Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports

Summary & key facts

Researchers looked at online reports where people mixed classic psychedelics (like LSD or psilocybin) with mood stabilizers. They found a lot of seizures reported when psychedelics were used with lithium, but no seizures in reports where the mood stabilizer was lamotrigine. The authors say this suggests a possible big seizure risk for people on lithium, but the data come from self-reported web posts so we can’t be sure. More careful research is needed.

Key facts:

• The study collected personal reports from three websites about people using classic psychedelics together with mood stabilizers.
• Out of 62 reports of people who used lithium plus a classic psychedelic, about half reported having a seizure.
• About two in five of the lithium-plus-psychedelic reports said the person needed medical attention after the experience.
• None of the 34 reports about lamotrigine plus a psychedelic described seizures.
• About two-thirds of the lamotrigine reports said the mood stabilizer did not change the psychedelic experience, while only a few lithium reports said the same.
• The authors say these findings suggest a possible substantial seizure risk when classic psychedelics are used with lithium, but they warn that the data are limited because they come from self-reported online posts and can’t prove cause and effect.

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 3 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 not affect 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.

Topics

Forensic Toxicology and Drug Analysis Pain Management and Placebo Effect Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Bipolar disorder Clinical psychology Depression (economics) Economics Epilepsy Hallucinogen Lamotrigine Lithium (medication) Macroeconomics Mania Mood Mood stabilizer Psilocybin Psychiatry Psychology

Substances

LSD Psilocybin

Conditions & symptoms

Depression Panic