History of epilepsy increases risk of psychedelic‐induced seizures

A survey of 613 U.S. adults who had used classic psychedelics at least once found that 1.5% had experienced a seizure while using the drug. Nearly half of those who had a seizure were also taking an antidepressant, mood stabilizer, or opioid replacement therapy. Seizures were more common among individuals with a personal or family history of epilepsy. Even after excluding those with a personal history of epilepsy, seizures remained more frequent among those with a family history. The findings suggest that screening for personal and family epilepsy history may be important for safety in both clinical and non-clinical psychedelic use.

Study at a glance

Abstract

Classic psychedelic drugs such as psilocybin have been associated with reduced depressive symptoms when used as an adjunct to therapy, but concern remains over the potential for adverse events such as seizures when these drugs are used outside controlled clinical settings. A study used a survey of U.S. adults to examine the association between use of classic psychedelics and seizures. The survey included adults who reported at least one lifetime use of a psychedelic. These individuals were asked if they ever had experienced a seizure when using a psychedelic, and if they answered affirmatively they were asked if they had been using other medications at the time, including antidepressants, antipsychotics, and mood stabilizers. Participants also reported whether they or a close family member had a history of epilepsy. A total of 1.5% of 613 individuals who had used a psychedelic had experienced a seizure while using. Nearly half of those who had experienced a seizure had been using an antidepressant, mood stabilizer, or opioid replacement therapy at the time. The investigators found that seizures were common among individuals with a personal or family history of epilepsy. When participants with a personal history of epilepsy were excluded, seizures were still more common among individuals with a family history of epilepsy. “These findings could have real‐world implications both for informing exclusion criteria in classic psychedelic trials and for educating individuals who use classic psychedelics outside of research settings,” the study's authors wrote. [Simonsson O, et al. Drug Alc Dep 2022; published online Aug 11; doi: 10.1016/j.drugalcdep.2022.109586]