LSA

Pre-existing hypertension compounds the vasoconstrictive effects of ergoline-class compounds. The documented case of LSA-induced PRES with status epilepticus (Legriel et al. 2008) involved acute hypertensive crisis leading to cerebrovascular autoregulatory failure.

Individuals with coronary artery disease, heart failure, or other cardiovascular conditions face elevated risk from ergoline-mediated vasoconstriction and acute blood pressure elevation.

Pre-existing cerebrovascular disease increases vulnerability to LSA's vasoconstrictive effects. The PRES case (Legriel 2008) represents direct evidence of cerebrovascular compromise from LSA.

The documented PRES case included status epilepticus. Individuals with seizure disorders face potentially elevated risk, though the mechanism (direct seizure provocation vs. secondary to PRES) is unclear.

Personal or family history of psychotic disorders is a relative contraindication shared across all serotonergic psychedelics. Post-use psychosis-like states requiring hospitalization have been documented for LSA (Castro & Maia 2024). The Klinke 2010 fatal case involved severely impaired reality testing.

Bipolar disorder is a class-level contraindication for serotonergic psychedelics. No LSA-specific data exist, but the 5-HT2A agonist mechanism carries the same theoretical risk as LSD and psilocybin.

LSA-containing seeds contain ergometrine and other ergoline co-alkaloids with documented uterotonic activity. Seed-based preparations pose direct abortifacient risk. Purified LSA's reproductive toxicity has not been evaluated, but the ergoline scaffold carries inherent uterotonic potential.

Concurrent use of MAOIs, SSRIs, SNRIs, tramadol, or other serotonergic agents is contraindicated due to serotonin syndrome risk. No published case report of LSA-induced serotonin syndrome exists, but the pharmacological mechanism is well-established.