[Solved] Remeron (Mirtazapine) + Ativan (lorazepam) and a psilocybin session

It is possible in some situations, but the combination may dampen the effects of psilocybin. Both mirtazapine and lorazepam can influence the experience, but in different ways. A proper assessment depends mainly on the dosages, how long you’ve been taking them, and whether you take them daily or occasionally. It’s also helpful to explain why the medication was prescribed to you.

1. Remeron (mirtazapine) and psilocybin/truffles

Mirtazapine acts, amongst other things, on serotonin systems and blocks the 5-HT2A receptor, the main receptor through which classic psychedelics such as psilocybin and LSD exert their characteristic effects.

Possible consequences:

• The trip can clearly be less intense.
• Fewer visual effects.
• Less emotional or mystical depth.
• Sometimes, however, a subtle effect does remain.

That is why mirtazapine is often regarded as a drug that can reduce the psychedelic effect.

Half-life and elimination of mirtazapine

The average half-life of mirtazapine is approximately 20–40 hours (averaging around 30 hours)

As a rule of thumb for medicines, it takes approximately five half-lives for the majority of the substance to be eliminated from the body.

In the case of mirtazapine, this roughly means:

• 1 half-life: 30 hours → 50% remaining
• 2 half-lives: 60 hours → 25% remaining
• 3 half-lives: 90 hours → 12.5% remaining
• 4 half-lives: 120 hours → 6%
• 5 half-lives: 150 hours → approximately 3%

So, in theory, it takes around 6–8 days for mirtazapine to be largely eliminated from the body. With long-term use, effects at the receptor level may be noticeable for longer, as neuroadaptations may have occurred.

Important: abruptly stopping mirtazapine simply to make a session more potent is sometimes actually not a good idea. Withdrawal symptoms, poorer sleep or the return of depressive or anxiety symptoms can actually have a negative impact on the psychedelic experience. It is therefore advisable to weigh up the pros and cons, as well as the rate at which the dose is tapered off. It is strongly recommended that you consult your treating doctor to ensure an accurate assessment. It may also be necessary to allow extra time for you to return to normal after tapering off the medication.

2. Ativan (lorazepam) and psilocybin/truffles

Lorazepam is a benzodiazepine and enhances the action of GABA, the brain’s main inhibitory system.

Possible effects on a psilocybin experience:

• Less anxiety and tension.
• Greater physical relaxation.
• Less emotional intensity.
• Perhaps less insightful depth.
• A rather lacklustre experience.

Benzodiazepines are sometimes used to reduce extreme anxiety during a psychedelic experience, but they mainly have a calming effect and are not a genuine "trip-stopper". The psychedelic experience may still continue.

Half-life and elimination of lorazepam

On average, lorazepam has a half-life of approximately 10–20 hours

In theory:

• 5 half-lives: approximately 2–4 days until it is largely eliminated.

In practical terms, this means:

• After 24 hours, around half may still be present.
• After 48 hours, approximately 25% may still be present.
• After 3 days, a small amount may still be present.
• After about 3–5 days, most of it will have been removed.

However, with daily use, the effects may build up and last for longer.

If someone wants as little interaction as possible and a reduced impact

From a pharmacological point of view, one would hope that:

Lorazepam:

• Will no longer be present at least a few days before the session.
• A conservative estimate is often 3–5 days, depending on usage patterns.

Mirtazapine:

• Requires a longer period due to the longer half-life and receptor action.
• In theory, it takes about a week or longer for it to be largely eliminated from the body.

Nuance: A session involving the least potential for interaction is not automatically the best solution. Someone who, as a result of stopping their medication, sleeps less well, experiences increased anxiety or becomes emotionally unstable may actually be in a more vulnerable state going into a psychedelic session, in which case it could have the opposite effect. For some people, it is actually better to settle for the reduced effects. A assessment by a treating doctor is strongly recommended in this regard.

Conclusion on the combination of Remeron and Ativan with psilocybin

If someone:

• takes mirtazapine daily,
• uses lorazepam regularly,
• and would like a therapeutic psilocybin or truffle session,

In that case, I would have this properly assessed first. There’s a good chance that:

• the experience is less intense when taking mirtazapine;
• lorazepam may inhibit emotional openness and processing;
• It is advisable to stop or adjust medication only under medical supervision.

An initial assessment and preparation are particularly important when medication is involved, as it is not only the substance itself but also sleep, anxiety levels, mood and stability prior to the session that are key factors. Psilocybin therapy It is therefore a comprehensive process involving preparation and integration, not just a matter of taking truffles. So please complete the intake form so that we can better assess what is needed, and discuss your plans with your own doctor.