DiPT

Pre-existing cardiovascular disease including coronary artery disease, uncontrolled hypertension, heart failure, or arrhythmias. Tryptamine class effects include tachycardia and hypertension. No DiPT-specific cardiovascular data exist, but class-level risk applies.

Personal or family history of schizophrenia, schizoaffective disorder, or other primary psychotic disorders. 5-HT2A agonists carry established risk of precipitating psychotic episodes in predisposed individuals. This is a class-level absolute contraindication for all serotonergic psychedelics.

Bipolar I and II disorder. Risk of triggering manic, hypomanic, or mixed episodes. Classified as relative rather than absolute because some clinical research has explored psychedelic-assisted therapy in bipolar populations under controlled conditions, but uncontrolled use carries significant destabilization risk.

Pregnancy and breastfeeding. No published data on DiPT teratogenicity, reproductive toxicity, or excretion in breast milk. Classified as absolute due to unknown risk profile and absence of any safety data.

Concurrent lithium therapy. Case reports associate lithium plus classical psychedelic combinations with seizures and severe adverse psychological reactions. This combination is considered high-risk despite incomplete mechanistic understanding.

Concurrent or recent use of monoamine oxidase inhibitors (irreversible: phenelzine, tranylcypromine; reversible: moclobemide; natural: harmaline/harmine). Serotonin toxicity risk from pharmacokinetic and pharmacodynamic interaction. Although DiPT is MAO-resistant enough for oral activity, residual MAO substrate activity means MAOI co-administration still amplifies serotonergic load.