Potential Drug-Drug Interactions With Psilocybin, MDMA, Ketamine

Pharmacy Times interviewed Kelan Thomas, PharmD, MS, associate professor of clinical sciences at Touro University California College of Pharmacy, on his recent presentations at Insight 2021 and the virtual Sana Symposium on psychedelic adverse effects and drug-drug interactions.

Alana Hippensteele: Are there other potential drug-drug interactions with psilocybin, MDMA, and ketamine to consider outside of interactions with psychiatric medications?

Kelan Thomas: Yeah, so MDMA, because of its broad metabolism by multiple different [cytochrome P450 (CYP)] enzymes, and, as I mentioned, its own autoinhibition, so it's also an inhibitor of CYP2D6 substrates, and so that's where I think you really would have to start to do drug interaction trials to get a sense of how much of a difference. But that's what I would be most concerned about is that MDMA could have interactions with a broad array of other drugs given it is a substrate of multiple CYP enzymes and it is also an inhibitor of CYP2D6.