•       Epinephrine (Adrenalin)

•       Escitalopram

•       Femoxitine

•       Fenfluramine (Pondimin)

•       Flavoxate Hydrochloride (Urispas)

•       Fluoxetine (Prozac)

•       Fluvoxamine

•       Furazolidone (Furoxone)

•       Guanethedine

•       Guanadrel (Hylorel)

•       Guanethidine (Ismelin)

•       Hydralazine (Apresoline)

•       5 Hydroxytryptophan

•       Imipramine (Tofranil)

•       Iprindole

•       Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida)

•       Iproclozide

•       Isocarboxazid (Marplan)

•       Isoniazid (Laniazid, Nydrazid)

•       Isoniazid rifampin (Rifamate, Rimactane)

•       Isoproterenol (Isuprel)

•       L dopa (Sinemet)

•       Levodopa (Dopar, Larodopa

•       Linezolid (Zyvox, Zyvoxid)

•       Lithium (Eskalith)

•       Lofepramine

•       Loratadine (Claritin)

•       Maprotiline (Ludiomil)

•       Medifoxamine

•       Melitracen

•       Meperidine (Demerol)

•       Metaproterenol (Alupent, Metaprel)

•       Metaraminol (Aramine)

•       Methamphetamine (Desoxyn)

•       Methyldopa (Aidomet)

•       Methylphenidate (Ritalin)

•       Mianserin

•       Milnacipran

•       Minaprine

•       Mirtazapine (Remeron)

•       Moclobemide

•       Montelukast (Singulair)

•       Nefazodone

•       Nialamide

•       Nisoxetine

•       Nomifensine

•       Norepinephrine (Levophed)

•       Nortriptyline (Aventyl)

•       Oxybutynin chloride (Ditropan)

•       Oxymetazoline (Afrin)

•       Orphenadrine (Norflex)

•       Pargyline (Eutonyl)

•       Parnate

•       Paroxetine (Paxil)

•       Pemoline (Cylert)

•       Percocet

•       Pethedine (Demerol)

•       Phendimetrazine (Plegiline)

•       Phenergen

•       Phenmetrazine

•       Phentermine

•       Phenylephrine (Dimetane, Dristan decongestant, Neo Synephrine)

•       Phenylpropanolamine (in many cold medicines)

•       Phenelzine (Nardil)

•       Procarbazine (Matulane)

•       Procainamide (Pronestyl)

•       Protriptyline (Vivactil)

•       Pseudoephedrine

•       Oxymetazoline (Afrin)

•       Quinidine (Quinidex)

•       Rasagiline (Azilect)

•       Reboxetine

•       Reserpine (Serpasil)

•       Risperidone

•       Salbutemol

•       Salmeterol

•       Selegiline (Eldepryl)

•       Sertraline (Zoloft)

•       Sibutramine

•       Sumatriptan (Imitrex)

•       Terfenadine (Seldane D)

•       Tegretol

•       Temaril

•       Tesofensine

•       Theophylline (Theo Dur)

•       Tianeptine

•       Toloxatone

•       Tramidol

•       Tranylcypromine (Parnate)

•       Trazodone

•       Tricyclic antidepressants (Amitriptyline, Elavil)

•       Trimipramine (Surmontil)

•       Triptans

•       Vanoxerine

•       Venlafaxine (Effexor)

•       Viloxezine

•       Yohimbine

•       Zimelidine

•       Ziprasidone (Geodon)

Also avoid the following herbs 2 weeks prior to your retreat start date:

•       St. Johns Wort

•       Kava

•       Kratom

•       Ephedra

•       Ginseng

•       Yohimbe

•       Sinicuichi

•       Rhodiola Rosea

•       Kanna

•       Boswellia

•       Nutmeg

•       Scotch Broom

•       Licorice Root

additional information and contradiction 

Using stimulants with MAOIs is particularly dangerous and can be potentially fatal. Using cocaine, amphetamines, or MDMA (ecstasy) with MAOIs may cause a severe increase in blood pressure, increasing the chances for stroke and cerebral hemorrhage and making it possible to overdose on a relatively small amount of cocaine. (A fatality has been recorded involving combining peganum harmala and cocaine. Fatalities resulting from combining amphetamines with pharmaceutical MAOIs have been recorded in the medical literature.)

Using other serotonin agonists or precursors with an MAOI can lead to serotonin syndrome. The main symptom of serotonin symptom may be a severe and long-lasting headache (the same symptom as MAOI tryptamine interaction) and/or fever (as high as 40 °C / 104 °F or more) Other symptoms of serotonin syndrome may include rapid heartbeat, shivering, sweating, dilated pupils, intermittent tremor or twitching, overactive or over-responsive reflexes, hyperactive bowel sounds, or high blood pressure. Severe serotonin syndrome may lead to shock, agitated delirium, muscular rigidity and high muscular tension, renal failure, or seizures, and can be life-threatening.

Using tricyclic antidepressants within two weeks of taking MAOIs may cause serious side effects including sudden fever, extremely high blood pressure, convulsions, and death.

Using Fluoxetine (Prozac) within five weeks of taking MAOIs may cause high fever, rigidity, high blood pressure, mental changes, confusion, and hypomania.

Using Benzedrine, Benzphetamine, Desipramine, Desoxyn, Dexedrine, Dopamine, Ephedrine (contained in Marax, Quadrinal, and other asthma drugs), Epinephrine, Guanadrel, Guanethidine, Hydralazine, Isoproterenol, L-dopa, Metaraminol, Methyldopa, Mirtazamine, Norepinephrine Oxymetazoline, Phendimetrazine, Phentermine, Phenylephrine, Phenylpropanolamine, Pseudoephedrine, Ritalin, or Venlafaxine with MAOIs may cause a hypertensive crisis (severe spike in blood pressure).

Using Adderall with MAOIs can result in high body temperature, seizure, and in some cases, coma.

Using Bupropion (Wellbutrin) within two weeks of taking MAOIs may cause serious side effects such as seizures.

Using Buspirone (Buspar) with MAOIs may cause high blood pressure and increased sedative effects.

Using Carbamazepine (Tegretol) with MAOIs may result in fever and may increase seizures, especially in epileptics.

Using Clomipramine with MAOIs may cause high fever (hyperpyrexic crisis) and seizures.

Using CNS depressants with MAOIs may increase the depressant effects.

Using Desipramine (Norpramin, Pertofrane) with MAOIs may result in hypertensive crisis.

Using Dextromethorphan with MAOIs may cause excitement, high blood pressure, and fever, or brief episodes of psychosis.

Using Fenfluramine with MAOIs may result in fever (hyperpyrexic crisis).

Using Kava with MAOIs may result in hypotensive crisis (severe blood pressure drop).

Using Lithium with MAOIs may cause fever and serotonin syndrome.

Using Meperidine (Demerol) with pharmaceutical MAOIs has resulted in deaths from a single dose.

Using Metaproterenol or other beta-adrenergic bronchodilators with MAOIs may cause blood pressure elevation and rapid heartbeat.

Using Mirtazapine (Remeron) with MAOIs may result in hypertensive crisis.

Using Nefazodone (Serzone) may result in high fever.

Using Temaril with MAOIs may increase chance of side effects.

Using Terfenadine with MAOIs may cause an increase in MAOI blood levels.

Using Theophylline with MAOIs may cause rapid heartbeat and anxiety.

Using Trazodone (Desyrel) with MAOIs may result in high fever.

Using Tryptophan or L-tryptophan with MAOIs may cause disorientation, confusion, amnesia, delirium agitation, memory impairment, hypomanic signs, or shivering.

Using Venlafaxine (Effexor) with MAOIs may result in hypertensive crisis.

Using Ziprasidone (Geodon) with MAOIs may cause serotonin syndrome.

Using alcohol with MAOIs may cause side effects like angina (chest pain) or headaches. The headache may mask or be mistaken for hypertensive crisis caused by MAOI interaction. MAOIs can also increase the sedative effect of alcohol.

Using opiates with MAOIs carries a risk of respiratory depression.

Using diuretics with MAOIs may cause a greater drop in blood pressure than normal and increase in MAOI blood levels.

Using anesthetics with MAOIs may potentiate the anesthetic effect.

Using sleeping pills, tranquilisers (major or minor), or barbiturates with MAOIs may increase the sedative effect.

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