Dave Rabin M.D., Ph.D. - Microdosing on SSRIs? A Psychiatrist’s Take

Jul 25, 2025

Dr. Dave Rabin, a board-certified psychiatrist and neuroscientist, dives into the intricate relationship between SSRIs and psychedelics. He discusses why mixing these treatments can be perilous, emphasizing the risks of serotonin syndrome. Dr. Rabin highlights the role of psychedelics in managing emotional range and the importance of tapering off SSRIs safely. He also explores specific psilocybin strains beneficial for anxious clients and shares practical tools for regulating the nervous system during withdrawal, paving the way for safer psychedelic integration in mental health.

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INSIGHT

How SSRIs Affect Emotion

SSRIs inhibit serotonin reuptake, increasing serotonin in synapses and stabilizing severe depression.
This stabilization shrinks the emotional awareness window, dulling both negative and positive emotions.

ADVICE

Don't Mix SSRIs and Psychedelics

Avoid combining SSRIs with serotonergic psychedelics due to risk of serotonin syndrome.
Taper off SSRIs safely, ideally under doctor guidance, before psychedelic use to prevent dangerous interactions.

ADVICE

Ketamine for SSRI Tapering

Use ketamine to accelerate SSRI tapering safely, unlocking neuroplasticity within days.
Follow ketamine-assisted tapering with therapeutic integration before starting microdosing protocls.

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Following our recent conversation with Dr. Robin Carhart-Harris on the neuroscience of SSRIs and psychedelics, this bonus episode takes the next step—focusing on clinical realities, tapering strategies, and patient safety.

Find full show notes and links here: https://thethirdwave.co/podcast/episode-313b/?ref=278

Dr. Dave Rabin—a board-certified psychiatrist, neuroscientist, and co-founder of Apollo Neuro—joins Paul F. Austin for a candid, protocol-driven conversation. Together, they unpack why combining SSRIs with psychedelics can be dangerous, how to safely taper with support tools like ketamine and CBDA, and how to prepare clients for deeper psychedelic work.

If you’re a facilitator, therapist, or simply someone navigating antidepressants and interested in microdosing, this episode offers practical, medically-grounded insights.

Highlights:

How SSRIs blunt emotional range and alter awareness
The neuroscience of serotonin and psychedelic receptors
Serious risks of serotonin syndrome when mixing with SSRIs
Ketamine’s role in tapering and unlocking neuroplasticity
Practical tools to regulate the nervous system during SSRI withdrawal
Recommended psilocybin strains for sensitive or anxious clients
How long-term SSRI use may (or may not) affect psychedelic response
Safety-first protocols for psychedelic integration
The future of microdosing as a sustainable antidepressant approach

Episode Links:

Curious about becoming a certified psychedelic coach? Join Paul F. Austin Thursday, July 31 2025, 10:00 AM PT for a free info session exploring the Psychedelic Coaching Institute’s Practitioner Certification Program—an immersive training that blends science, ceremony, and real-world coaching to help you lead others through lasting transformation. Learn More.

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