What a Real Medical Screening Asks You
Updated: Oct 14
Every retreat website says it is safe. The word appears on all of them, ours included, and it tells you nothing.
Here is something that does tell you something: the questions they ask you before they take your money.
Screening is the single most reliable signal of how a centre operates, because it is the one part of the process that costs them bookings. A centre with a real screening process turns people away. A centre with a form and a payment link does not. You can assess this from the outside, before you commit, and you should.
So this is what a proper screening covers. Use it as a checklist against whoever you are considering — including us.
Medication, in full
Not "are you on antidepressants." The full picture:
Every prescribed medication, with dose and how long you have taken it
Over-the-counter medication, including cold and allergy remedies containing dextromethorphan or pseudoephedrine
Supplements — St John's wort, 5-HTP, tryptophan, melatonin, adaptogens
Migraine medication, particularly triptans
Painkillers, particularly tramadol
Anything you take occasionally rather than daily
The last two lines are where the real risk hides. People declare the SSRI they think of as medication and forget the triptan in their bag, which is also serotonergic.
A screener who accepts "nothing, just a few supplements" and moves on is not screening.
Psychiatric history — yours and your family's
This is the section that gets softened most often, because it is the one that disqualifies people.
A proper screening asks about personal or first-degree family history of schizophrenia, psychosis, bipolar disorder, and any previous psychotic or dissociative episode. These are not "proceed with caution" items. A family history of psychosis is a genuine risk factor for a serotonergic psychedelic, and a centre that shrugs at it is gambling with something it cannot fix in the room.
It should also ask about current suicidality, recent psychiatric hospitalisation, active eating disorder, and where you are in relation to any recent bereavement or acute crisis. Not to judge, but because "I want to do this because I am in a very bad place right now" is often a reason to wait rather than a reason to book.
Cardiovascular status
Ayahuasca reliably raises blood pressure and heart rate. That is a normal pharmacological effect, and for most people it is unremarkable. For some it is not.
Screening should cover known heart conditions, arrhythmia, previous cardiac events, uncontrolled hypertension, and stroke history. If you have any of these, a centre should want a letter or clearance from your doctor rather than your reassurance that you feel fine.
The MAOI questions people forget
Because the brew inhibits monoamine oxidase, the screening should also reach into territory that does not feel psychiatric at all:
Blood pressure medication
Diabetes medication, and blood sugar management generally
Liver and kidney function — both metabolise the alkaloids
Pregnancy or breastfeeding
Epilepsy or seizure history
Recreational drug use, honestly and recently — including cannabis and MDMA
It should also confirm that you understand the tyramine restriction and why it exists, rather than simply sending you a food list.
The non-medical questions that matter as much
A good screening is not only clinical. It should ask:
Why now? Not to gatekeep, but because the answer reveals a great deal. Someone processing an acute crisis of three weeks' standing needs a different conversation from someone who has been circling this for two years.
What is your support structure at home? Because the retreat is four days and the integration is months. Someone returning to an environment with no support is at higher risk of a difficult aftermath, and that is worth planning for in advance rather than discovering afterwards.
Have you done this before? And if so, what happened. A previous difficult experience is not a barrier. An undisclosed one is.
Screening is not a formality that stands between you and the ceremony. It is the first part of the work.
What it means if nobody asks
If you can book a ceremony with a deposit and a WhatsApp message, you have learned something important. Not that the facilitators are bad people — often they are not — but that there is no mechanism in place to catch the person who should not be in the room.
And that person exists in more or less every group. Someone on lithium who did not think to mention it. Someone with a family history of psychosis they have never told anyone about. Someone who tapered their venlafaxine in four days because a website said six weeks and they had five.
The screening is the only thing standing between that person and a ceremony. If there is no screening, there is nothing.
Questions to ask them
Turn it around. Before you book anywhere, ask:
Who conducts the screening, and what is their background?
What would cause you to turn someone away?
How many people have you declined in the past year?
What is the plan if someone has a medical or psychiatric emergency in ceremony?
How far is the nearest hospital, and who drives?
The third question is the sharpest one. A centre that cannot name a number has probably never said no.
Note. This article is educational and is not medical advice. Retreats are not medical treatment or a substitute for professional care.
Ours is a 1:1 call, not a form. You can see what it covers and book a health evaluation here.
Ritshi Zenati, Speaker & Life Coach
Founder at Holistika Center.
Holistika Center holds plant medicine retreats across Barcelona, Málaga, Mallorca, Switzerland, Germany, Norway, Colombia and Mexico.
Also, different programs like Microdosing, Life and Spiritual Guidance, etc.
Visit Holistika Center to explore upcoming programs.
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