4-AcO-DET

Significant cardiovascular disease (heart failure, uncontrolled hypertension, recent myocardial infarction) is a relative contraindication due to class-level cardiovascular effects including tachycardia and blood pressure elevation.

Personal or family history of psychotic disorders (schizophrenia, schizoaffective disorder, brief psychotic disorder) is an absolute contraindication. 5-HT2A agonism disrupts thalamocortical gating and may trigger psychotic decompensation in predisposed individuals.

Bipolar disorder (type I and II) represents a relative contraindication due to risk of manic episode precipitation. The risk may extend to individuals with family history of bipolar disorder.

Pregnancy and breastfeeding are absolute contraindications due to complete absence of reproductive safety data and the known role of serotonin in fetal development.

Concurrent use of monoamine oxidase inhibitors (MAOIs) is absolutely contraindicated. Inhibition of MAO-A-mediated metabolism of the active metabolite 4-HO-DET could produce dangerously potentiated and prolonged serotonergic effects.

Concurrent lithium therapy is an absolute contraindication due to reported seizure and cardiac arrhythmia risk when combined with serotonergic psychedelics.

Concurrent tramadol use is absolutely contraindicated due to well-documented serotonin syndrome risk from additive serotonergic mechanisms.