Psilocybin and lithium
DangerousMood stabiliser · also: lithium carbonate, priadel, camcolit, lithobid, eskalith
Psilocybin and lithium: dangerous, the clearest interaction signal for any psychiatric medication studied with psychedelics so far, with seizures described in nearly half of the online reports of the combination.
Seizures, in people with no seizure history. In the same reports, many people sought medical attention.
Claims re-checked against the cited sources:
Why it happens
Not established in humans. In rats, lithium pretreatment turned a normally non-convulsant dose of a 5-HT2 agonist into a seizure-causing one, and a 5-HT2 blocker prevented this, which suggests lithium amplifies signalling downstream of the receptor psilocin acts on. Lithium toxicity can also cause seizures on its own. The human evidence comes from user reports and case reports, not trials.
What is known
The strongest signal for any psilocybin drug interaction. Nayak et al. (2021) analysed 62 online reports of lithium combined with a classical psychedelic: 47% involved a seizure, and 39% involved medical attention. That is a very high rate, though the sample is self-selected. The same study found no seizures in 34 reports of lamotrigine.
- 2021
- Of 62 online reports of lithium combined with a classic psychedelic (LSD or psilocybin among others), 47% involved seizures, a further 18% described bad trips, and 39% involved medical attention. None of 34 lamotrigine reports involved a seizure. Nayak et al., 'Classic psychedelic coadministration with lithium, but not lamotrigine, is associated with seizures', Pharmacopsychiatry
- 2024
- A 15-year-old with no seizure history had three generalised seizures within 30 minutes of taking LSD after recently starting low-dose lithium; earlier LSD use on fluoxetine and bupropion had not caused seizures. Edwards et al., 'New-onset seizures in an adolescent following use of LSD while on low-dose lithium therapy: a case study', S D Med
- 2024
- A scoping review concluded that classic psychedelics may not raise seizure risk in healthy people taking no other drugs, but that co-use of other substances, such as lithium, could; it also notes the data have limited external validity. Soto-Angona et al., 'Do classic psychedelics increase the risk of seizures? A scoping review', Eur Neuropsychopharmacol
- 1994
- In rats, lithium pretreatment caused seizures after a dose of the 5-HT2 agonist DOI that did not cause seizures in lithium-naive rats; ritanserin pretreatment blocked them. Williams & Jope, 'Lithium potentiates phosphoinositide-linked 5-HT receptor stimulation in vivo', Neuroreport
- 2026
- The lithium label lists seizure among the severe manifestations of lithium toxicity. LITHOBID (lithium carbonate ER) US prescribing information, DailyMed (label version Aug 2026)
Safety guidance
- Do not combine psilocybin with lithium; this is the one firm no on the list.
- Do not stop or skip lithium to make room for a trip; that decision belongs with whoever prescribes it, because stopping risks a manic or depressive episode.
- A low lithium dose is not a safe zone: a published seizure case involved low-dose lithium that had only recently been started.
- Lamotrigine is not the same risk; the same study found no seizure signal with it.
When to seek help
Call emergency services for any seizure, jerking or stiffening, loss of consciousness, or confusion that does not lift. Tell responders that the person takes lithium and has taken mushrooms. Emergency red flags.
Common questions
Is a small dose of mushrooms safe if I take lithium?
There is no known safe dose. The reports do not show a threshold, and one published seizure happened with low-dose lithium.
Is lamotrigine as risky as lithium?
No. The 2021 report analysis found seizures in 47% of lithium reports and in none of 34 lamotrigine reports.
Should I stop my lithium before a trip?
No. Stopping lithium has its own serious risks. If you want to explore psychedelics, talk to whoever manages your lithium first.
Sources
How we research this: sources, evidence grading, review and updates.