DET

Tachycardia and elevated heart rate documented in early DET clinical studies. Individuals with severe hypertension, heart failure, or recent cardiac events face elevated risk from sympathomimetic stimulation.

DET's primary mechanism — 5-HT2A receptor agonism — directly engages the receptor system implicated in psychotic symptomatology. Individuals with schizophrenia, schizoaffective disorder, or other psychotic spectrum conditions are at elevated risk of acute psychotic crisis.

Bipolar disorder with psychotic features or Type I with history of psychotic episodes represents absolute contraindication. Bipolar II without psychotic history may represent relative contraindication depending on clinical judgment.

First-degree family history of schizophrenia or psychotic disorders elevates the risk of psychosis precipitation. This is a relative contraindication — risk is elevated but not certain.

No DET-specific reproductive data exist. Given the absence of safety data and the theoretical risk of serotonergic disruption during fetal neurodevelopment, pregnancy and breastfeeding represent absolute contraindications.

Lithium is a class-level absolute contraindication for all serotonergic psychedelics. Case reports document seizures and cardiac arrhythmia with psychedelic-lithium combinations. The mechanism is not fully elucidated.

Irreversible MAOIs (phenelzine, tranylcypromine) combined with serotonergic tryptamines create serious serotonin syndrome risk. DET does not require MAOIs for oral activity, making co-administration medically unjustified and dangerous.

SSRIs may blunt, intensify, or paradoxically alter DET's psychedelic effects while adding to serotonergic load. Serotonin toxicity risk is present though lower than with MAOI combinations.