Interaction between Vyvanse and MDMA + diet

[Pallyress]

I'm on prescribed Vyvanse, diagnosed with ADHD and PTSD. Vyvanse doesn't make me high, it makes me function normally.

I'll give some background so it's possible to take this in consideration.

I have used MDMA over the last year to assist self therapy, using the same doses (125 mg) and similar setup as described in research protocols (MAPS). I have built up some toletance due to several sessions. Usually 1 month between, but also longer, and a couple of times just 3 weeks apart. I always feel much better and have reduced PTSD symptoms afterwards. I do it alone, meditate and "cry it out".

When I changed from Concerta to Vyvanse, I experienced a drop in the MDMA effect. The euphoria dissapeared. One time it might have been due to starvation, PTSD flare ups makes it impossible for me to eat (I believe it is when I get stuck in fight/flight mode due to triggers). That time I experienced a mild increase in the roll when I was able to drink nutrition during the roll. My weight had plummeted for the past weeks due to not eating. Next day I woke up super hungry, my IBS was gone, and I ate 3 full meals with no problem, even with joy.

Second time I rolled on Vyvanse I ate first, to ensure availability of neurons in brain. By now my dose was increased, possible a tine but too high, but I let it drop, then combined MDMA with a small dose Vyvanse (to keep my mind from getting adhd chaotic, and be able to meditate/keep string of thoughts).

This time I felt it stronger, but it was still mild, with hardly any euphoria. This was only 3 weeks after previous roll, because I was 'shutting down' and not able to care/get visits from my children. I know it's not ideal with so short time between. I also smoked as I have heard that nicotine makes one more sensitive to dopamine.

Both times the MDMA worked so mildly that I wasn't able to work on the worst issues, but I worked on other stuff, and both times I experienced a good after effect, as I always do. Also, I wasn't emotionally exhausted/drained afterwards, went about my appointments/chores, just feeling a bit tired.

Simultaneously, I have also started a high tryptophan diet to try to avoid anti-depressant, so even when food intake has been low or starved, I've eaten eggs, fat fish, olive oil ++ in a larger extent than earlier. I have read that increasing sensitivity to MDMA can be done by having a low tryptophan diet.

I'll guess I have done MDMA about 9 times the last year. Effect was good until I changed to Vyvanse, then it plummeted. On Concerta I would run the plasma concentration low before rolling, which is difficult to do on Vyvanse because it would require me getting off meds for a couple of days. This would be too dangerous for me to do, due to PTSD flaring up and possible getting suicidal when ADHD isn't kept at bay.

Is it true that it is dopamine that creates the MDMA euphoria? Why would it then dissappear with Vyvanse? Or is the smooth ride from Vyvanse making me less sensitive to dopamine?

I'm thinking that I will have a long break from MDMA now, and ask my doctor about starting me up on SSRI, but I'm still very curious about the last couple of rolls. I've tried to read about it, but it's difficult to know where to start, and... it's just really difficult to understand.

Any insights, or possible 'dumb down' explanations?

 

[Bagseed]

doing MDMA every month is a lot, so this could be just tolerance kicking in, and maybe you noticing it and the medication switch was purely coincidental...

 

[Pallyress]

No, I do not think that is the full explanation.

Yes, I have noticed a shift in tolerance, but up until Vyvanse I could work on severe trauma details on a 125 mg dosis. I had a break for about 2.5 months before the first roll on Vyvanse, which was the first time I didn't experience euphoria. The second time on Vyvanse I increased the dose to 137 mg, and felt it a bit more, but still much less than earlier. Not enough that I felt I could freely think of the most difficult issues, which I always could earlier.

I have always dosed 125 mg the last year, and haven't rolled crazy hard, which I assume would build up tolerance faster. (Not sure if it is right to assume that?)

I would expect increased tolerance with just 3 weeks apart, but the previous time I had very little effect, so I thought that would counter the tolerance increase somewhat.

Last year I rolled with 3-4 weeks apart without experiencing so much increase, and I benefitted massively from it. Was able to both get rid of daily use of anxiety meds (including diazepam) and my panic attacs stopped. They were so bad I would collapse of standing up.

Now, even with over 2 monts break (rolled 3-4 times last 6 months, with a long gap before last two times), it's like euphoria is almost missing compleatly, and the first wave is like the end of a normal roll. It's like 1/3 of a regular, ok-ish roll.

Earlier, on Concerta, the adhd meds would vary a lot more. Vyvanse is very even and decreases over 2-3 days after taking a capsule. Concerta would make me crash after 8 hours. Could that be it? Body builds up tolerance more due to very steady medication?

 

[farmacista]

9 times a year with doses of 125 mg shouldn't build that tolerance...i think it is because amphetamine inhibits the DAT, SERT and NET preventing mdma from entering in monoaminergic neurons

 

[aced126]

9 times a year with doses of 125 mg shouldn't build that tolerance...i think it is because amphetamine inhibits the DAT, SERT and NET preventing mdma from entering in monoaminergic neurons

Amphetamine only has minor effects on SERT phosphorylation. It is fair enough to say that since DAT will be phosphorylated, it will not be able to bring MDMA into the dopaminergic neuron and prevent MDMA from releasing dopamine. However, there will already be significant dopamine release due to the Vyvanse, probably more so than would've been achieved by the MDMA alone.

A similar observation is that when cocaine users IV administer cocaine after having taken ritalin, they experience a deadened rush. This could be explained by the fact that the user already has a steady state of dopamine reuptake inhibition, and injecting the cocaine will not significantly increase the rate of dopamine concentration increase in the synaptic cleft. A similar thing could be happening here.

Nevertheless, having less DA action from MDMA could in fact make for a more therapeutic session. Nichols himself said that MDBD might be a better psychotherapeutic tool than MDMA because it tends to cause less euphoria, and sometimes MDMA could be too euphoric that it was turned into a distraction from the main aim.

 

[Weltmeister]

Nevertheless, having less DA action from MDMA could in fact make for a more therapeutic session. Nichols himself said that MDBD might be a better psychotherapeutic tool than MDMA because it tends to cause less euphoria, and sometimes MDMA could be too euphoric that it was turned into a distraction from the main aim.

Others disagree with nichols tho and think that the euhpria is an essential part of what makes MDMA useful for psychotherapie

 

[Pallyress]

Amphetamine only has minor effects on SERT phosphorylation. It is fair enough to say that since DAT will be phosphorylated, it will not be able to bring MDMA into the dopaminergic neuron and prevent MDMA from releasing dopamine. However, there will already be significant dopamine release due to the Vyvanse, probably more so than would've been achieved by the MDMA alone.

A similar observation is that when cocaine users IV administer cocaine after having taken ritalin, they experience a deadened rush. This could be explained by the fact that the user already has a steady state of dopamine reuptake inhibition, and injecting the cocaine will not significantly increase the rate of dopamine concentration increase in the synaptic cleft. A similar thing could be happening here.

Nevertheless, having less DA action from MDMA could in fact make for a more therapeutic session. Nichols himself said that MDBD might be a better psychotherapeutic tool than MDMA because it tends to cause less euphoria, and sometimes MDMA could be too euphoric that it was turned into a distraction from the main aim.

Thank you for awesome reply. I'd like to ask a question or two, but not sure if thw questions are relevant/already answered. Definitely learning stuff by reading up on the clues you give in your answer.

I'm trying to figure out if dexamphetamine prevents reuptake of dopamine, or/and increases dopamine production.

One of the theories about (some types of) adhd is that it is caused by to many dopamine reuptakers. Stumulants like methylphenidate inhibit dopamine reuptake so it is leveled to a normal function person.

Following that theory, and how I experience it, methylphenidate makes me normal, and never makes me high. Exceptions when changing dose, and I would crash when it went out. On methylphenidate, due to shorter half life, I would go to a minimum medicated level when rollong, due to safety percussions.

I don't know if dexamphetamine work the excact same way, but I experience a smoother positive effect, without the ups and downs. So when I mix Vyvanse and MDMA, there isn't an abundance of dopamine available, which would be the case for someone taking it recreationally. I'm more like a person off of speed when I'm not medicated, if I compare energy level and ups/downs.

Still, I'm not the same either, as any medication would affect several things. And if my dose gets (slightly) over the therapeutic window I will become lethargic. However, if I go way over the prescribed medical dose (did it accidentally with methylphenidate once) I certainly will get high/speedy, very intense, fearless, all that stuff as recreational abusers might choose to achieve by choice.

It seems that dexamphetamine and methylphenidate works slightly different, or that Vyvanse has so long half-time that I'm not able to bring it down enough before rolling (due to PTSD I would currently get way to sick that it would be advisable to seponate for a day or two, even if I gain long term improvement for my PTSD. Conventional trauma therapy will be my primary focus) .

I still don't know if the change is due to a more consistant plasma level with dexamphetamine, or because methylphenidate and dexamphetamine works slightly different in the brain.

 

[Pallyress]

Others disagree with nichols tho and think that the euhpria is an essential part of what makes MDMA useful for psychotherapie

I don't think euphoria is necessary for all psychotherapy. For me the euphoria is necessary to enable me to work on severe trauma. Without MDMA/diazepam some flashbacks are so terrifying and painful it will make me vomit or enter a freeze response. I used to have dicossiation and memory loss, which I have struggled a lot with to understand. The high on MDMA is the only way I have been able to process it. I even dread doing it even if I start to fall apart after some time, because the idea of me working on my trauma makes me avoid taking MDMA. After a while without MDMA its like I forget the soesifics of my memories, even if PTSD symptoms worsens.

The first wave with euphoria is where I feel good enough, and allow myself to enjoy and love again, that I choose to do self therapy when the second phase comes. I let myself take the final decision if I should focus on trauma or not after I'm on MDMA. If not I would not take MDMA, because I know the intense sorrow and pain I will face. I've had rolls where tears have dehydrated me more than sweat. I've soaked my hair, having to swap pillows, because of tears. I never imagined emotions could be so strong, and comming from me with ADHD, who is already out of the normal range emotion-wise, I don't think I can explain how heavy it really is.

I dread MDMA. Hate it. Love it. Depend on it. Need it. Teaches me to live again. Gives my children their mother back, bit by bit.

 

[aced126]

I don't think euphoria is necessary for all psychotherapy. For me the euphoria is necessary to enable me to work on severe trauma. Without MDMA/diazepam some flashbacks are so terrifying and painful it will make me vomit or enter a freeze response. I used to have dicossiation and memory loss, which I have struggled a lot with to understand. The high on MDMA is the only way I have been able to process it. I even dread doing it even if I start to fall apart after some time, because the idea of me working on my trauma makes me avoid taking MDMA. After a while without MDMA its like I forget the soesifics of my memories, even if PTSD symptoms worsens.

The first wave with euphoria is where I feel good enough, and allow myself to enjoy and love again, that I choose to do self therapy when the second phase comes. I let myself take the final decision if I should focus on trauma or not after I'm on MDMA. If not I would not take MDMA, because I know the intense sorrow and pain I will face. I've had rolls where tears have dehydrated me more than sweat. I've soaked my hair, having to swap pillows, because of tears. I never imagined emotions could be so strong, and comming from me with ADHD, who is already out of the normal range emotion-wise, I don't think I can explain how heavy it really is.

I dread MDMA. Hate it. Love it. Depend on it. Need it. Teaches me to live again. Gives my children their mother back, bit by bit.

Anyway, just abstaining from Vyvanse about a day or two before an MDMA dose will mean the blood concentrations of lisdexamfetamine and amphetamine are negligible, and all dopamine transporters are functioning normally.

 

[Pallyress]

Anyway, just abstaining from Vyvanse about a day or two before an MDMA dose will mean the blood concentrations of lisdexamfetamine and amphetamine are negligible, and all dopamine transporters are functioning normally.

Yeah, it's just that I'm perhaps not well enough to do that. Last year I've tried to have breaks from concerta/ritalin. Makes me crash very bad, get uncontrolllable flashbacks, extreme anxiety and also unpredictable suicidal in short amount of time. Been hospitalised every time, eithet because I've paniced so bad I tried to kill myself, or just because I was too far in that direction. It's like having a PTSD suicidal person, then dropping stimulate withdrawal symptoms on top of that.

I can't take the risk, the point is to get better, not jepardize it all. Guess I could drop over to concerta a few days, but it would still mess up a week of stabile medication, so I'm just going to take a break from mdma now. Still, would love to have it as a possible option if PTSD would get worse again, it is nothing that gets me back on track like that, within just few hours.

I'm going to start anti depressants, my therapist suggested it could help with my lack of appetite when I get PTSD flare up. Not eating makes it so much worse. Don't think I can do any mdma or (careful doses of) lsd/psilocybin when on anti depredsants; been reading on apetite enhancing anti D's. Don't like the increased risk with that cocktail, I need to be more careful than most due to my psyche.

Suppose I'll just finally learn how to knit. *sad pouty face* Don't see my therapist (it's actually a team of therapists/doctors, they are wonderful) respond well to me asking for alternative stimulates because I need Vyvanse break to roll harder. Haha, bet that would lead to "a serious talk". I've been very responsive to treatment, so they are a bit enthusiastic, don't want to break their bubble by telling what really makes me have progress so good. I have leaps in progress in their trauma programme each time I've done MDMA/self therapy/meditation. Bet main therapist will get some in-house reward of the year...

Sorry, on holiday, no TV, finally got wifi. Talkative.

 

[aced126]

Yeah, it's just that I'm perhaps not well enough to do that. Last year I've tried to have breaks from concerta/ritalin. Makes me crash very bad, get uncontrolllable flashbacks, extreme anxiety and also unpredictable suicidal in short amount of time. Been hospitalised every time, eithet because I've paniced so bad I tried to kill myself, or just because I was too far in that direction. It's like having a PTSD suicidal person, then dropping stimulate withdrawal symptoms on top of that.

I can't take the risk, the point is to get better, not jepardize it all. Guess I could drop over to concerta a few days, but it would still mess up a week of stabile medication, so I'm just going to take a break from mdma now. Still, would love to have it as a possible option if PTSD would get worse again, it is nothing that gets me back on track like that, within just few hours.

I'm going to start anti depressants, my therapist suggested it could help with my lack of appetite when I get PTSD flare up. Not eating makes it so much worse. Don't think I can do any mdma or (careful doses of) lsd/psilocybin when on anti depredsants; been reading on apetite enhancing anti D's. Don't like the increased risk with that cocktail, I need to be more careful than most due to my psyche.

Suppose I'll just finally learn how to knit. *sad pouty face* Don't see my therapist (it's actually a team of therapists/doctors, they are wonderful) respond well to me asking for alternative stimulates because I need Vyvanse break to roll harder. Haha, bet that would lead to "a serious talk". I've been very responsive to treatment, so they are a bit enthusiastic, don't want to break their bubble by telling what really makes me have progress so good. I have leaps in progress in their trauma programme each time I've done MDMA/self therapy/meditation. Bet main therapist will get some in-house reward of the year...

Sorry, on holiday, no TV, finally got wifi. Talkative.

If you start on SSRI treatment, then you will definitely lose the ability to take MDMA with any efficacy. SSRIs block MDMA from entering serotonergic neurons and thus it cannot exert its action.

 

[Pallyress]

If you start on SSRI treatment, then you will definitely lose the ability to take MDMA with any efficacy. SSRIs block MDMA from entering serotonergic neurons and thus it cannot exert its action.

I'm probably going to start up on mitrazapine next week. It's not an SSRI, rather it increases serotonin production. The outcome will be the same; I cannot risk taking MDMA. Mitrazapine will increase the effect of MDMA, Vyvanse will diminish the effect. It's just too unpredictable to add MDMA into such a cocktail when I'm already suffering from an disabling mental illness (PTSD).

It's a bummer that also LSD probably is out of the question, but I've used it im small dosis to be abke to have days where I function normally, as I used too. Hopefully I will get sufficient aid from the meds so I will get better/more stable, it has felt a bit silly to do LSD and then just use the high to clean the house or pay my bills.

 

[aced126]

Thank you for awesome reply. I'd like to ask a question or two, but not sure if thw questions are relevant/already answered. Definitely learning stuff by reading up on the clues you give in your answer.

I'm trying to figure out if dexamphetamine prevents reuptake of dopamine, or/and increases dopamine production.

One of the theories about (some types of) adhd is that it is caused by to many dopamine reuptakers. Stumulants like methylphenidate inhibit dopamine reuptake so it is leveled to a normal function person.

Following that theory, and how I experience it, methylphenidate makes me normal, and never makes me high. Exceptions when changing dose, and I would crash when it went out. On methylphenidate, due to shorter half life, I would go to a minimum medicated level when rollong, due to safety percussions.

I don't know if dexamphetamine work the excact same way, but I experience a smoother positive effect, without the ups and downs. So when I mix Vyvanse and MDMA, there isn't an abundance of dopamine available, which would be the case for someone taking it recreationally. I'm more like a person off of speed when I'm not medicated, if I compare energy level and ups/downs.

Still, I'm not the same either, as any medication would affect several things. And if my dose gets (slightly) over the therapeutic window I will become lethargic. However, if I go way over the prescribed medical dose (did it accidentally with methylphenidate once) I certainly will get high/speedy, very intense, fearless, all that stuff as recreational abusers might choose to achieve by choice.

It seems that dexamphetamine and methylphenidate works slightly different, or that Vyvanse has so long half-time that I'm not able to bring it down enough before rolling (due to PTSD I would currently get way to sick that it would be advisable to seponate for a day or two, even if I gain long term improvement for my PTSD. Conventional trauma therapy will be my primary focus) .

I still don't know if the change is due to a more consistant plasma level with dexamphetamine, or because methylphenidate and dexamphetamine works slightly different in the brain.

Methylphenidate blocks dopamine from re-entering a dopaminergic neuron through the dopamine transporter (DAT). Methylphenidate itself does not enter the dopaminergic neuron much. Amphetamine enters the dopaminergic neuron through DAT. Once in the neuron it causes release of dopamine from clear synaptic vesicles, and also causes DAT to work in reverse, pumping dopamine from the cytoplasm into the synaptic cleft.

Hence methylphenidate blocks dopamine reuptake and amphetamine causes release of dopamine. In fact, if one takes methylphenidate before amphetamine, this blocks amphetamine induced neurotoxicity, because the methylphenidate occupies the substrate position for amphetamine on DAT, and amphetamine is unable to enter the neuron through DAT and cause cellular changes.

 

[aced126]

I'm probably going to start up on mitrazapine next week. It's not an SSRI, rather it increases serotonin production. The outcome will be the same; I cannot risk taking MDMA. Mitrazapine will increase the effect of MDMA, Vyvanse will diminish the effect. It's just too unpredictable to add MDMA into such a cocktail when I'm already suffering from an disabling mental illness (PTSD).

It's a bummer that also LSD probably is out of the question, but I've used it im small dosis to be abke to have days where I function normally, as I used too. Hopefully I will get sufficient aid from the meds so I will get better/more stable, it has felt a bit silly to do LSD and then just use the high to clean the house or pay my bills.

Where did you get that mirtazapine increases serotonin levels?

Mirtazapine antagonises 5HT2a receptors, so it will definitely attenuate the effects of LSD. But it antagonises 2A with not that strong of a binding affinity (only 70nM), so it is possible LSD could still work.

 

[Jabberwocky]

I'll guess I have done MDMA about 9 times the last year. Effect was good until I changed to Vyvanse, then it plummeted.

Have you had the MDMA tested via GCMS? If not you can't be sure what it is.

 

[aced126]

Have you had the MDMA tested via GCMS? If not you can't be sure what it is.

Lol what % of MDMA users do you think put their MDMA into a GCMS machine, let alone have access to one...

 

[Pallyress]

Where did you get that mirtazapine increases serotonin levels?

Mirtazapine antagonises 5HT2a receptors, so it will definitely attenuate the effects of LSD. But it antagonises 2A with not that strong of a binding affinity (only 70nM), so it is possible LSD could still work.

It's just what I understood from reading about it online, but I might have misunderstood it? Please advice me if I got it backwards.