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Chemistry Gate

If meds are in the picture, clear chemistry first.

Do not negotiate with interactions by taking more. Rule out the red lines first, then open the page that matches the real medication question.

Hard red lines — do not combine

  • Lithium — seizure risk
  • MDMA + MAOIs / 5-MeO-DMT + MAOIs — the MAOI combinations that still stay red
  • Tramadol — serotonin syndrome risk

MAOI correction

Recent 2024-2025 reviews do not support a blanket “all MAOIs plus psychedelics” hard stop. The defensible hard red lines are MDMA + MAOIs and 5-MeO-DMT + MAOIs.

Classical psychedelics and DMT with MAOIs still need chemistry-specific handling because potency, duration, and protocol assumptions change fast. Syrian Rue belongs in that chemistry-review bucket, not in casual optimization.

Name the real chemistry question
Interaction, contraindication, blunting, or mixed medication risk: use the screen.
SSRI timing, spacing, or receptor recovery: use the washout route.
Safe spacing is not the same thing as a readable recovery signal.

Important

Do not push dose upward just to overpower blunting. That bargain usually buys side effects without solving the chemistry problem.

This is pharmacology framing, not personal medical advice. Use the tools, then discuss real medication changes with the prescriber who knows your history.

Read the medications chapter →