Cacao is a strong bitter and stimulant, so there are some potential side effects to be aware of, as well as certain specific contra-indications. Since cacao is consumed in higher doses in ceremony, people might experience symptoms such as being lightheaded, sweaty palms, headache or nausea. Simply slow down, drink water and practice self-care as needed until symptoms subside. Cacao can also stimulant detox symptoms in some cases. If this happens, take it as a blessing and drink plenty of water as your body lets go of whatever it didn’t like. This will likely be accentuated for people on a raw diet or who are fasting. Go with lower doses in this case
Certain anti-depressants are worth extra consideration. MAOI based anti-depressants are contraindicated with the tyramine in chocolate, so a larger dose of cacao is not recommended. MAOI based anti-depressants are first generation anti-depressants and are less common these days. People taking them are on a restricted diet that includes limiting or avoiding chocolate, so they should know if they can consume or not. Side effects could include more serious headache and nausea, so make sure to check medications first. Additionally, there has been some concern with larger doses of cacao and SSRI type anti-depressants, because of the MAOI's in cacao. Specifically, the tryptophan, a type of MAOI which is a pre-cursor to serotonin has been cited by some as a possible contraindication. The research about this interaction is minimal, but studies on both the amounts of tryptophan in chocolate and how that might cause 'serotonin syndrome' don't indicate any problem. However, to be on the safe side, for those on SSRI's, we suggest consulting with your doctor and/or pharmacist regarding higher doses of cacao and to consider starting with low doses.
If any symptoms do present, drink lots of water, get some rest and it will pass.