Safety & Contraindications

This wiki is educational. Use extra caution with pregnancy, breastfeeding, children, bipolar disorder, psychosis history, seizure disorders, heart disease, kidney disease, liver disease, sleep apnea, anticoagulants, psychiatric medications, and controlled substances.

High-risk combinations

• Serotonergic load: 5-HTP with SSRIs, SNRIs, MAOIs, triptans, tramadol, linezolid, MDMA, LSD, Psilocybin, or Methylene Blue. St. Johns Wort inhibits serotonin reuptake and can cause serotonin syndrome combined with SSRIs/SNRIs. Tropisetron (5-HT3 antagonist) also carries QT-interval prolongation risk — avoid with other QT-prolonging drugs.
• Stimulant load: Caffeine, Matcha, Chai, Guarana, Theacrine, Adderall, Ritalin, Amphetamines, Modafinil, Armodafinil, Nicotine, Mucuna Pruriens, and L-Tyrosine.
• Cholinergic load: Alpha-GPC, Citicoline, Choline, Phosphatidylcholine, DMAE, Huperzine A, Racetams (and all individual racetams: Piracetam, Aniracetam, Oxiracetam, Pramiracetam, Coluracetam, Nefiracetam, Phenylpiracetam), and Noopept.
• Bleeding tendency: Ginkgo Biloba, high-dose Omega-3 Fish Oil, Resveratrol, Reishi, Cat’s Claw, Vinpocetine, high-dose Curcumin, anticoagulants, antiplatelets, and surgery.
• Sedation/dependence load: GABA, Glycine, Melatonin, Oleamide, CBD, Lemon Balm, Valerian Root, Passionflower, Kava (cycling required; max 3x/week), Phenibut, Ashwagandha, alcohol, benzodiazepines, opioids, Kratom, and cannabis.
• CYP450 drug interactions: CBD inhibits CYP3A4 and CYP2D6 and can raise blood levels of many medications (warfarin, antiepileptics, statins, antidepressants). Check interactions before combining CBD with any prescription medication.
• Vasodilation and blood pressure: L-Citrulline, Nitrates, Epicatechin, Ginkgo Biloba, Methylene Blue, PDE5 inhibitors, nitrate medications, and antihypertensives.
• Hormonal/endocrine: Testosterone & Anabolics, Vitamin D, Ashwagandha, Lithium, Berberine (CYP enzyme interactions; blood sugar effects), thyroid medication, fertility goals, and hormone-sensitive conditions.
• Methylation intensity: Folate & 5-Methylfolate, Vitamin B12, Vitamin B6, Choline, Phosphatidylcholine, and high-dose methylated B complexes can feel destabilizing in sensitive users.
• Experimental peptides/research chemicals: BPC-157, Dihexa, 9-Me-Bc, PE-22-28, Epithalon, Pinealon, NSI-189, Semax, Selank, Cerebrolysin, Cortexin, ACD-856, BPN-14770, and Neboglamine.

Dynamic high-caution table

TABLE category, caution_level, mechanisms, dosage_range
FROM "Basics" OR "Supplements" OR "Peptides & Chemicals" OR "Controlled Substances"
WHERE contains(caution_level, "High") OR contains(category, "controlled") OR contains(type, "prescription medication")
SORT category ASC, file.name ASC

Practical rules

Change one variable at a time. Track sleep, mood, blood pressure, resting heart rate, appetite, anxiety, and next-day performance. Stop and reassess when a compound causes insomnia, chest pain, severe anxiety, mania-like symptoms, allergic symptoms, fainting, confusion, or compulsive redosing.