SSRIs and otger serotonergic drugs (Ketamine).

[Enlight Spurrett]

So I've been on Fluoxetine (Prozac) for a year and 5 months now and have since refrained from using any serotonergic drugs such as MDMA etc due to the possibility of Serotonin toxicity. However, I have a deep love for Ketamine and want to use it again. Does anybody know whether the serotonergic effects of Ketamine are strong enough to interfere with SSRIs and whether there is any danger of serotonin toxicity? How much of an SSRI is Ketamine? Any info would be great. Thanks.

 

[IamMe90]

So I've been on Fluoxetine (Prozac) for a year and 5 months now and have since refrained from using any serotonergic drugs such as MDMA etc due to the possibility of Serotonin toxicity. However, I have a deep love for Ketamine and want to use it again. Does anybody know whether the serotonergic effects of Ketamine are strong enough to interfere with SSRIs and whether there is any danger of serotonin toxicity? How much of an SSRI is Ketamine? Any info would be great. Thanks.

From what I understand, SSRIs simply blunt, and sometimes completely eliminate the effects of serotonin releasors and agonists. I have not read anything indicating that the combination is dangerous (however, keep in mind that combining serotonergic drugs with MAOIs is dangerous, and can be fatal). Given that the serotonergic effects of ketamine are weaker, I don't foresee any issues.

Edit: However, I did just find out that DXM and SSRI can result in SS. I'm not really sure why that is, but I also did some googling and have only heard that ketamine and SSRIs is benign, so I still think you'll be okay.

 

[.:Holy::Toast:.]

Ketamine works on serotonin through its function as a non-selective monoamine reuptake inhibitor although I'm not sure of the extent.
I have never heard of any interactions with ketamine and SSRI's though, and given that ketamine is now being used to treat depression patients I doubt there will be any interactions

 

[FAD]

ssri, worst shit i've ever taken in my whole life...for real, i got multiple life long problems after that ssri "treatment " and it has been many years when i used them...total scam, most of AD are a scam and not being researched eanough, not proven to be more effective than placebo and doctors giving them away like candy...

 

[Enlight Spurrett]

Thanks for the info Iamme90 and Holytoast. So the fact that it's an MAOI could interact with my SSRIs? I have heard that most anti-depressants have a kind of safe guard when it comes to SS. Maybe I should just avoid it on the safe side? The anxiety of such issues may also give me a bad experience.

FAD - Do you have any scientific evidence to support that they are a scam? I'd be interested in reading if you have any scientifically legitimate links?

 

[.:Holy::Toast:.]

Thanks for the info Iamme90 and Holytoast. So the fact that it's an MAOI could interact with my SSRIs? I have heard that most anti-depressants have a kind of safe guard when it comes to SS. Maybe I should just avoid it on the safe side? The anxiety of such issues may also give me a bad experience.

FAD - Do you have any scientific evidence to support that they are a scam? I'd be interested in reading if you have any scientifically legitimate links?

Antidepressants don't have a "safe guard" per se, their mechanism of action generally isn't likely to be conducive to development of serotonin syndrome.
Current generation antidepressants (SSRI's) are certainly safer on the body and less likely to have dangerous interactions with other drugs compared to, say, tricyclic antidepressants.
With that being said serotonin syndrome is still possible with SSRI's although it is far less likely than mixing strong serotonin releasers with MAOI's like amphetamines; interactions with MAOI's remain the most likely way to develop true serotonin syndrome.
With that being said ketamine itself does not act as an MAOI, at least not to any appreciable degree (if it does at all I would be unaware).

 

[Solipsis]

No ketamine is not a MAOI, but it does appear to inhibit reuptake of serotonin and other monoamines... serotonin levels are not elevated.
http://www.ncbi.nlm.nih.gov/pubmed/6460944

DXM is a much more extensive SRI, and combining it with MDMA is quite dangerous whereas MDMA with K is not considered to be much of an issue, at least I never heard of it.

 

[Enlight Spurrett]

See it wasn't anything to do with MDMA really. I wanted to use that as an example. It's my Fluoxetine I was worried about. The fact that Fluoxetine inhibits reuptake of Serotonin as well as Ketamine, I assume there is danger there? Sorry if I've misunderstood. I assumed that by inhibiting the reuptake of serotonin, that the levels of serotonin would naturally be elevated? That maybe the combination of the two would become a more powerful agonist on the receptors and either be neurotoxic or possibly cause SS. It's always been a fear if mine because it can kill you so quickly.

 

[.:Holy::Toast:.]

See it wasn't anything to do with MDMA really. I wanted to use that as an example. It's my Fluoxetine I was worried about. The fact that Fluoxetine inhibits reuptake of Serotonin as well as Ketamine, I assume there is danger there? Sorry if I've misunderstood. I assumed that by inhibiting the reuptake of serotonin, that the levels of serotonin would naturally be elevated? That maybe the combination of the two would become a more powerful agonist on the receptors and either be neurotoxic or possibly cause SS. It's always been a fear if mine because it can kill you so quickly.

It doesn't increase serotonin a considerable degree compared to serotonin releasers because serotonin is still released at a natural level, the reuptake inhibition only prevents the serotonin from being recycled by the cell, yet this is not always the preferential fate of released serotonin, remember a lot is degraded by endogenous monoamine oxidase which is why inhibiting MAO is more likely than SSRI's to cause serotonin syndrome.

 

[Enlight Spurrett]

Oh thanks for the clear distinction holytoast. Really helpful to know that. Can I add you as a friend? May be beneficial?

 

[.:Holy::Toast:.]

For sure for sure feel and feel free to pm me anytime with any questions.
Also what I posted is just a likely theory I have for this phenomenon, I'm not sure if it's actually correct or not haha

 

[Enlight Spurrett]

Cool. Yeah me too. I'm sure I must have some helpful knowledge somewhere Haha! But theories are always helpful. If it wasn't for people like us (including nearly all of the bluelight members), no one would know anything about these things. When I first joined I was dubious about people on here, but it just gets better by the day. Anyway nice to meet you.

 

[swilow]

I took lots of ketamine when I was on sertraline (Zoloft) with no ill effect. I used many psychedelics heavily during that period, no ill effect. Meaningless anecdotes though, YMMV. I tried several SSRI's due to side-effects, including prozac, which I was on when I took LSD, various 2C's, etc.

You would want to be cautious in using either MXE or DXM with SSRI's though...

I think the reason that SSRI's do not work very well is because, while they increase the levels of serotonin in the brain, this increase leads to downregulation of receptors. You become tolerant to serotonin through protective mechanism of the brain. It is a bit amazing that these drugs are still prescribed.

 

[liz0]

Ketamine works on serotonin through its function as a non-selective monoamine reuptake inhibitor although I'm not sure of the extent.
I have never heard of any interactions with ketamine and SSRI's though, and given that ketamine is now being used to treat depression patients I doubt there will be any interactions

new around here but I have been on SSRI's for over 20 years. Talk about fucked up withdrawal? go cold turkey off that. Worst ever. I have been researching so much and come to find out serotonin depletion is not the *cause od chemical depression, it just helps. I am so on board with the Ketamine infusion therapy, which I have heard the FDA will have approved by 2018. Can not freakin wait http://www.sciencealert.com/ketamin...lievable-effect-in-treating-severe-depression