1B-LSD

Severe or uncontrolled cardiovascular disease is a relative contraindication. LSD produces mild-to-moderate heart rate and blood pressure increases that may be clinically significant in individuals with pre-existing cardiac conditions.

Epilepsy or conditions that lower seizure threshold represent a relative contraindication. While no 1B-LSD-specific seizure data exist, the psychedelic class is associated with potential seizure threshold reduction.

Personal or family history of psychotic disorders is an absolute contraindication. LSD-class psychedelics act primarily through 5-HT2A receptor agonism, which can trigger acute psychotic episodes and potentially precipitate chronic psychotic illness in predisposed individuals.

Bipolar disorder, particularly type I, is a relative contraindication. Psychedelic-induced mood destabilization may precipitate manic, hypomanic, or mixed episodes.

Known CYP2D6 poor metabolizer status is a relative contraindication. These individuals experience substantially higher LSD exposure after prodrug conversion, resulting in prolonged and intensified effects that increase the risk of adverse psychological outcomes.

Pregnancy is an absolute contraindication. No reproductive toxicity data exist for 1B-LSD. Ergoline compounds possess uterotonic properties, and serotonergic agents may affect fetal neurodevelopment.

Concurrent lithium use is an absolute contraindication based on consistent anecdotal reports of seizures and severe adverse reactions when lithium is combined with LSD-class psychedelics. No controlled study has confirmed the mechanism, but the consistency of reports warrants absolute classification.

Concurrent tramadol use is contraindicated due to the risk of serotonin syndrome. Tramadol's serotonin reuptake inhibition combined with LSD's direct 5-HT2A agonism creates the multi-mechanism serotonergic activation required for life-threatening serotonin toxicity.