Combinations - MDMA With an SSRI

[RxPosterChild]

Swim has tried xtc twice. Both times he had been on his usual dose of Lexapro, which he realizes is an SSRI and would conceivably diminish the experience. Both the same thing apparently happened. SWIM would feel the initial rush and come up (talkative, dancey mood) and would feel euphoric for only a half hour at most.

Speaking with SWIM's friends he has come to the understanding that MDMA can be like a roller coaster: meaning that your highly euphoric due to some stimulus, then you don't roll as hard, but you come back up. SWIM has found this to be impossible to do.

What would be SWIM's best bet to maximize a MDMA experience?

[N0ly]

Swim had the same problem when he first started, He was on Prozac at the time. The only way to get the full experience out of mdma is to stop taking your medication. Depending on your personal need for your anti-depressants this may not be recommendable. For swim it was the best decision of his life. Once he gave up the Prozac he rolled balls in front of a mirror and completely reinvented his self image permanently removing the need for his medication.

[RxPosterChild]

Interesting, for SWIM the Lexapro has done wonders for his anxiety and depression. He recently switched from Celexa to Lexapro. The only problem with quitting the medication is the withdrawals from a cold turkey stop with them :\ (imagine that? a drug that produces a physical dependence that IS legal and is given to kids)

SWIM supposes that that poses (no rhyme intended) another question. What would the lowest effective amount of an SSRI in SWIMS brain that would allow a large amount of his Serotonin to bridge the gap in his receptors?

[chillinwill]

SWIM was on Lexapro as well and the same exact thing happened with him as well when on MDMA....SWIM would feel some of the effects but nowhere near the effects when he stopped taking Lexapro....SWIM thinks that for SWIY to get the full benefit of MDMA is to stop taking your SSRI

[RxPosterChild]

How long would SWIM have to stay off his medication for this to work? SWIM wants to stay mentally stable with his SSRI, but would like to experience a full blown roll at least once in his life. He doesn't know if he wants to deal with the tapering/cold turkey bullshit of his SSRI, but he'd like to get a great experience from E.

Hmmmm, quite the dilemma?

[chillinwill]

SWIM stayed off his Lexapro for around 5 weeks and then tried MDMA again and it was absolute bliss

[Panthers007]

For complete removal and restoration of normal brain-chemical levels after being on SSRI's for more than a month, it is estimated 6 months is needed. This is not to say MDMA can't work for this long a period - it obviously can. I am just pointing out it takes that long for one's brain chemistry to fully recover.

This is part of the reason we here at D-F so strongly urge people never to try to take SSRI's as a recreational substance.

[Nacho]

Sorry to bump the thread but it's not that old.


My friend Steve has been on anti-depressants (various ssri's and now on Wellbutrin and Depakote) and wants to try MDMA. He was wondering if stopping medication for a week before trying it is safe. He doesn't want to do it if there's still a risk of serotonin syndrome.

[RaverHippie]

It's not as much of a contraindication for serotonin syndrome, but rather, steve is likely not to feel effects. And one week of abstinence isn't long enough to say that it may work, but it isn't very likely at all. One of my raver friends was on an SSRI and stopped for 3 weeks prior to attempting to roll. It still didn't work off two decent pills.

[Cryptic Concoction]

Presumably, MDMA primarily exerts its effects through acting on serotonin reuptake transporters. Researchers postulate that it may act on these transporters, causing them to run in reverse and pump serotonin into the synapse.

Because SSRIs (selective serotonin reuptake inhibitors) block serotonin reuptake transporters, some infer that SSRIs significantly abate the effects of MDMA by blocking its action on the reuptake transporter molecules.

Thus, it does not seem likely that SSRIs would substantially increase the risk of serotonin syndrome, given that they reduce the increased activity of the serotonergic system mediated by MDMA. MDMA alone would likely cause a greater increase in serotonergic activity than the combination of SSRIs and MDMA (if we assume that MDMA exerts its effects through the serotonin reuptake transporters). But it would be exteremely irresponsible of me to conclusively assert this. I highly suggest that Steve researches any potential contraindication. Serotonin syndrome is a perilous condition. Please keep in mind that this is purely speculation, and while I have discovered no evidence that SSRIs and MDMA combination poses significant risks, it is important to always remain wary.

However, dependant on the pharmacokinetics of the SSRI Steve is taking, one week may not be ample time to yield unabated effects of MDMA. The half-life of norfluoxetine (the active metabolite of fluoxetine), for example, is over two weeks after long-term use. Many SSRIs have somewhat protracted half-lifes from long-term use, though it depends on the SSRI in question. Some SSRIs, or their active metabolites, are still detectable in the blood and are still present in the brain for weeks, even months, after cessation of treatment.

Thus, contingent on the pharmacokinetics of the SSRI Steve is taking, one week may not furnish sufficient time for the drug to be eliminated from his body. Consequently, the SSRI (or its active metabolite) may still be exerting its effects on serotonin reuptake transporters, impeding MDMA's mechanism of action, and possibly attenuating effects. Steve should research the pharmacokinetics of the SSRI(s) he is using. The pharmacokinetics and half-life vary significantly among SSRIs.

Of course, I am not an expert and it is always sage to understand potential drug interactions before combining psychotropics. I cannot espouse the combination of drugs without comprehensive knowledge of their potential interactions. In the face of ignorance, I think it is always best to excercise circumspection and remain vigilant of potential dangers. Please do not confuse my lack of knowledge of any serious contraindications for a lack thereof.

I will advise Steve that one week of cessation may not be sufficient to eliminate the drug from his body, depending on the pharmaceutical and how long he has taken it. If the drug is not eliminated from his body, its action on serotinin reuptake transporters may inhibit MDMA's effects (if we assume that MDMA's primary mechanism of action is on serotonin reuptake transporters).

If Steve is taking an MAOIs he should not take MDMA as this could certainly lead to serotonin syndrome. I would not advise using MDMA without understanding any potential interactions between MDMA and any drugs that may linger in Steve's system.

It may be imprudent to use any psychotropics if Steve is already using several medications. Unless he fully understands their potential interactions with MDMA (and any other drugs that the pills may be adulturated with), he may be placing his mind and body in jeapoardy. It is always best to observe caution when altering the functioning of cells in one's body, especially when the ramifications are uncertain.

I earnestly implore Steve to consider thoroughly researching the pharmacology of the medications he is taking and any potential contraindications. I do not recommend mixing medications with illicit dugs. But this is his mind, his body, and his life.

I would like to add that it may be potentially dangerous to mix pills with medications, given the uncertainty of pills purveyed as ecstasy.

Edit:
If Steve plans on using illicit drugs, I suggest that he either ensures that the drugs will not longer be exerting their effects (they they have been excreted entirely) or fully understands how the drugs will affect one another and his body. This can be difficult, given that one can never be certain what the substances sold as certain illicit drugs comprise. It is never judicious to mix drugs unless one has a well developed understanding of how they will interact. I just want to punctuate this.

Reputation Comments on this post:

	very thorough post
	Very helpful, informative post. Thank you :)
	I'm liking your posts. Evidence based and well written

[dutch-marshal]

don't use drugs with ssri's... thats really stupid if SWIY would ask SWIM

[Nacho]

Steve has done an okay amount of drugs and been fine.

Marijuana
Alcohol
Alprazolam
Clonazepam
Salvia
LSA
Diphenhydramine
Codeine
Hydrocodone
Morphine
Heroin
Amphetamine

He never did huge doses of anything though. He's done an okay amount of research on it and has seen two contradictory comments. Some say that it's harder to feel Ecstasy's effects when taking SSRI's and others say that E should be taken very carefully with SSRI's for risk of serotonin syndrome.


Steve is hoping to get off of SSRI's altogether so he doesn't have to worry about this crap. He's always been very careful with his drug usage but still wants to expand it (like with E - atleast once).

[dutch-marshal]

SWIM has done the same but still... when your on the meds.. just wait.. even though you are allright.... doesn't mean it's not better to do it off ssri's..

thats just advice... but suit SWIY self

Reputation Comments on this post:

Thanks for looking out and posting :)

[Nacho]

Originally Posted by dutch-marshal

SWIM has done the same but still... when your on the meds.. just wait.. even though you are allright.... doesn't mean it's not better to do it off ssri's..

thats just advice... but suit SWIY self

I appreciate your replies but can you post supporting facts/links?

Steve could use some guidance with this. All help is appreciated.

+rep

[beemac]

A few weeks ago, swim had been on fluoextine 20mg (prozac) for aproximately 5 weeks. He stopped taking the prozac for 4 days prior to having some mdma, 2 good quality pills.

His friends had an amazing time and two of them had to go home as they were a bit far gone and were about to get chucked out from the club.

Swim noted that although he was most definitely under the influence of the mdma, it was nothing like normal. There was an abundance of energy but no will to dance. There was no gurning or jaw tensions and swim usually has this pretty bad. Most importantly though, there was very little, if any euphoria at all.

Swim realises now that he did not leave enough time at all between stoppings the SSRIs and rolling.

Swim has now stopped with the SSRIs, cold turkey. Swim thinks they were making him anti-social and too lathargic.

Swim is hoping to roll like a mofo over christmas

[Shampoo]

Originally Posted by beemac

A few weeks ago, swim had been on fluoextine 20mg (prozac) for aproximately 5 weeks. He stopped taking the prozac for 4 days prior to having some mdma, 2 good quality pills.

His friends had an amazing time and two of them had to go home as they were a bit far gone and were about to get chucked out from the club.

Swim noted that although he was most definitely under the influence of the mdma, it was nothing like normal. There was an abundance of energy but no will to dance. There was no gurning or jaw tensions and swim usually has this pretty bad. Most importantly though, there was very little, if any euphoria at all.

Swim realises now that he did not leave enough time at all between stoppings the SSRIs and rolling.

Swim has now stopped with the SSRIs, cold turkey. Swim thinks they were making him anti-social and too lathargic.

Swim is hoping to roll like a mofo over christmas

SSRI treatment results in the downregulation of 5-HT receptors, meaning that there are less receptors present to be overstimulated in the presence of a SERT reverser like MDMA. This would explain why your friend had little effect from his dose. The effects that were still present were probably noradrenergic and dopaminergic, since those systems should not have been regulated prior to dosing (unless the monkey was also on antipsychotics, tricyclics, or something of the sort).

Additionally, SSRIs should not be quit "cold turkey". Gradual tapered doses should be administered to prevent withdrawal symptoms which can consist of splitting, unrelentless headaches, nausea, dizziness, disorientation, slurred mobility/speech/fine motor movements...etc. Please do not stop taking the medication without consulting your doctor and receiving tapered doses.