LSZ

Severe uncontrolled hypertension, recent myocardial infarction, or conditions where acute hemodynamic stress poses significant risk. Relative contraindication based on class-level cardiovascular effects.

Lithium must be fully cleared before psychedelic use. Even subtherapeutic lithium levels may be sufficient to trigger seizures, as documented in a case report of an adolescent on low-dose lithium therapy (Edwards et al. 2024).

Pre-existing seizure disorders or epilepsy may increase vulnerability to seizure-related adverse effects, though direct evidence for LSZ is absent.

Personal or first-degree family history of psychotic disorders or schizophrenia-spectrum conditions. 5-HT2A agonism disrupts cortical filtering mechanisms implicated in psychosis.

Bipolar disorder of any type. Risk of triggering manic or mixed episodes applies regardless of current mood stability.

Pregnancy and breastfeeding are absolute contraindications on precautionary grounds. Ergoline class uterotonic effects pose theoretical risk.

Concurrent or recent tramadol use due to serotonin syndrome risk from dual serotonergic activation.