What are the risks of a truffle ceremony? Who may it suit, and who may it not suit?

You have been reading about truffle ceremonies and are curious. But you take antidepressants. Or you experience anxiety, depression or the effects of trauma. Perhaps you feel healthy yourself, but you are breastfeeding, or there is a history of mental health problems in your family. You find yourself wondering: is a ceremony right for me?

I regularly receive emails from women with questions like these. They want to know what a ceremony involves, but above all whether it is right for them. Can I take part while on my medication? What about my health? And what if I feel very nervous about it?

I understand. You can be curious and still have questions or doubts. In my practice, I find that many women first want to understand the risks and what they need to take into account.

In this article, you can read who a truffle ceremony may be suitable for, what the risks are and when I advise against taking part. I also discuss the main contraindications: health concerns or circumstances in which participation is discouraged or further discussion is needed.

Why do women choose a truffle ceremony?

The women I support have generally made a conscious choice to take part in a truffle ceremony. They want to pause and reflect on something in their lives: a relationship, their work, creativity, spirituality or health.

Perhaps you recognise that. You want to understand yourself better, explore something or find greater depth in a process you have been working through for some time. Truffles can be a tool in that process. For many women, that wish also touches on deeper themes: a longing for a stronger connection with themselves, their bodies and life.

When might a truffle ceremony be right for you?

A ceremony may be right for you if you are curious, have consciously chosen the experience and feel that you have enough stability and support in your life. Your physical and mental health are important considerations too. Perhaps you feel drawn to this special experience and ready to look inwards. Not only to understand something, but also to feel and experience it.

I feel nervous. Does that mean it is not right for me?

Many of the women I support are curious and feel nervous at the same time. A truffle experience can be intense, and you do not know in advance what you will encounter. Talk to your guide about what makes you nervous, what you need and whether a ceremony feels right for you at this point in time.

What are the risks of a truffle ceremony?

Psilocybin, the active substance in truffles, has relatively low physical toxicity. It generally causes little direct harm to the body. For healthy people, the physical risks are usually limited. A safe setting, a carefully chosen dose and good support are important. You may, however, experience nausea, a headache or dizziness. Your blood pressure and heart rate may also rise temporarily.

Important risks are psychological. A truffle journey can bring a great deal to the surface: you may encounter fear, sadness or old pain. A strong emotion does not immediately mean that something is going wrong, but it can feel overwhelming. Good support is therefore important. If you have a mental health vulnerability, this calls for extra care. In some situations I advise against taking part. In others, the decision needs to be considered carefully.

When is a truffle ceremony not suitable?

The main considerations are:

• medication, such as antidepressants;
• a personal or family history of psychosis, schizophrenia or mania;
• severe or acute mental health concerns;
• physical health vulnerabilities, such as high blood pressure, heart problems or epilepsy;
• pregnancy or breastfeeding.

These situations are not all the same. Taking medication, for example, calls for a different assessment from having a history of psychosis. Below, you can read about the differences.

Can I take truffles if I take antidepressants?

This is a question I am often asked, especially by women who take SSRIs. Perhaps you have read that antidepressants and psychedelics do not mix. One concern often raised about combining them is serotonin syndrome. This is a potentially serious reaction in which the serotonin system is overstimulated, for example because of an interaction between substances.

In recent years, more research has been done into combining antidepressants and psychedelics. In 2025, researchers brought together findings from eighteen studies. They found no clear indication of an increased risk of serotonin syndrome, particularly with psilocybin. However, not all medicines and combinations have been studied equally well. As a result, it is still unclear how this applies to each individual medicine.

Some studies also suggest that antidepressants can dampen the psychedelic experience. You may feel the effects less strongly. So we know more than we did a few years ago, but not enough to say that combining psychedelic truffles and antidepressants is safe for you. It matters which medicine you take, why you take it, what other substances you use and how you are feeling at the moment.

The most cautious choice is not to take truffles while there is uncertainty about your medication and the possible risks. Do you take antidepressants? Never stop or change your medication yourself in order to take part in a ceremony. Discuss your plans with the doctor who prescribes your medication, and tell your guide what you take.

Stopping or reducing your medication yourself can cause withdrawal symptoms or bring existing symptoms back. A guide should not advise you to change prescribed medication without discussing it with your doctor.

What if I take medication for anxiety, sleeping tablets or other medication?

I am also regularly asked about oxazepam, other benzodiazepines and sleeping medication. There is little research available on combining many of these medicines with psilocybin. It matters which medicine you take, how much you take, and whether you use it every day or occasionally. Other medication, such as antipsychotics, ADHD medication and mood stabilisers, also needs to be taken into account in the assessment.

Do not change your medication yourself or skip a dose for a ceremony. Not even if a guide suggests it. Discuss that advice with your doctor first.

An example from my practice

During a free discovery call, a woman told me that she used sleeping medication at a low dose during certain periods. She had been wondering for some time whether she still needed it and whether it was right for her. She wanted to stop, but found it difficult to take that step.

I advised her to discuss it with her GP. Together, she and her GP made a plan to reduce her medication. We stayed in touch during that process. It went well, and she had stopped completely two weeks before the ceremony.

For her, that in itself felt like a great achievement. The ceremony took her further into a process that had already begun. This is her personal experience. Reducing medication is not the right choice for everyone.

What about psychosis, schizophrenia or mania?

Have you experienced psychosis or mania yourself, do you have schizophrenia, or has any of this occurred in your family? It is important to know that psychedelics may involve additional risks. In psilocybin research, people with a history of psychosis, schizophrenia or bipolar disorder are often excluded. Many studies also exclude people with a family history of psychosis or bipolar disorder.

There are concerns that psychedelics may trigger or worsen psychosis or mania. We still do not know enough from scientific research about exactly how great the risk is or who may be more vulnerable. Because these groups are often excluded from studies, there is little information about safety for them.

In my screening, I consider a personal history of psychosis, schizophrenia or mania a clear contraindication. I also always advise against taking part if there is a family history of these conditions. These situations involve risks that we cannot properly assess in advance.

Could a ceremony be suitable if I experience anxiety, depression or trauma?

Perhaps your own concerns have made you curious about psychedelics. You may have read about research into depression or heard that someone was able to work through something important during a ceremony.

Anxiety, depression or trauma does not automatically rule out a ceremony. Whether it is right for you does, however, need careful consideration. The severity of your symptoms, how long you have had them and how stable you feel now all make a difference. The support and guidance you have are important too.

Research is being carried out into psilocybin for mental health concerns, with promising results for conditions including depression. If you are dealing with concerns like these yourself, I understand that this can give you hope and make you curious.

Participants in these studies are carefully selected. They receive support during the experience and generally have preparatory conversations and follow-up support as well. The amount of support or therapy involved differs between studies. You cannot simply apply those results to a truffle ceremony: the circumstances and the care around it may be very different.

It is especially important to remember that a truffle ceremony does not replace medical or psychological care if you have severe or acute concerns.

What if I have high blood pressure, heart problems or epilepsy?

Psilocybin can temporarily increase your heart rate and blood pressure during the experience. If you have high blood pressure or heart problems, it is important to discuss this in advance. The same applies to epilepsy, neurological conditions or another physical health vulnerability. Tell your guide about this during screening, even if your symptoms are controlled with medication. Depending on your situation, you may need to speak to your doctor first, or taking part may be discouraged.

Can I take part while pregnant or breastfeeding?

I advise against taking part in a truffle ceremony during pregnancy. There is not enough research into the possible effects on pregnancy and an unborn baby.

There is also no good evidence about safety or possible effects on a baby during breastfeeding. Perhaps you are wondering whether the dose makes a difference. Is a microdose safer than the dose used in a ceremony? Or can you wait for a certain amount of time after a ceremony before breastfeeding again?

At present, there is no reliable, well-researched answer to these questions. No scientifically established waiting period has been identified after which it is safe to breastfeed again. A lower dose does not provide that certainty either. Are you breastfeeding and considering taking truffles? Discuss it with your guide. Because so little is known about the safety for your baby, waiting until you have finished breastfeeding remains the most cautious choice.

The importance of screening

Screening is a standard part of my preparation. We talk about how you are feeling, what medication you take and whether there are any mental or physical health considerations. By speaking openly about these things, we can better consider whether a ceremony is right for you and whether you first need to speak to your doctor or practitioner.

If you book a ceremony somewhere and are not asked about your health or medication beforehand, ask how the guide decides whether it is suitable for you to take part. Screening is part of careful preparation.

What could I ask my guide beforehand?

Are you unsure whether a truffle ceremony is right for you? These questions may help. Ask your guide:

• How do you assess whether it is appropriate for me to take part?
• Could my physical or mental health concerns be a reason to advise against taking part?
• Could my medication involve risks when combined with truffles?
• When should I speak to my GP or practitioner first?
• In what situations would you advise postponing a ceremony?

Many of the women who email me have questions about their own situation. Perhaps you recognise yourself here, but your question has not (fully) been answered. Or perhaps you are not sure whether your medication or concerns fall into one of the groups mentioned. You are welcome to send me an email and tell me what you are unsure about. You do not have to work it all out on your own. We can simply have an informal chat about it.

In brief

Whether a truffle ceremony is right for you depends on your health, your medication and how you are feeling at the moment. Good information and careful screening can help you make an informed choice. Sometimes a ceremony may be suitable; sometimes postponing or not taking part is wiser.

Even with careful screening and good support, the risks can never be ruled out completely.

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