Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures: an analysis of online psychedelic experience reports
OpenAlex – February 24, 2021
Source: OpenAlex
Summary
For individuals managing bipolar disorder with Lithium, combining it with a hallucinogen like Psilocybin carries significant risks. Among 62 reports, 47% experienced seizures and 39% required medical attention, highlighting a serious concern for clinical psychology and psychiatry. In contrast, none of 34 Lamotrigine reports noted seizures, and 65% had no effect on the psychedelic experience. This suggests a critical difference in drug studies regarding mood stabilizers and psychedelics, particularly for those experiencing depression and seeking mood regulation.
Abstract
Introduction: Psychedelics show promise in treating unipolar depression, though patients with bipolar disorder have been excluded from recent psychedelic trials. There is limited information on the use of classic psychedelics (e.g. LSD or psilocybin) in individuals using mood stabilizers to treat bipolar disorder. This is important to know as individuals with bipolar depression may attempt to treat themselves with psychedelics while on a mood stabilizer, particularly given enthusiastic media reports of the efficacy of psilocybin for depression.Methods: This study analyzed reports of classic psychedelics administered with mood stabilizers from three websites (Erowid.org, Shroomery.org, and Reddit.com).Results: Strikingly, 47% of 62 lithium plus psychedelic reports involved seizures and an additional 18% resulted in bad trips while none of 34 lamotrigine reports did. Further, 39% of lithium reports involved medical attention. Most of the lamotrigine reports (65%) but few (8%) of the lithium reports were judged to have no effect on the psychedelic experience.Discussion: Although further research is needed, we provisionally conclude that psychedelic use may pose a significant seizure risk for patients on lithium.