TL;DR — SSRIs, SNRIs and MAOIs are on our list of medications that rule out participation, because combining them with ayahuasca carries a serious interaction risk. Tell us everything you take before you book, and never stop a medication on your own.
If you take an antidepressant, you need to tell us before you book, in full, including the name, the dose and how long you have been on it. Antidepressants in the SSRI, SNRI and MAOI families are on our list of medications that are incompatible with ayahuasca, because taking them together carries a serious interaction risk. This is not a formality. It is the single most important thing a guest can disclose to us, and it is the one people are most tempted to leave out.
This article explains why we ask, what happens when you tell us, and what we will never ask you to do.
Why antidepressants and ayahuasca do not mix
Ayahuasca is made from two plants. One of them, the Banisteriopsis caapi vine, contains compounds that act on the same systems in the body that many antidepressants act on, in particular the systems involving serotonin. When two things push on that same system at once, the result can be an interaction that is unpredictable and in some cases dangerous. That is the whole reason, and we are not going to dress it up with more pharmacology than that. The details belong in a conversation with your doctor.
What we can tell you is that this risk is well known in every serious retreat, and any center that does not ask about your medications before accepting your booking is a center you should not go to.
The medication families we treat as incompatible are:
- SSRIs, the most commonly prescribed antidepressants.
- SNRIs, a related family.
- MAOIs, an older family with the highest interaction risk of all.
If you are not sure which family your medication belongs to, tell us the name and we will look at it with you.
Why disclosure matters more than you think
Every year we hear from people who want to attend and are afraid that telling us about their medication will mean a no. So they consider not mentioning it. Please do not do that.
Our facilitators are responsible for you during a ceremony. Erick or a member of his family stays sober and present for the whole night, with a group that is never larger than five. That works because they know who is in the room and what each person's body is carrying. A medication they do not know about is a risk they cannot manage, and it puts you, and everyone else in that room, in a position nobody chose.
Disclosure is also how we protect you from a wasted trip. Better to find out by email that this is not the right month than to fly to Costa Rica and be turned away at the door, which is what would happen.
Never stop a medication on your own
This is the part we want to be completely clear about. Do not stop, reduce or skip an antidepressant because you want to attend a retreat. Not ours, not anyone's.
Some medications can be paused ahead of a ceremony. Whether yours can, and how, is a decision for the doctor who prescribed it and nobody else. Stopping certain antidepressants suddenly can cause its own problems, and doing it in secret, without medical supervision, to make a booking work is exactly the kind of decision a retreat should never push you toward. We will not give you a tapering schedule, and we will not accept a booking from someone who tells us they stopped their medication without their doctor's involvement.
If your doctor agrees a pause is appropriate for you, and confirms how far in advance it needs to happen, then we can talk about dates. If your doctor does not agree, that answer stands.
The other things on the list
Antidepressants are the most common issue we see, but they are not the only one. Our safety page has the full list. In short, the medications and substances we consider incompatible include:
- Anti-anxiety medications.
- Certain blood pressure medications.
- Prescription painkillers.
- Stimulants such as those prescribed for ADHD.
- Cold and flu medications, which people forget to mention because they seem harmless.
- Recreational drugs and alcohol.
- Some herbal supplements, including St. John's Wort and 5-HTP, and high doses of L-tryptophan.
- Ephedra and yohimbe.
There are also health conditions that rule out participation regardless of medication: serious heart conditions, severe respiratory illness, significant kidney or liver conditions, epilepsy or seizure disorders, uncontrolled diabetes, and pregnancy. On the mental health side: psychotic disorders, bipolar disorder, severe unmanaged anxiety, and recent suicidal ideation.
If you read that list and something applies to you, the right next step is to write to us for a confidential review before you apply, not after.
What happens when you tell us
Every guest completes a health application before any booking is confirmed. It asks for your medical history, your mental health history, and every medication and supplement you take, prescription or not. We read every one of them ourselves. If something is unclear we write back with questions.
Then one of three things happens.
Nothing on your application is a concern. We confirm your suitability, you choose your dates, and you receive the preparation materials. This is the most common outcome.
Something needs a conversation. Perhaps a medication your doctor may be able to pause, or a condition we want to understand better. We talk it through with you, and often the answer is a different month rather than a no.
Something rules you out. We tell you plainly and we tell you why. It is not a judgment about you. It is a limit on what we can do safely, and we would rather say it clearly than hedge. Some guests come back a year later, in a different situation. Some do not, and that is the right decision for them.
Questions we hear often
"I stopped my antidepressant a year ago. Does it still matter?" Tell us anyway. A medication you no longer take is not an interaction risk, but the reason you took it is part of your history, and we look at the whole picture. Most guests in this situation are fine to attend.
"I only take it occasionally." Occasional use is still use. Tell us what you take, how often, and when you last took it. We will look at it with you.
"Can I just not take it the week of the retreat?" No. That is a decision for your prescribing doctor, and only with their supervision. See the section above.
"Will you tell anyone?" No. What you share in your health application is read by the people who screen applications and lead ceremonies, and by nobody else. Our privacy policy explains how we handle it.
What this is not
We are not doctors, and a retreat is not a treatment. Our ceremonies are a traditional practice, held in a lineage connected to the indigenous peoples of Costa Rica, and we make no medical claims about them. If you are living with depression, the decisions about your medication and your care belong with the professionals who know your history. What we can do is be honest with you about what we can hold safely, and refuse to hold what we cannot.
Before you write to us
Have this ready, and the conversation will go quickly:
- The name and dose of every medication you take, including anything you take occasionally.
- Every supplement, even the ones that seem trivial.
- How long you have been on each, and whether your doctor knows you are considering a retreat.
- Any diagnosis you have received, even if you no longer take medication for it.
Then read our preparation page so you understand the diet and lifestyle guidelines that begin seven days before arrival, and send us a message. We will treat what you tell us with care, we will answer honestly, and if the answer is not yet, we will say so.