Psilocybin and lamotrigine
Low riskMood stabiliser / anticonvulsant · also: lamictal
Lamotrigine has not been linked to seizures or other serious problems with psychedelics, unlike lithium, but the bipolar disorder it is often prescribed for carries its own risk of mania.
No characteristic interaction identified.
Claims re-checked against the cited sources:
Why it happens
Lamotrigine is an anticonvulsant thought to work by inhibiting voltage-sensitive sodium channels; it does not act at 5-HT2A. It is not expected to change psilocybin's effects or raise seizure risk. The main concern is the underlying diagnosis: psilocybin use in bipolar disorder has been followed by new or worsening manic symptoms in some people.
What is known
Worth stating clearly because lamotrigine is often lumped in with lithium as 'a mood stabiliser'. The Nayak 2021 analysis looked at both and found the seizure signal with lithium and NOT with lamotrigine.
- 2021
- In an analysis of online reports, 47% of 62 lithium-plus-psychedelic reports involved seizures, while none of 34 lamotrigine reports did; 65% of lamotrigine reports were judged not to affect the psychedelic experience. Nayak et al., Pharmacopsychiatry 2021
- 2026
- The Lamictal label describes inhibition of voltage-sensitive sodium channels as a proposed mechanism and warns that it should not be stopped abruptly because of withdrawal seizures. LAMICTAL (lamotrigine) US prescribing information, DailyMed
- 2023
- In a web survey of 541 people with bipolar disorder who had used psilocybin, 32.2% described new or increasing symptoms afterwards, prominently manic symptoms, sleep problems and anxiety; 3.3% used emergency services. Morton et al., Journal of Psychopharmacology 2023
Safety guidance
- Lamotrigine is not in the same risk category as lithium.
- If you have bipolar disorder, the diagnosis is the main risk; watch for poor sleep, racing thoughts and elevated mood in the days after.
- Do not stop lamotrigine to take mushrooms; the label warns against abrupt discontinuation.
- Protect your sleep before and after.
When to seek help
Contact your care team or a doctor if you notice signs of mania such as little need for sleep, racing thoughts or risky behaviour in the days after, or seek emergency help for a seizure. Emergency red flags.
Common questions
Is lamotrigine dangerous like lithium?
No signal has been found. In one analysis none of 34 lamotrigine reports involved seizures, compared with 47% of lithium reports.
Will lamotrigine weaken the trip?
Most lamotrigine reports in one analysis were judged not to affect the experience.
Why be careful then?
Because lamotrigine is often prescribed for bipolar disorder, and psilocybin use has been followed by manic symptoms in some people with bipolar disorder.
Sources
How we research this: sources, evidence grading, review and updates.