The individual monographs detail the contraindications specific to each substance. This page synthesizes the overarching contraindications that apply to almost all the psychoactive medicines treated in the atlas — ayahuasca, jurema, kambô, peyote, psilocybes, LSD, MDMA, iboga, etc. This list does not exhaust the subject but flags the zones where caution is non-negotiable. In case of doubt, an informed medical opinion remains indispensable.
Formal contraindications
A trap worth knowing: the rushed withdrawal
The washout periods required above — often several weeks — create a temptation: to stop one's antidepressant abruptly in order to "be ready" in time for a ceremony. This is a potentially serious mistake, for two distinct reasons.
First, abrupt cessation frequently provokes a discontinuation syndrome: electric-shock sensations in the head ("brain zaps"), dizziness, nausea, a flu-like state, insomnia, irritability, anxiety — all the more marked the shorter the molecule's half-life. Second, and this is the major risk, stopping exposes one to the return of the depression itself — the depressive rebound — often more intense than before treatment.
The rule is therefore unambiguous: any cessation is done by gradual reduction — a tapering spread over weeks — under medical supervision, never rushed to meet a ceremony date. If the washout cannot be done safely, it is the ceremony that gets postponed, not the washout that gets rushed.
Contextual vulnerabilities
Beyond the formal medical and psychiatric contraindications, certain life situations justify postponing an intense psychoactive practice:
- Recent bereavement (less than six months for someone in the innermost circle) — the emotional tangle is not stabilized.
- Major life crisis underway — separation, job loss, a structuring move — without parallel psychotherapeutic support.
- Vulnerable physical state — undernutrition, dehydration, prolonged overwork.
- Acute psychological vulnerability — an untreated severe depressive episode, unstabilized generalized anxiety.
- Absence of post-ceremony support — social isolation, lack of space for integration.
These elements are not absolute prohibitions. They are signals for rigorous evaluation, and — in the absence of competent clinical accompaniment — for waiting.