Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures: an analysis of online psychedelic experience reports
Sandeep M. Nayak, Natalie Gukasyan, Frederick S. Barrett, Earth Erowid, Fire Erowid, Roland R. Griffiths
February 24, 2021 preprint DOI: 10.31234/osf.io/r726d via OpenAlex
Summary
AI-generated from the abstractClassic psychedelics such as LSD or psilocybin may pose a significant seizure risk for people taking the mood stabilizer lithium. Analysis of online reports found that 47% of 62 accounts of combining lithium with a psychedelic involved seizures, and an additional 18% resulted in bad trips; 39% required medical attention. In contrast, none of 34 reports of the mood stabilizer lamotrigine combined with a psychedelic involved seizures, and most lamotrigine reports (65%) indicated no effect on the psychedelic experience. The authors provisionally conclude that psychedelic use with lithium carries a seizure risk, warranting further research.
Study at a glance
| Characteristics | Retrospective analysis of online reports |
|---|---|
| Sample size | 96 |
| Population | Individuals who reported combining a classic psychedelic with a mood stabilizer (lithium or lamotrigine) on Erowid.org, Shroomery.org, or Reddit.com |
| Interventions | Classic psychedelics (e.g. LSD or psilocybin) |
| Topics | Psilocybin |
| Keywords | Mood stabilizer Lamotrigine Lithium medication Bipolar disorder |
| Citations | 10 |
| Key finding | 47% of lithium plus psychedelic reports involved seizures, whereas no lamotrigine plus psychedelic reports did. |
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.