If the patient is euthyroid then thyroid medication should be continued throughout the treatment.
Note that patients with hyperthyroidism that is not properly managed may subjectively interpret these symptoms as symptoms of opioid withdrawal. It is highly beneficial to make sure that symptoms are well managed prior to treatment, and to be mindful of this effect throughout the treatment process.
All psychiatric medication is centrally acting (Ch. 2), and, in communication with the patient’s psychiatrist, should be tapered and stopped prior to treatment.
Patients who are taking long-acting psychiatric medications like a once a month shot, or who cannot stay off of their medications for 5 days, should be considered poor candidates.
If patient is stable, psychiatric medications can be re-started 24 hours after treatment.