Bupropion & MDMA - potential SS experience

[Metabrz]

Hey everyone,

A few nights ago, my friend and I took some MDMA. My friend is on 300mg of Zyban daily, and has been taking this for roughly 5 weeks after a few years of various SSRIs not being effective with their depression and anxiety disorder. We both have experience with MDMA and they have never had a negative experience while rolling, albeit some rough drops the day after.

We took 100mg each, and had half a trip of ALD-52 about half an hour afterwards. My friend came up fine and happy, until they started feeling slightly nauseous and dizzy. Putting it down to the combination we took, we had some more MDMA a couple of hours after the first dose (they had 70mg this time).
Their nausea got worse and they had to lie down for some relief. For the next few hours, they were retching and vomiting bile and constantly felt like they needed to vomit but couldn't get anything up. My friend began to experience convulsions in their shoulders, forearms, and legs. They were sensitive to light and couldn't stand or walk properly.
After the extreme nausea ceased a bit and they were able to talk and breathe properly, they decided to stay at home and not seek medical attention.
My friend took two 1mg Lorazepam tablets to come down and ease the muscle convulsions. They continued to have random muscle spasms for the next 24 hours.

After doing some research, we believe it was potentially Serotonin Syndrome. In saying that, we aren't 100% sure. We believe it could be a combination of the Zyban and MDMA, yet the threads we've read can't confirm if there is any proven link with the two - they all seem to say it is based on the individual.

What I'd like to know is -

• What are the most accurate risks associated with Zyban/Bupropion and MDMA, besides a lowering of the seizure possibility?
• What are the risks associated with having MDMA again, not long after this potential SS occurence?
• Does the fact that my friend had these tremors/convulsions lead to an increased risk of seizures in the future?

We will be joining friends to celebrate New Years and want to know if a lowering of dosage is the best option or to steer completely away from it for a while.
They are considering bringing this experience up with their care worker.

My friend has never experienced a seizure or has any other medical issues besides their mental health.

Thank you in advance for your input.

 

[Cotcha Yankinov]

I would say that it does indeed read like some degree of serotonin syndrome (your friend is lucky it wasn't more serious) and my wager is that the buproprion/ALD-52 contributed.

Buproprion doesn't have many direct effects on serotonin but it will tend to increase serotonin cell firing, body temperature and muscle tone.

One of the main issues with serotonin syndrome are these muscle convulsions, and overdose on amphetamines/cathinones can even produce rhabdomyolysis by virtue of an increase in muscle tone. Buprorpion increases norepinephrine and dopamine similarly to amphetamines, and this will increase body temperature and muscle tone This is bad news in terms of serotonin syndrome vulnerability.

Supposedly a lot of the issues with body temperature in serotonin syndrome are due to not only excess dopamine but also excess activation of a particular serotonin receptor called 5-HT2A expressed in some of the brain regions that help regulate body temperature. The 5-HT2A receptor is the primary target of psychedelics such as ALD-52. So its possible that the ALD-52 also contributed. People can also have muscle tone problems on psychedelics occasionally, and of course nausea.


I wouldn't be worried about seizures in the future et cetera but I would take it easy for a while and be much more careful, and be prepared to hit the ER/call an ambulance. I would have your friend avoid substances like MDMA for new years, give it another few months at least I'd say.

Can I get some clarification on the dosages here? I assume you didn't accidentally typo the decimal in the wrong spot/accidentally use milligrams and this is supposed to be referring to MDMA dosages?

"We took 1mg each - we had some more a couple of hours after the first dose (they had 0.7mg this time)"

Any questions are welcome,
CY

 

[Metabrz]

Thank you CY for the prompt response.

Yes the dosage was a typo. We both had 100mg MDMA first time around, then my friend had a further 70mg second time around. I'll edit the post.

We will take on board what you've said and play it safe.

Once again thank you for such a quick and comprehensive reply. If anyone else has something to add feel free.

Happy new year.

 

[Cotcha Yankinov]

To have those kinds of symptoms off of 170mg, I think the other drugs must have been significantly contributing.

Stay safe and happy New Years,
CY