Warning/Caution

Not all people should use magic mushrooms or LSD to treat their cluster headaches. There might be problems with this treatment for some people, and mushrooms or LSD may interact with other drugs. As well, there are situations that people using mushrooms or LSD may want to be careful of or avoid altogether.

Who should seriously consider not taking mushrooms or LSD to treat their cluster headaches?

People diagnosed in the past or present with a psychotic disorder, or people with biological parents or siblings diagnosed with a psychotic disorder should seriously consider not taking psilocybin-containing mushrooms or LSD.. Schizophrenia is the most common psychotic disorder, but there are others, such as delusional disorder or affective (mood-related) psychosis. Mushrooms or LSD may exacerbate symptoms of psychosis and they may trigger psychosis in people who were psychotic in the past, or with immediate family members who were or are psychotic. In addition, the medications prescribed for psychosis interact with mushrooms and LSD. They can reduce some of the effects, and at least one (haloperidol, or Haldol) can make some of the negative effects of mushrooms, like anxiety, worse.

People taking lithium, whether it is for preventing cluster headaches or for some other reason (it is often prescribed for people with bipolar affective disorder - see below for more on bipolar disorder). Anecdotal reports suggest that lithium can greatly potentiate the effects of LSD or mushrooms, and that it can produce very unpleasant feelings, and an examination of a number of reports suggested that lithium can either increase or decrease effects. This combination may even produce episodes that sound like, and that perhaps are, epileptic seizures. If people are taking lithium for treating cluster headaches and it is not working, they may want to talk with their doctor about not taking it any more before trying mushrooms or LSD. If people are taking lithium for bipolar affective disorder, they probably should continue taking lithium, and they should avoid taking mushrooms or LSD for cluster headaches.

When should people think carefully before using mushrooms or LSD as a treatment for their cluster headaches?

Taking psilocybin-containing mushrooms or LSD during or immediately after a period of emotional upheaval, as happens after a relationship breakup or after the death of a loved one, may intensify negative emotions associated with these troubles, even to a proportion that feels "out of control." Some people confront intense distress as part of therapy for dealing with difficult life problems, but not everyone is willing or able to use psychedelics in this way, and some people may place themselves at risk of harming themselves or others by taking mushrooms or LSD when very upset. There may be times when a person may have to choose between dealing with stressful life situations or treating a cluster headache. People should think carefully about how much they are prepared for and interested in confronting intense fear, anger, or sadness when deciding whether they should treat a headache or break a cycle during a time of intense emotional distress, and they may want to speak with a doctor, psychotherapist or trusted friend before reaching a decision.

People should speak with their doctor before using mushrooms or LSD as a cluser headache treatment when:

They have clinical depression or are having thoughts about harming themselves right before taking mushrooms or LSD (It is understood that sometimes people feel this way during a cluster attack). Mushrooms or LSD could intensify these feelings.

They are taking certain types of antidepressants ("tricyclic" antidepressants, such as Trofanil (imipramine), Anafranil (clomipramine) and others, may intensify the psychedelic effects of mushrooms or LSD; "SSRIs," such as Prozac (fluoxetine), Paxil (paroxetine) and others, may blunt those effects. It is unknown whether these medications also intensify or blunt the effects of mushrooms or LSD on cluster headaches, but this possibility exists.)

They are just starting to take a monoamine oxidase inhibitor (MAOI) such as Nardil or Parnate, medications usually prescribed for depression, but sometimes for other conditions. Initially, MAOIs taken along with mushrooms or LSD may greatly intensify the experience. However, after continued use (as perhaps after a month or more), MAOIs will tend to reduce the psychedelic effects of mushrooms and LSD. It is unknown whether chronic MAOI use also reduces the effectiveness of mushrooms or LSD as a preventative for cluster headaches, but the possibility exists.

They are taking other types of psychiatric medication (Haldol, Risperdal, Zyprexa). First of all, these medications are often prescribed for people with psychosis. Even if that is not the reason for taking them, they may reduce psychedelic effects and/or actually make them worse to some degree (in the case of Haldol).

They have Reynaud's syndrome (cold-triggered reduction or loss of circulation in fingers and toes) because this condition will be made worse by taking a vasoconstrictor, and mushrooms and LSD are vasoconstrictors.

They have serious liver problems; mushrooms might have compounds that could affect the liver.

They have serious cardiovascular (high blood pressure or heart) problems. Though physiological effects of psilocybin-containing mushrooms are not great, they do increase blood pressure to some degree.

Where to take mushrooms or LSD - and where not to take them.

Even though most people will be using only slightly psychedelic doses of mushrooms or LSD, it is a good idea for people to take these substances in a space where they feel safe and with people they trust and like. Once a person is comfortable with the effects, he or she can probably be less cautious about taking mushrooms or LSD in public places or new places, but most people should probably start in places and with people they know well. They should arrange things so that they do not have to drive a car or other motor vehicle when under the influence of mushrooms or LSD, and they should be sure that if they really need medical help, they can get it quickly.

People should avoid taking mushrooms or LSD in places where they do not feel safe (especially in any place where they feel frightened or upset) or with people they do not trust. Even if nothing bad happens, anxiety or worry may enhance any negative changes in mood from mushrooms or LSD. People should avoid taking mushrooms or LSD in a situation where they must drive a motor vehicle at any time while they are experiencing the effects of mushrooms or LSD.

Prepared by Clusterbusters with major contributions from:

Ilsa Jerome PhD
Research Associate
Multidisciplinary Association for Psychedelic Studies