2C-T

hypertension, arrhythmia, structural heart disease

Pre-existing cardiovascular disease (hypertension, arrhythmia, structural heart disease) is a relative contraindication. The 2C class produces sympathomimetic effects at supratherapeutic doses, and 5-HT₂B partial agonism adds a theoretical chronic cardiac risk. Caution warranted even at common doses in individuals with compromised cardiovascular function.

lithium carbonate, lithium citrate

Concurrent lithium use is absolutely contraindicated. Seizures have been reported in combination with serotonergic hallucinogens (LSD, psilocybin class). No 2C-T-specific data exist, but the pharmacodynamic interaction is class-level and the consequence is severe.

schizophrenia, schizoaffective disorder, family history of psychosis

Personal or family history of psychotic disorders (schizophrenia, schizoaffective disorder) is an absolute contraindication. 5-HT₂A agonism is the primary mechanism of psychedelic action and may trigger psychotic episodes in predisposed individuals. This is a class-level contraindication applying to all serotonergic psychedelics.

bipolar I disorder, bipolar II disorder

Bipolar disorder, especially Type I, is a relative contraindication. Serotonergic psychedelics may precipitate manic episodes or destabilize mood cycling. No 2C-T-specific data; this is a class-level inference from serotonergic psychedelic literature.

pregnancy, breastfeeding

Pregnancy and breastfeeding are relative contraindications on precautionary grounds. No reproductive toxicity studies have been conducted for 2C-T or any 2C-class compound. Standard precautionary principle applies to all bioactive substances lacking reproductive safety data.

phenelzine, tranylcypromine, moclobemide, selegiline, harmaline, Syrian rue, ayahuasca

Concurrent use of monoamine oxidase inhibitors — whether prescription (phenelzine, tranylcypromine, moclobemide, selegiline) or plant-derived (harmaline, Syrian rue, ayahuasca) — is absolutely contraindicated. MAO is the presumed primary metabolic pathway for 2C-T; inhibition prolongs exposure and potentiates both serotonergic and sympathomimetic effects, risking serotonin toxicity characterized by hyperthermia, neuromuscular excitability, and altered mental status.

SSRIs, SNRIs, tramadol

Concurrent serotonergic medications (SSRIs, SNRIs, tramadol) represent a relative contraindication due to unpredictable pharmacodynamic interactions. Serotonin syndrome risk exists through additive serotonergic load. SSRIs may blunt psychedelic effects via chronic 5-HT₂A downregulation, but the interaction is bidirectional and dose/timing-dependent.