Pharmacopsychiatry 2021; 54(05): 240-245
DOI: 10.1055/a-1524-2794
Original Paper

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

Sandeep M. Nayak
1   Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Natalie Gukasyan
1   Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Frederick S. Barrett
1   Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Earth Erowid
2   Erowid Center, Grass Valley, CA, USA
Fire Erowid
2   Erowid Center, Grass Valley, CA, USA
Roland R. Griffiths
1   Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
3   Department of Neuroscience, Johns Hopkins University School of Medicine, USA
› Author Affiliations
Funding: The Center for Psychedelic and Consciousness Research is funded by philanthropic support from the Steven and Alexandra Cohen Foundation, as well as Tim Ferriss, Matt Mullenweg, Blake Mycoskie, and Craig Nerenberg. NG is also funded by NIDA T32DA07209. The funders had no input on the design, execution, or interpretation of this report.


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 (,, and

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.

Supplementary Material

Publication History

Received: 28 February 2021
Received: 11 May 2021

Accepted: 25 May 2021

Article published online:
04 August 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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