Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures: an analysis of online psychedelic experience reports
Analysing reports from Erowid, Shroomery and Reddit, the authors found that 47% of 62 psychedelic experiences reported while taking lithium involved seizures (39% required medical attention), whereas none of 34 reports from people taking lamotrigine did. They provisionally conclude that classic psychedelics co‑administered with lithium — but not lamotrigine — may pose a substantial seizure risk and warrant further research.
Authors
- Roland Griffiths
- Frederick Barrett
- Sandeep Nayak
Published
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.
Research Summary of 'Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures: an analysis of online psychedelic experience reports'
Introduction
S. and colleagues situate their study in the context of renewed clinical and public interest in classic psychedelics (drugs acting primarily at the 5-HT2A receptor such as LSD and psilocybin) as potential treatments for psychiatric conditions. They note that people with bipolar disorder have been excluded from most modern psychedelic trials because of safety concerns (for example, precipitating mania or psychosis), but that the combination of (a) limited treatment options for bipolar depression, (b) growing public enthusiasm for psilocybin, and (c) the availability of psychedelics outside clinical settings raises the possibility that people prescribed mood stabilizers may self-administer psychedelics. The authors emphasise that little systematic information exists about interactions between classic psychedelics and commonly prescribed mood stabilizers such as lithium and lamotrigine. The paper therefore aims to identify signals of risk by analysing first- and second-person anecdotal ‘‘experience reports’’ posted on public online forums. The objective is not to establish causality but to assess whether reports available in public forums contain evidence of adverse interactions—particularly seizures—when classic psychedelics are coadministered with lithium or lamotrigine, to inform clinicians and guide future research and trial design.
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Study Details
- Study Typeindividual
- Journal
- Compounds
- Topics
- Authors
- APA Citation
Nayak, S., Gukasyan, N., Barrett, F. S., Erowid, E., Erowid, F., & Griffiths, R. R. (2021). Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures: an analysis of online psychedelic experience reports. https://doi.org/10.31234/osf.io/r726d
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Dourron, H. M., Nichols, C. D., Simonsson, O. et al. · Psychopharmacology (2023)
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Nayak, S., Jackson, H., Sepeda, N. D. et al. · Frontiers in Psychiatry (2023)
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Kopra, E., Ferris, J. A., Winstock, A. R. et al. · Journal of Psychopharmacology (2022)
Sarparast, A., Thomas, K., Malcolm, B. et al. · Psychopharmacology (2022)
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