SWIM has searched extensively online for answers. Unfortunately, has yet to find what he thinks are answers relevant to his questions either here or on the Google machine. He apologizes about the length.

He has vaped freebase DMT twice. He would like to safely make another attempt at a breakthrough. However, the situation is complicated since he's bipolar. His symptoms were a bit atypical - while he was showing symptoms he never went 'full manic' or had anything resembling psychosis at any point. He is stable, and has been for over a decade now. If this weren't the case, he would leave DMT alone and wait until he had a lot more time under his belt. This is where the real catch comes in:
The medication 'team' that has worked so well for him for years now consists of Parnate (an MAOI) and Lithium carbonate.

Since he's on an MAOI, ayahuasca is off the table, but he is looking to vape. Going into it the first (and only so far) time, he was curious as to see what effect the MAOI would have, given that it wasn't taken as a tea, but was thoroughly 'in the system'. He figured that if anything, he'd have a longer experience.

For anyone else on a prescribed daily MAOI, when he tried vaped freebase, he was there and back in twenty minutes. This does match the descriptions of 'typical' timelines he read about. Of course, this could just be his personal chemistry. 30's. Male. 250lbs-ish. 50mg freebase.

The experience itself was totally hellish. Abject terror. No entities. No beautiful colors. No rooms. No personal growth. Nothing that could even be seen as the kind of 'this is a rough trip, but it is what you need to grow' stuff he'd read about sometimes. Total fear. Lots of fragmentation, for sure. Strangely enough, if he didn't count the fragmentation, he didn't experience anything that he would describe as outright hallucinogenic. Given the nature of his experience and those he's read about, he's honestly not even sure if he broke through or was just about to but then dealt very, very badly with the concept of ego death.

Afterwards, he figured that he might have dosed too much (of course he read many times that one should always start low, but totally spaced it when measuring--stupid). Or there was something with the set and setting. Or both.

He tried with 10mg a few weeks later. Not even enough for fractals. Body high. No problems. Pleasant, but nothing to write home about.

He had read up on the MAOI as a potential problem because of its interactions with other medication, though he totally missed the Lithium part. Later on, he found that Lithium responds very badly with psychedelics.

In short:
Lithium + LSD = trip to hell (best case) and possibly seizures.

Strangely enough, the more he read on the Lithium interaction, the more he saw the strong consensus that though Lithium responded badly to psychedelics, the specific drugs mentioned were frequently acid and LSD, with DMT sort of 'lumped in'. Maybe it was how he read it, but it kind of seemed like people knew that Lithium didn't play nice with the psychedelic kids on the playground, but that DMT was almost an assumption. "Well, we know that it doesn't work with LSD and acid, along with some other psychedelics, and DMT is a psychedelic, so we'll just include it on the list..."

So, in hindsight, he's not sure if the nasty first attempt was a result of bad set/setting/dosage/luck or if it was pretty much guaranteed to be bad because of the lithium and if anything he should count himself lucky that he didn't have a seizure.

He would like to try again. However, now that he has found out about the possible Lithium issue, he's not sure how to best proceed. Of course, he doesn't want another terrible experience like the first time, and the risks of seizures outweigh any benefit outright. So he's essentially left wondering if Lithium is nasty and downright dangerous for LSD, acid, etc... but not DMT. Trying again is safe?

If it turns out that Lithium is dangerous with these drugs, DMT included, he'd need to either stop or taper off of Lithium, vape, and then resume if he still wanted to try for it. If he did, what would a timeframe for that look like? He's seen references to lithium being 'out of your system' range from a few days to months and doesn't really know what kind of timeframe he's looking at.