What does a MAO-I do?

[Alfa]

Holy shit! I just realised that there is no thread (unless i searched wrong) about what Mono-Amine-Oxidase-Inhibitors (MAO-I's) exactly do.
Please post info here. If possible in terms that are not to technical.

[fnord]

Monoamine oxidase inhibitors (MAOIs) are a powerful class of antidepressant drugs prescribed for the treatment of depression. They are particularly effective in treating atypical depression, and have also shown efficacy in helping smokers to quit.

Due to potentially lethal dietary and drug interactions they had been reserved as a last line of defense, used only when other classes of antidepressant drugs (for example tricyclic antidepressants and selective serotonin reuptake inhibitors) have been tried unsuccessfully. Recently, however, a patch form of the drug selegiline, called Emsam, was developed. It was approved for use by the FDA on February 28, 2006. When applied transdermally the drug does not enter the gastro-intestinal system as it does when taken orally, thereby decreasing the dangers of dietary interactions associated with MAOI pills.

Monoamine oxidase inhibitors include:

* Isocarboxazid (Marplan)
* Moclobemide (Aurorix, Manerix, Moclodura®)
* Phenelzine (Nardil)
* Tranylcypromine (Parnate contents 5 mg, Jatrosom contents 10 mg)
* Selegiline (Selegiline, Eldepryl), and Emsam
* Nialamide
* Iproniazid (Marsilid, Iprozid, Ipronid, Rivivol, Propilniazida)
* Iproclozide
* Toloxatone
* Many tryptamines have MAOI properties. Harmine (present in Harmal, Banisteriopsis caapi, and tobacco) is a powerful MAOI, which is often used as one of the ingredients of ayahuasca. Certain synthetic trytptamines such as AMT, 5-MeO-DMT or 5-MeO-AMT produce only minor MAO inhibition. The phenethylamine derivatives substituted with a sulfur at the 4-position, such as 2C-T-7 are quite potent MAO-A inhibitors, which makes them potentially dangerous when taken in large doses, or when combined with stimulants such as ephedrine or MDMA. Some deaths have occurred from such combinations.

cut/paste from wikipedia

[Heretic.Ape.]

Broad topic but I guess I'll just start with the most common aspect in a forum such as this: potentiation.
Many neurotransmitters and molecules that mimic those transmitters are amines: dop-amine is a great example of a neurotransmitter; trypt-amines are a great example of types of drugs that effect brain function, ex. LSD, DMT, psilocybin, et cetera.
The body, in its constant stuggle for homeostasis and effort to keep the brain funtioning normally, is constantly releasing monoamine oxidase which oxidizes, or catalyzes the breakdown, of amines to regulate levels of such molecules created by the body and to guard against the influence of chemicals taken into the body. Some drugs, like LSD for example, are fairly slowly broken down by the bodies defenses and thus a good solid trip for several hours can be obtained by ingesting the substance before it is broken down completely. Some substances, like DMT, are made in the body so the body is very good at breaking them down. What an MAO-I (monoamine oxidase inhibitor) does is to, well, inhibit the production of monoamine oxidase. Thus, using the example of DMT, if an individual ingests an MAO-I a little while before ingesting a DMT containing substance, the production of MAO will be drastically reduced and the DMT will have an opportunity to reach and affect the brain; which it could not before.

Reputation Comments on this post:

I've been wondering this for a while. Great, informative, post.

[Heretic.Ape.]

These foods can be dangerous while taking maoi's
http://www.biopark.org/maoi-1.html

Foods to Avoid ALCOHOLIC BEVERAGES - avoid Chianti wine and vermouth. Consumption of red, white, and port WINE in quantities less than 120 mL present little risk (Anon, 1989; Da Prada et al, 1988; McCabe, 1986). BEER and ALE should also be avoided (McCabe, 1986), however other investigators feel major domestic (US) brands of beer is safe in small quantities (1/2 cup or less than 120 mL) (Anon, 1989; Da Prada, 1988),
but imported beer should not be consumed unless a specific brand is known to be safe. WHISKEY and LIQUEURS such as Drambuie(R) and Chartreuse(R) have caused reactions. NONALCOHOLIC BEVERAGES (alcohol- free beer and wines) may contain tyramine and should be avoided (Anon, 1989; Stockley, 1993).
BANANA PEELS - a single case report implicates a BANANA as the causative agent, which involved the consumption of whole stewed green banana, including the peel. Ripe banana pulp contains 7 mcg/gram of tyramine compared to a peel which contains 65 mcg/gram and 700 mcg of tyramine and dopamine, respectively (McCabe, 1986).
BEAN CURD - fermented bean curd, fermented soya bean, soya bean pastes contain a significant amount of tyramine (Anon, 1989).
BROAD (FAVA) BEAN PODS - these beans contain dopa, not tyramine, which is metabolized to dopamine and may cause a pressor reaction and therefore should not be eaten particularly if overripe (McCabe, 1986; Anon, 1989; Brown & Bryant, 1988).
CHEESE - tyramine content cannot be predicted based on appearance, flavor, or variety and therefore should be avoided. CREAM CHEESE and COTTAGE CHEESE have no detectable level of tyramine (McCabe, 1986; Anon, 1989, Brown & Bryant, 1988).
FISH - fresh fish (Anon, 1989; McCabe, 1986) and vacuum- packed pickled fish or CAVIAR contain only small amounts of tyramine and are safe if consumed promptly or refrigerated for short periods; longer storage may be dangerous (Anon, 1989). Smoked, fermented, pickled (Herring) and otherwise aged fish, meat, or any spoiled food may contain high levels of tyramine and should be avoided (Anon, 1989; Brown & Bryant, 1988).
GINSENG - some preparations have resulted in a headache, tremulousness, and manic-like symptoms (Anon, 1989).
PROTEIN EXTRACTS - three brands of meat extract contained 95, 206, and 304 mcg/gram of tyramine and therefore meat extracts should be avoided (McCabe, 1986). Avoid liquid and powdered PROTEIN DIETARY SUPPLEMENTS (Anon, 1989).
MEAT, nonfresh or liver - no detectable levels identified in fresh chicken livers; high tyramine content found in spoiled or unfresh livers (McCabe, 1986). Fresh meat is safe, caution suggested in restaurants (Anon, 1989; Da Prada et al, 1988).
SAUSAGE, BOLOGNA, PEPPERONI and SALAMI contain large amounts of tyramine (Anon, 1989; Da Prada et al, 1988; McCabe, 1986). No detectable tyramine levels were identified in country CURED HAM (McCabe, 1986).
SAUERKRAUT - tyramine content has varied from 20 to 95 mcg/gram and should be avoided (McCabe, 1986).
SHRIMP PASTE - contain a large amount of tyramine (Anon, 1989).
SOUPS - should be avoided as protein extracts may be present; miso soup is prepared from fermented bean curd and contain tyramine in large amounts and should not be consumed (Anon, 1989).
YEAST, Brewer's or extracts - yeast extracts (Marmite) which are spread on bread or mixed with water, Brewer's yeast, or yeast vitamin supplements should not be consumed. Yeast used in baking is safe (Anon, 1989; Da Prada et al, 1988; McCabe, 1986).
The foods to use with caution list categorizes foods that have been reported to cause a hypertensive crisis if foods were consumed in large quantities, stored for prolong periods, or if contamination occurred. Small servings (1/2 cup, or less than 120 mL) of the following foods are not expected to pose a risk for patients on MAOI therapy (McCabe, 1986).
FOODS TO USE WITH CAUTION
(1/2 cup or less than 120 mL)
Alcoholic beverages - see under foods to avoid.
AVOCADOS - contain tyramine, particularly overripe (Anon, 1989) but may be used in small amounts if not overripened (McCabe, 1986).
CAFFEINE - contains a weak pressor agent, large amounts may cause a reaction (Anon, 1989).
CHOCOLATE - is safe to ingest for most patients, unless consumed in large amounts (Anon, 1989; McCabe, 1986).
DAIRY PRODUCTS - CREAM, SOUR CREAM, cottage cheese, cream cheese, YOGURT, or MILK should pose little risk unless prolonged storage or lack of sanitation standards exists (Anon, 1989; McCabe, 1986). Products should not be used if close to the expiration date (McCabe, 1986).
NUTS - large quantities of PEANUTS were implicated in a hypertensive reaction and headache. COCONUTS and BRAZIL NUTS have also been implicated, however no analysis of the tyramine content was performed (McCabe, 1986).
RASPBERRIES - contain tyramine and small amounts are expected to be safe (McCabe, 1986).
SOY SAUCE - has been reported to contain large amounts of tyramine and reactions have been reported with teriyaki (Anon, 1989), however analysis of soy sauce reveals a tyramine level of 1.76 mcg/mL and fermented meat may have contributed to the previously reported reactions (McCabe, 1986).
SPINACH, New Zealand prickly or hot weather - large amounts have resulted in a reaction (Anon, 1989; McCabe, 1986).
More than 200 foods contain tyramine in small quantities and have been implicated in reactions with MAOI therapy, however the majority of the previous reactions were due to the consumption of spoiled food. Evidence does not support the restriction of the following foods listed if the food is fresh (McCabe, 1986).

[Heretic.Ape.]

An interesting side note on MAO and drug use: people who score high on standard psychological tests for the personality attribute of "sensation-seeking", defined as the drive to seek out novel, complex, varied, and intense experiences regardless of legal, social, or physical risk, show a negative correlation to MAO levels. High sensation seeking is known as a fairly good guage as to the likelyhood of a person using drugs and how many different types of drugs they take.

[longdistancerunner]

Originally Posted by heretic.ape.

An interesting side note on MAO and drug use: people who score high on standard psychological tests for the personality attribute of "sensation-seeking", defined as the drive to seek out novel, complex, varied, and intense experiences regardless of legal, social, or physical risk, show a negative correlation to MAO brain levels. High sensation seeking is one of the best guages as to the likelyhood of a person using drugs and how many different types of drugs they take.

Do you have a link to that study?

[fnord]

i think we need a list of food that are ok to eat,swim had MANY problems finding one of those the best he could find was foods that might be ok,and white rice is fine to eat,swims also had no problem with saltine crackers

[Heretic.Ape.]

I'll look around for that source. I just remember it from some studies I did a year ago (it stuck out becuase monkey scores high on sensation seeking and has been known to be rather experimental ). It wasn't an electronic source (which means it's buried somewhere in the mountain of papers and books passing for my room) but I'm sure I can find an electronic version of the research and upload it some time, probably next week.

[Heretic.Ape.]

Ok, the source was an introductory text on biological, psychological, and environmental Motivation theory by Lambert Deckers but the sources are not noted thruoghout the text so I can't tell where specific information came from. I did a quick gander online and found a few articles--just the first things I came across as an example. If anyone wants I can upload some of these or similar (i'll look around more when I'm back in town next week).

Personality traits and platelet MAO activity in alcohol and drug abusing teenage boys.
Acta Psychiatr Scand. 1987; 75(3):307-14 (ISSN: 0001-690X)
von Knorring L; Oreland L; von Knorring AL
The aim of this study has been to investigate whether teenage boys with mixed drug abuse differ from those with pure alcohol abuse as concerns personality traits and platelet monoamine oxidase activity. The series included 1129 consecutive 18-year-old males called to the Enlistment Center in the northern part of Sweden. A special inventory was constructed based on Zuckerman Sensation Seeking Scale (SSS), Eysenck's Personality Inventory (EPI), the Karolinska Scales of Personality (KSP) and questions about alcohol and drug consumption. The subjects with mixed drug abuse (n = 96) had high scores in the two subscales of SSS and KSP related to ability to stand boredom, high scores in both subscales of EPI and KSP related to impulsivity, high scores in Thrill and Adventure Seeking (TAS) and Experience Seeking (ES) of SSS as well as low platelet monoamine oxidase activity. The males with pure alcohol abuse (n = 33) also showed signs of monotony avoidance and impulsivity, but this type of abuse was not clearly related to low platelet monoamine oxidase activity and not to the aspects of curiosity included in the SSS such as TAS and ES. These findings are consistent with the picture earlier found as concerns "Type II" alcoholism which has an early onset, is genetically transmitted, is associated with mixed drug abuse and social complications.


Psychological correlates of monoamine oxidase activity in normals.
J Nerv Ment Dis. 1978; 166(3):177-86 (ISSN: 0022-3018)
Schooler C; Zahn TP; Murphy DL; Buchsbaum MS
This study replicates and extends earlier work by finding that low levels of platelet monoamine oxidase (MAO) activity correlate with sensation seeking, high ego strength, positive affect, and high leisure time activity levels, somewhat similar psychological correlates also being found for plasma amine oxidase activity. Although there are several ways in which a schizophrenia/MAO relationship may exist and still be congruent with the present data, these results pose difficulties for theories which link low MAO activity levels specifically to schizophrenia. Nothing in the present findings, however, is incongruent with the possibility of an association between low platelet MAO activity and bipolar affective disorder.


Personality traits related to monoamine oxidase activity in platelets.
Psychiatry Res. 1984; 12(1):11-26 (ISSN: 0165-1781)
von Knorring L; Oreland L; Winblad B
Platelet monoamine oxidase (MAO) activity and intellectual level were examined in a large series of 1,129 18-year-old boys, selected from the general population. Personality traits were determined by means of selected subscales from several personality inventories such as the Zuckerman Sensation Seeking Scale, the Eysenck Personality Inventory, and the Karolinska Hospital Personality Inventory. Information was also gathered concerning alcohol consumption habits, signs of alcohol dependence, and use and abuse of tobacco, cannabis, glue, opiates, and amphetamine. Low MAO subjects were found to be more sensation seeking and to have higher scores on impulsivity and monotony avoidance. They also had higher use of tobacco and alcohol, showed more signs of possible alcohol dependence, and showed more drug abuse. When low MAO subjects were subdivided according to intellectual level, low MAO subjects with high intellectual level were found to have higher psychological functioning as judged by a psychologist after a clinical interview. Low MAO subjects with low intellectual level were found to have more use and abuse of alcohol and drugs, i.e., less accepted forms of sensation seeking, and they had a significantly lower level of psychological functioning. This subgroup seems to be the real "high risk" group that according to the high risk paradigm could be expected to show more alcohol abuse and higher tendencies to suicidal behavior.

[Salvinorin A]

This slideshow has a great simple explanation of neurotransmitters, and how MAOIs affect them (you have to scroll on through towards the end, but I suggest you read all of it, you'll get a much better understanding of what's going on in the brain).

http://www.dancesafe.org/slideshow/intro.html

(Hope I'm allowed to link to that btw, since I can't post the swf.)

Reputation Comments on this post:

	awesome, awesome link!
	liked your link

[rocksmokinmachine]

MAOI are monamine oxidase inhibitors. Monamine Oxidase is the enzyme which breaks down serotonin in the brain. These are usually perscribed as anti depressants, different from SSRI (selective serotonin reputake inhibitors) such as prozac. Taking MAOI can be dangerous when taken in conbination with other substances. so be careful.

[kareena]

As has been said monoamine oxidase is an enzyme that breaks down certain neurotransmitters. These include serotonin, dopamine and noradrenaline. So a monoamine oxidase inhibitor inhibits this enzyme thereby increasing levels of these neurotransmitters in the brain. Very effective for treatment resistant depression and social phobia. MAOIs also have some effect on increasing GABA levels, Phenelzine (Nardil), having more of a GABA effect than some other MAOIs. Each MAOI affects these (and other) neurotransmitters in slightly different ways (ie exert more of an effect on a particular NT or other). The potential for a hypertensive crisis (dramatic increase in blood pressure possibly leading to stroke possibly being lethal) when combined with tyramine, found in certain foods and lots of other OTC drugs makes them a last line treatment although they can be very effective when used in a sensible manner.

Newer reversible monoamine oxidase inhibitors such as Selegiline decrease the risks of hypertensive crisis when combined with tyramine although this is all a bit of a bogus marketing ploy because the dietary restrictions still apply when a high therapeutic dose is reached.

A reversible MAOI is in clinical trials- trade name Tyrima - which claims to be effective and lack the dietary restrictions but the jury will be out if this ever makes it onto the market. Interesting name considering it's similarity to tyramine- the absolute nemesis of anyone using an MAOI!

MAOIs were the first antidepressants discovered in the 1950s. The first was Iproniazid (Marsilid) initially developed for tuberculosis. Reversible MAOIs, such as Selegiline and Moclobemide, are being used more and more, while the only irreversible MAOIs commonly prescribed are Phenelzine (Nardil) and Tranylcypromine (Parnate) although Isocarboxazid (Marplan) is sometimes used.

Although I have no personal experience I have read a lot of anecdotal evidence that supports their efficacy for certain conditions and I think they are often underused, for various reasons- the whole hypertensive crisis thing plus the fact there's no patents left on them and so no economic reasons to 'push' them despite their efficacy- and they have been taken over by the SSRIs/SNRIs which are safer but still have a load of side effects but generate a lot of money for the pharmaceutical companies. Interestingly not all people taking MAOIs have hypertensive reactions when consuming tyramine and it is quite an overblown, but present, phenomena IMO. Heck, they were widely used for years before the tyramine reaction was discovered upon and there weren't loads of people dropping dead from hypertensive crises. I have read that users sometimes gradually test their sensitivity to tyramine out, and some realise they do not have a great sensitivity to a great deal of foodstuffs on the diet list while others realise they do and avoid them (they dont have a stroke as they're only testing it out with small quantities, not eating a massive lump of stilton washed down with two bottles of red!). All just anecdotal stuff I've read mind.

A lot of long term Phenelzine (Nardil) users are seriously pissed that Pfizer changed the formulation in 2003 and claim that it is now less effective.

Sorry for not using SWIM language, I thought it uneccessary considering I don't use these, they have zero recreational value and are only used as treatment for chronic treatment resistant mental conditions. Apologies if I've repeated some already written points, I hope it was interesting to someone!

Reputation Comments on this post:

Good post!

[fnord]

alfa i would HIGHLY recommend a forum on maoi's + whatever.it would do alot for harm reduction.

[simulatedreality]

Fnord, my fellow Illuminatus, I could not agree more: there needs to be a seperate section on MAOIs/Amino Acids/and their interactivty (chemical & pharmacological) with each other in both the human body and the reaction vessel. Here is my second to your vote to start up such a thread. Please respond Alfa - soon as you get the time as I know you are a busy man obviously !!! By the way, Fnord/Alfa, did you read my thread (intro) - I pasted it in here below, but first to answer you question: the basic gist of MAOIs is that the two major prescribed types (Tranylcypromine/Phenelzine) are NON-SELECTIVE and target both MAO-type A and MAO-type B - both these MAOs together have the job of acting as an enzyme in the body that breaks down all tyramines, indoles, phenethylamines, catecholamines, and even opiods if you want to get complex - ie Tramadol etc... But the thing is these NON-SELECTIVE types which inhibit BOTH types of MAO are IRREVERSIBLE. One type of MAO has a more dedicated job at regulating metaboloism of said foods etc and it is easier to bring you back to life when you overdose on Tranylcypromine/Phenelzine. The other MAO type controls your beta and alfa adrenergic receptors as well so - there is a not a hospital can do - maybe pump you full of clonazepam and hope the GABA effect slows down the enzyme reaction. Other than that - you are pretty much on the defribilator - then dead (or if you are lucky like me - still alive ;-D)

Anyway here is my original post - please reply:

Thanks for the intro and warm welcome.

I am a medicine student and am looking at how it is possible to break open the cyclopropane ring on tranylcypromine to form amphetamine.

Any ideas or can you point me in the right direction ?

Thanks - please CC: simulatedrealitylimited@gmail.com as my internet is not working well.

PS: Also interested in any ELECTROLYSIS based processes and conversion of pure nature's own phenylalanine to amphetamine ) --> Oh, and Tranylcypromine (Parnate) is a non-hydrazine MAOI that anyone can get as a S4 drug - for next to nothing.

[toe]

Just uploaded a PDF that should make this info more accessable: Nom de Plume.

Would it be shamless for me to plug it on the psychopharm-specific (benzos, stimulants, SSRIs, anti-psychotics) pages as well?

Reputation Comments on this post:

	good work, enjoyed the article
	Good file. Can you please correct the link to http://www.drugs-forum.co.uk/forum/local_links.php?action=jump&id=2973...

[Pino]

SWIM has a couple of questions about selegiline. SWIM understands he shouldn't use selegiline with any stimulant (so no cocaine, amphetamines, mdma, nicotine(?) or whatever).
SWIM is also concerned about GBL and nicotine, which does something noticeably with dopamine. SWIM probably should leave that alone too .

However can swim take selegiline with opiates? He specifically wants to know about kratom, codeine, morphine and tramadol (but he thinks the last one can be dangerous, when combined). And is drinking coffee safe?

Swim is interested in these matters, because swim would like to experiment with the stuff.

[eltimmy]

That's a great post Kareena, thanks.

>Although I have no personal experience I have read a lot of anecdotal evidence that supports their efficacy for certain conditions and I think they are often underused,

No doubt. There's evidence pointing to more efficacy than other SSRIs in atypical depression and social anxiety. Some researchers point to inhibiting monoamine oxidase as a more "holistic" method of increasing neurotransmitter tone than blocking the reuptake pumps.

To SWIM, the side effect profile regardless of dietary restrictions is much more favorable than with SSRIs -- or for that matter, psychostimulants.

Fairly shortly SWIM will be trying a EMSAM patch/nicotine patch combination for attention and focus during the school year.

>Reversible MAOIs, such as Selegiline

Selegiline is an irreversible inhibitor of MAO-B. Reaching a certain dosage level, it inhibits MAO-A as well. However the transdermal selegiline patch that's available seems to produce no tyramine problems at the lowest dosage, and the FDA has said such restrictions are unnecessary. At the higher dosages, the diet is still mandated but, like with other MAOIs but especially so here, there's evidence that the restrictions may be overblown. Several studies indicated no pressor reactions -- the patch may effectively bypass the gut.

>they have zero recreational value and are only used as treatment for chronic treatment resistant mental conditions

Then again ...

Tranylcypromine addiction: a case report and review.
http://www.ncbi.nlm.nih.gov/sites/en...t=AbstractPlus

[eltimmy]

Pino, tobacco smoke is itself MAO-B -- nicotine is fine. I suggest that GBL is not a contraindication either. It has more to do with a problem of metabolizing phenethylamines themselves that leads to contraindications with sympathomimetics, also what looks like a "processing loop" with serotonin that can cause dangerously high levels of this monoamine (itself a more dangerous proposition then an excess of dopaminergic activity). One should carefully in all cases ...

However ...

CONTRAINDICATIONS

Meperidine and Other Analgesics: MAOI is contraindicated for use with meperidine. Serious reactions have been precipitated with concomitant use of meperidine (e.g., Demerol and other tradenames) and MAO inhibitors including selective MAO-B inhibitors. These reactions have been characterized by coma, severe hypertension or hypotension, severe respiratory depression, convulsions, malignant hyperpyrexia, excitation, peripheral vascular collapse and death. At least 14 days should elapse between discontinuation of MAOI and initiation of treatment with meperidine.

For similar reasons, MAOI should not be administered with the analgesic agents tramadol, methadone, and propoxyphene.

Other Drugs: MAOI should not be used with the antitussive agent dextromethorphan. The combination of MAO inhibitors and dextromethorphan has been reported to cause brief episodes of psychosis or bizarre behavior. MAOI is also contraindicated for use with St. Johns wort, mirtazapine (a tetracyclic antidepressant), and cyclobenzaprine (a tricyclic muscle relaxant).

Sympathomimetic Amines: Like other MAOIs, AZILECT is contraindicated for use with sympathomimetic amines, including amphetamines as well as cold products and weight-reducing preparations that contain vasoconstrictors (e.g., pseudoephedrine, phenylephrine, phenylpropanolamine, and ephedrine). Severe hypertensive reactions have followed the administrations of sympathomimetics and non-selective MAO inhibitors. At least one case of hypertensive crisis has been reported in a patient taking the recommended doses of a selective MAO-B inhibitor and a sympathomimetic medication (ephedrine).

MAO inhibitors: MAOI should not be administered along with other MAO inhibitors because of the increased risk of non-selective MAO inhibition that may lead to a hypertensive crisis. At least 14 days should elapse between discontinuation of MAOI and initiation of treatment with MAO inhibitors.

Surgery: As with other MAOIs, patients taking MAOI should not undergo elective surgery requiring general anesthesia. Also, they should not be given cocaine or local anesthesia containing sympathomimetic vasoconstrictors. MAOI should be discontinued at least 14 days prior to elective surgery. If surgery is necessary sooner, benzodiazepines, mivacurium, rapacuronium, fentanyl, morphine, and codeine may be used cautiously.

Pheochromocytoma: MAOI is contraindicated in patients with pheochromocytoma.

Reputation Comments on this post:

Thank you very much, very helpful information for swim :)

[Fantasian]

While MAO-I and serotonin agonist like MDMA are potentially lethal is it physically possible to gauge a euphoric combination of the two using a much lower dose. SWIF would never do this but is interested in the concept pharmacologically.

[Pino]

Originally Posted by Fantasian

While MAO-I and serotonin agonist like MDMA are potentially lethal is it physically possible to gauge a euphoric combination of the two using a much lower dose. SWIF would never do this but is interested in the concept pharmacologically.

It is probably even possible to use it safe, however no one should ever try. An SSRI and Maoi would be interesting. Both drugs can be acquired cheap. However it is dangerous. A bit of a shame. The last trip report, I collected, uses small doses of Syrian Rue and MDMA, which seemed to work.

I gathered some Erowid experiences, exotic combinations of maoi and psychedelic drugs.

• http://www.erowid.org/experiences/exp.php?ID=1814
  • MDMA and harmala.
  • Duration: >18 hours.
  • Dosage: 60 mg of mdma. Unknown amout of Syrian Rue.
  • Huge bloodpressure, 145+ hearth rate. Not positive. Felt like more than 300 mg of mdma.
• http://www.erowid.org/experiences/exp.php?ID=39568
  • Citalopram and harmala.
  • Duration: 3 hours.
  • Dosage: 1 Tbsp Syrian Rue, cannabis and 60 mg citalopram
  • Very intense experience. A lot of hallucinations. Peak duration 40 minutes. Mental fatigued afterwards. He seemed to be positive about the trip.
• http://www.erowid.org/experiences/exp.php?ID=9530
  • DXM, Pseudoephedrine, salvia and harmala.
  • Duration: A couple of days (including after effects).
  • Dosage: A very small amount of salvia with 3 grams of syrian rue.
  • Strange and incoherent report. Writer took salvia with syrian rue and became very scared. The experience was longer (30-40 minutes) and was comparable to 5-meo-dmt. He got a huge flashback couple of days later with his ego completely dissolved in public. Mentions he used also dxm and pseudoefedrine, but this is nowhere to be found in the story. He also fasted for 5 days and 10 hours and didn't drink water for 30 hours, why he does it he doesn't explain.
• http://www.erowid.org/experiences/exp.php?ID=40621
  • Selegiline and 2c-b
  • Duration: 9 hours.
  • Dosage: 5mg selegiline and 25 mg 2c-b at t=0h and 10 mg 2c-b at t=2h.
  • At first he took 25 mg, which seemed to leave him unaffected. Then he took an booster dose of 10 mg. Loss of memory, tried to jump out the window on the second floor. Subjectively the trip was positive perceived.
• http://www.erowid.org/experiences/exp.php?ID=23633
  • GHB and selegiline
  • Duration: 12 hours.
  • Dosage: 5 mg deprenyl after 2.5 grams of GHB.
  • The effect of the GHB was intensified and prolonged. Memory loss was experienced. The experience was perceived as messy.
• http://www.erowid.org/experiences/exp.php?ID=6404
  • Syrian Rue, Cacti - T. peruvianus, 2C-E, 4-AcO-DMT & DMT
  • Duration: 6/7 hours?
  • Dosage: 3 gram syrian rue, 30 gram of the cactus, 3 mg 2c-e (IM), 4 mg Aco-DMT, 2 x 25 mg DMT (IM).
  • The experience goes well, until the writer injects 2 time 25 mg of dmt. After the second injection the dmt effect increases 6 fold. The dmt experience is for 1 and half minute a success. After this the writer is experiencing extreme disorientation, tears from his eyes, muscle weakness, hot feeling. At some point he grinds his teeth and bald his fists and is unwillingly forced to get into fetal position, while experiencing spasms. He is sweating excessively. Vomits and stop breathing while convulsing. Vomits again and starts convulsing every 30 seconds. The whole dmt experience was 1.5 hours. Perceived trip partially as positive.
• http://www.erowid.org/experiences/exp.php?ID=6611
  • P. harmala (Syrian Rue), Phalaris & Methadone
  • Duration: ?
  • Dosages: 53 mg methadone, 2 caps syrian rue, 2 caps phalaris grass.
  • All taken together at once. Two persons didn't experiencing ill effects, they didn't use methadone . The other two, who did use methadone, kept vomiting during the experience, which is accompanied by profuse sweating, lack of coordination, nausea and tremors.
• http://www.erowid.org/experiences/exp.php?ID=9591
  • Codeine, MDMA, 5-meo-DMT, & St.John's Wort (Tea)
  • Duration: 9 hours.
  • Dosages: 1 cup of St John's Wort tea, T + 5.30 125 mg mdma, T + 5.45 120 mg codeine, T + 9:35 50 mg 5-meo-dmt insufflated.
  • After the writer insufflated the 5-meo-dmt, he felt he was dying and doesn't have memories from the peak. He only felt he was nothing, complete ego loss. The mdma hadn't much effect.
  • Note: St John's worth isn't a maoi. So I thought, however erowid provides a source, where something else is stated. [source]
• http://www.erowid.org/experiences/exp.php?ID=38345
  • Moclobemide & Methylone
  • Duration: 4 hours.
  • Dosage: 75 mg Moclobemide & 28 mg Methylone.
  • After 40 minutes the writer feels the effects are like 80 mg of methylone (without the maoi). It is still building after 1.5 hours. However subjectively the writer feels the dose is quite low. The hangover is significant. He describes it as a hangover from 100 to 200 mg. The writer doesn't find the combination rewarding. BP and heartrate are fine.
• http://www.erowid.org/experiences/exp.php?ID=51688
  • 2C-T-2 & Syrian Rue
  • Duration: 10 hours.
  • Dosage: 2.5 grams of Syrian Rue.
  • The experience is greatly amplified. The experience is not particularly negative or positive. The writer senses it is taking to long. He also feels it is bad for his body. The visuals don't seem to be changed. After hour 7 the effects stop building and the peak is reached. At this point the writer says he really enjoys the trip, but would never do it again.
• http://www.erowid.org/experiences/exp.php?ID=43802
  • MDMA, Syrian Rue & Alcohol
  • Duration: 4 hours.
  • Dosage: 0,4 gram syrian rue (4x extract) and 7 mg mdma (1) then 12 mg mdma. (2) Followed by 0.6 gram syrian rue (4x extract) and +/- 30 mg of mdma. (3) All mixed in alcohol.
  • After (1) the writer finds it to weak and take and additional 12 mg. This is about 10% stronger than the whole pill, which he already know from experience. At T + 2 hours he boosts the experience with (3). He report small visual disturbances (which can be from sleep deprivation), hot feeling, but nothing extreme. He find the boosting quite good and describes the experience as subtle. He feels syrian rue makes mdma 4 to 6 times stronger in effect. However he thinks it also can be 12 times as strong. He isn't sure.

There are a lot more experiences and all they seem to share a certain unpredicableness of effects. The last one with the combination with MDMA and Syrian Rue in small dosages seems pretty interesting, but swim wouldn't like to try it and wouldn't recommend to anybody.

Reputation Comments on this post:

interesting, good work

[flipthecandy]

I seem to remember consumption of an MAOI allows DMT to activate orally? Resulting in a much longer trip...is this correct?

[simulatedreality]

This is correct - DMT is metabolised by MAOI too quickly when taken orally.

Read Jeremy Narby's THE COSMIC SERPENT.

I think DMT would be easy to make from ERGOTAMINE or even DESERIL - easy to get and costs nothing.

[JDreaming]

Neurotransmitters that are effected by MAO-A and MAO-B inhibitors:

The MAO-A isoform breaks down: serotonin, melatonin, epinephrine, norepinephrine, and dopamine.
The MAO-B isoform breaks down: phenylethylamine, and dopamine.

Most MAOIs associated with psychedelic drug use are MAO-A selective. It could be assumed that the ingestion of substances like harmine, harmaline and beta-carboline, as well as AMT and 2C-T compounds, will increase levels of serotonin, melatonin, epinephrine, norepinephrine, AND dopamine in the brain (correct me if I'm wrong).

Citation 1
Citation 2

A friend of mine has some questions regarding the planning involved in having a psychedelic experience involving an MAO-inhibiting chemical.

Questions about MAOI use:

1) How long of a period should an MAOI-appropriate diet be followed before taking an MAOI?

2) It has been pointed out that tyramine-containing foods must be avoided in combination with MAOIs, since it could lead to a hypertensive disaster. What about food containing tryptophan?Could the presence of a serotonin precursor not create a risk of serotonin syndrome when combined with an MAOI? Do we need to add foods like turkey, chicken, beef, lamb, pork, and eggs have to our list of unsafe foods?

3) Is there any kind of meat that a non-vegetarian person can safely eat while observing an MAOI-appropriate diet?

4) Other than SSRIs and tricyclics which are obviously dangerous, what is the potential for a dangerous cross-reaction between MAOIs and other medications, such as non-SSRI antidepressants?