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Paroxetine (Paxil) + MDMA

Boomslang

Bluelighter
Joined
Sep 16, 2003
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I have a few questions in regards to using MDMA whilst on Paxil. I have spent the last 2 hours searching the archives and the www but cannot come up with anything definitive. Although I have read many posts that claim to be the definitive guide, i cannot find a clear answer to my questions there. Realizing this topic has been covered many times before, i will make my questions very specific and clear...

1. Is it dangerous to take MDMA whilst on Paxil (being used to treat an anxiety disorder)?

2. Does MDMA have little to no effect if taken whilst using Paxil?

3. My understanding is that Paxil will reduce the effects during a roll. Why, therefore, do some people preload on Paxil?.. To reduce neurotoxicity yeah..?.. But doesn't this greatly reduce the effects of the MDMA..?

4. How long will it take for me to be able to experience the full (pre Paxil) MDMA effects after i stop taking Paxil?... Will i ever be able to experience the full (pre Paxil) MDMA effects after i stop taking Paxil?

Thanks in advance.
Boomslang.
 
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In regards to question 3.. am i wrong in suggesting people preload with Paxil?.. should that be postload?.. that makes alot more sence. Sorry, just skip that question.
Thanks again.
 
1)There is no evidence that I'm aware of which directly contraindicates MDMA while on Paxil. However, personally I don't think these drugs should be taken together.

2) The roll can be expected to be less in intensity. From people I've known who have continued to take MDMA after months of being prescribed Paxil, the general opinion is that intensity of the roll is greatly reduced.

3) IMO, although Paxil will reduce the neurotoxicity by reducing intensity of the role, there is no practical benefit from taking Paxil as a preload. You may as well just take less E without the Paxil. It's job as a SSRI is to block the transporter-reuptake mechanism which means MDMA is prevented from entering 5HT neurons where it weaves it's magic (and destruction). Paxil is reported as being one of the most potent drugs in it's class, so as a post load, in theory it should provide the most protection. But as said, I as do many, have reservations about recommending taking a SSRI as a postload.

4) Impossible to say as individual factors come into play. The length of time that the drug is taken will affect how long neuronal changes take to return to "normal" (if they ever do) once treatment is ceased.



I have known several people who have used MDMA while on paxil, but the 2 who spring to mind were both going hard anyway at the time. One girl requested a script thinking it would be a good rec drug. She went really hard for six months, at one point taking very high doses of Paxil, 60-80mg/day with- 3 or more E's twice a week, booze, whiz, coke, dope - consuming whatever she could get her hands on. She would use her monthly script in 2 weeks and even when she renewed her script she somehow convinced her GP the dose was working. But her life was going downhill fast and being a close friend of the family I eventually saw it as my duty to talk to her. We asked both girls who were on this road to come over, thinking it would be a good opportunity to get them talking. It turned out both wanted desperately to get back on track. Because both girls had heard something about MDMA and SSRI's being safe, they'd somehow thought the 2 would produce an additive affect.

I started by explaining what each drug basically does & why it is silly to take anything else while on daily medication like paxil. I remarked that it made no sense whatsoever and was playing a sort of chemical russian roulette. No-one knows what other interactions occur between MDMA and SSRI's with long term or regular use. The research has never been done.

At this stage both girls were looking quite confused so I went on trying to explain the differences of antidepressant therapy to that of self administered rec drug use, at least as I see it. As one girl was a musician I used the following sine wave analogy to describe the different roles of a drug like MDMA compared to a drug like Paxil.

A wiggly line representation of; psychology, life dynamics and the effects of antidepressants & rec drugs.
(If only it were that easy 8))

If you can accept the old what goes up must come down model, try to imagine your emotional ups and downs as the peaks and troughs of a sine wave with the X axis ( or y=0) being in an emotion-less state. Perhaps it is the resting state; sleeping and unaware, or perhaps it is meditative; awareness but with no emotional response. Some people, no matter what they seem to do, never seem to spend long on or around the zero or middle line while they are conscious. Our daily lives swing the sine wave of our emotions through periods of elation, satisfaction, happiness and spiritual contentment, to balancing periods of anxiety, anger, sadness and introspection. When these peaks are too extreme, or the rate too frequent, it is impossible to coordinate or rationalise anything. Their positive peaks are just that; short lived (high frequency) pulses that prevent focused thought. Naturally, the person finds it harder to control reactions are often only aware of their reaction after the change. However, some people enjoy a life rich in emotional dynamics, in much the same way as some people enjoy a roller coaster and others detest the physical ups and downs accompanied with a feeling of being thrown way out of center.

In the same way, some people find it impossible to do the social norm -9 to 5, family, money etc - if they are an emotionally dynamic person. The constant up's and down's are too unsettling, or at least too hard to manage in accord with other priorities. Efficiency suffers and self worth is constantly doubted.

Other people seem to have a naturally smooth emotional sine wave, with relatively few bumps.

Then there are those who seem to be able to "ride" the peaks and troughs with little or no negative impact on their day to day activities. At the end of the day they are happy and the daily cycle is easy to manage. For a large number of these people MDMA probably won't be too disruptive. Providing sensible limits aren't exceeded, dealing with such large peaks and troughs can be easily accommodated. I think most of society would fall into this category using this model.

But for those who do not cope well with these society inflicted compliances, large dynamics are the last thing they need. A drug which reduces the dynamics -the peak heights of emotionally intensive periods- means less time is spent dealing with or attempting to understand why you've been unwittingly swept into these states. Without some relief, day to day living can become hell. Some people lose it completely, some turn to god, some turn to heroin, some turn to rambling around and some end up with nothing, though there's plenty to spare (to borrow from Joni)

So these people can often benefit from reducing the peak intensities. SSRI's do this by regulating chemical responses to emotional triggers, which in turn affects severity of the psychological response. The bumps are easier to get over and life goes on, seemingly much less hindered.

So MDMA and similar drugs are like dynamic expanders; positively lifting consciousness and accentuating life's qualities before completing the cycle through the negative or introspection phase. SSRI's and similar compounds on the other hand work as dynamic compressors; limiting the peaks and troughs.

So, if you accept those analogies, why would anyone want to take MDMA or similar drugs while being prescribed SSRI's? One completely defeats the purpose of the other. It's effectively like taking an upper and and a downer to stay as you are. You either live in a world of dynamics - worts and all - where MDMA can be regarded as an occasional dynamic booster, or you choose to restrict dynamics by using a SSRI or similar.

....2003...the choice is yours!


I believe SSRI's have their place and for some people are definitely beneficial. What I have trouble with is the thought of people taking a single compound for extended periods. This definitely applies to Aropax (Paxil). It has profound affects on the way people look after years of being on it. I have detected similar facial expressions with those who have been on Aropax for years, to those expressed by longterm patients on MAOI's (my exposure was when I did electronic work at a psychiatric hospital where my mate's dad was head psychiatrist).

With my friend in the above story, I'm pleased to say she stopped both the Paxil and the rec. drugs and now lives happily with her family and only parties on special occasions. I don't know whether it was that description that made her slow down, or this piece of wisdom. It's slightly out of date, but still very relevant to your questions. From Q & A archives; SSRI's and Ecstasy; The Final Word (Hopefully)


Sorry bout the long winded post. Hope my wacky model made some sense :)
 
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How good was that...

I have no experience with anti-depressants at all, but still fascinating...
 
Correct. I also would have accepted..

1. Yes.
2. Yes.
3. No.
4. Hard to say, probably not.

Or..
Search the archives Boomslang.

Cheers phase_dancer, you're a legend.
 
I can assure you your questions have indeed been covered before, but try searching more broadly than just paroxetine, such as "SSRI", and names of other SSRI's like citalopram, fluoxetine, sertraline etc for more results. Also, try both E. Discussion and Health q & a.
 
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