Psilocin
4-hydroxy-N,N-dimethyltryptamine
Lethal interactions
| Combination | Type | Severity | Mechanisms | Confidence |
|---|---|---|---|---|
| MAOIs | Drug class | lethal | 2 | high |
Dangerous interactions
17 dangerous interactions recorded for this substance.
See the full interactions tableContraindications
| Condition | Severity | Note |
|---|---|---|
| Cardiovascular | ||
| uncontrolled hypertension | relative | Transient but clinically significant blood pressure elevations documented across all dose ranges in pooled meta-analysis. Patients with uncontrolled hypertension, recent MI, unstable angina, or heart failure should not receive psilocin without cardiology consultation. |
| Psychiatric | ||
| psychotic disorders | absolute | Personal or family history of schizophrenia, schizoaffective disorder, or other psychotic disorders. All clinical trials exclude these populations. Johnson et al. 2018 identified psychosis exacerbation as a primary harm concern. |
| bipolar disorder | absolute | Bipolar disorder type I is an absolute contraindication. Bipolar II may represent a relative contraindication depending on clinical context and stability. |
| Pregnancy & Breastfeeding | ||
| pregnancy and breastfeeding | relative | Insufficient safety data to characterize risk. All clinical trials exclude pregnant and breastfeeding participants. Contraindication based on absence of safety data rather than documented harm. |
| Other | ||
| lithium use | absolute | Concurrent lithium was the strongest pharmacological predictor of both challenging experiences and overall harm risk in multivariate regression analysis (Simonsson et al. 2023, N=613). Seizure risk is elevated. |
| mood stabilizer use | absolute | Co-use of mood stabilizers other than lithium was also significantly associated with challenging experiences and harm in epidemiological data. |