SSRI's and psychedelics - There is no serotonin syndrome its a myth..

[BizMarkie1000]

My own professional Psychiatrist (MD) who I saw for 11 straight years had the following to say:

Me: "My old doctor said that taking Tramadol (Legal and prescribed for brutal back pain) can cause a serious deadly complication called Serotonin syndrome that can cause seizures and death. Is this true, Doc?"

Doctor: "No, he's just covering his own ass (by trying to scare you into believing a lie)"

 

[Ismene2]

I enjoy the effects of 5-htp on trips - 5-htp is supposed to release serotonin. If you increase GABA too it gives you this marvellous deep inner peace on acid.

 

[BizMarkie1000]

Serotonin Syndrome was invented to scare people away from ANY drug that can potentially cause Euphoria.

Serotonin Syndrome is always tacked onto Psychedelics, uppers like Adderall, Tramadol and Demerol (opioids), and Dextromethorphan.

 

[Allylbenzene]

Key findings

• Mild serotonin syndrome can occur in primary care patients with treatment-resistant depression following the introduction of a second antidepressant.

• Effective interventions, such as discontinuation or dose reduction of serotonergic medications, led to symptom resolution within three weeks for all patients.

https://doi.org/10.21037/acr-24-123

 

[iom]

Serotonin syndrome is not a myth, and the fact that many warnings about it may appear excessive is because the specific drug combinations and circumstances that lead to it are not entirely well understood. Some things that appear perfectly safe for some people turn out to be very dangerous for others. The warnings are for harm reduction because serotonin syndrome can cause permanent damage or death if it is severe and prolonged enough.

Also, the effects of psychedelics can mimic or copy the effects of serotonin syndrome to a degree, depending on the substance and dose. For stuff like LSD, DMT, and psilocybin, this is less likely to be a safety concern because their serotonin-like action saturates above a certain dose or else they are metabolized quickly enough to not cause cumulative problems. Though it's possible that if low-level serotonin syndrome is already present, introducing one of these psychedelics could push things into more dangerous territory. More concerning on their own would be overdoses of some of the long-acting phenethylamines, like possibly (but not limited to) 2C-E, 2C-P, the DOX drugs, 2C-T-4, or 2C-T-7. In practice, very little data is available about the consequences of overdoses on these substances, but more than a few have been implicated in overdose deaths, at least some of which may have occurred via serotonin-syndrome-like mechanisms.

 

[Didgital]

Serotonin syndrome is not a myth, and the fact that many warnings about it may appear excessive is because the specific drug combinations and circumstances that lead to it are not entirely well understood. Some things that appear perfectly safe for some people turn out to be very dangerous for others. The warnings are for harm reduction because serotonin syndrome can cause permanent damage or death if it is severe and prolonged enough.

Also, the effects of psychedelics can mimic or copy the effects of serotonin syndrome to a degree, depending on the substance and dose. For stuff like LSD, DMT, and psilocybin, this is less likely to be a safety concern because their serotonin-like action saturates above a certain dose or else they are metabolized quickly enough to not cause cumulative problems. Though it's possible that if low-level serotonin syndrome is already present, introducing one of these psychedelics could push things into more dangerous territory. More concerning on their own would be overdoses of some of the long-acting phenethylamines, like possibly (but not limited to) 2C-E, 2C-P, the DOX drugs, 2C-T-4, or 2C-T-7. In practice, very little data is available about the consequences of overdoses on these substances, but more than a few have been implicated in overdose deaths, at least some of which may have occurred via serotonin-syndrome-like mechanisms.

Thanks @iom for stopping dangerous misinformation. serotonin syndrome is real. Anything that releases serotonin combined an SSRI can lead to way too much serotonin. Serotonin the happy drug, seems like an absolutely terrible thing to overdose on.

Regardless, prolly not wise to trust your life to a random wook on a drug forum that doesnt seem to care much about their own safety. Even me. Especially me.

Here is a report of a fatal DMT + venlafaxine (SSRI) + mirtazapine (tricyclic antidepressant) Its unclear how the mirtazapine affected the outcome, but i imagine without the SSRI the experience would not have been fatal.

Fatalities following DMT use: two case reports and a review of the literature - PubMed

N, N-Dimethyltryptamine (DMT) is a hallucinogen found in the South American Psychotria viridis plant and is the major psychoactive ingredient in the brew ayahuasca. In this report, we performed a review of the surrounding literature and detail two deaths which recently occurred in the UK...

pubmed.ncbi.nlm.nih.gov

"There have been three previous reports of fatalities following DMT use, all deemed accidental in nature, with DMT consumption taking place as part of an ayahuasca ceremony in two of these cases. NPSUM cases-Two cases were identified (Case Report 1 [CR1] & Case Report 2 [CR2]), neither of which occurred in the context of an ayahuasca ceremony. DMT was detected and quantified in femoral blood in both cases (CR1 0.23 mg/l; CR2 0.24 mg/l). There was evidence of polydrug use in both cases (CR1 n = 6; CR2 n = 9), which in each case included additional compounds which can increase serotonergic drive (CR1 cocaine, amphetamine; CR2 venlafaxine, mirtazapine)."

 

[red22]

"… what actual drugs do we have to worry about? So for clinicians, what all this means is that you can be very confident about what's going on and what's safe and what isn't safe in terms of what drugs you can and can't give in combination with MAOIs. Because it's really all about MAOIs. There aren't any other combinations that you're going to encounter as a clinician which are going to cause serious problems.[ … ]But for 99.99% of practical purposes, the only thing you'll ever encounter is a mixture of an MAOI with a serotonin reuptake inhibitor. So drugs that are not significantly potent serotonin reuptake inhibitors cannot cause serotonin toxicity. End of story."  Ken Gillman, M.D.  Understanding serotonin toxicity  @psychotropicalresearch5653  2019.08.22  h‍ttps://m.youtube.com/watch?v=TpjxydNxjNI&t=1660s  27:40–29:04

 

[ChemicallyEnhanced]

I have done mushrooms, 2cb, lsd, all on 10mg of ciprelex.....

No serotonin syndrome, just an extreme lack of psychedelic effects, making me take more of the drug. (like 3.5 of mushrooms felt like a gram)

Whoever says you get serotonin syndrome from a combination does not know what there talking about.

Does everyone on here agree so we can bust this myth, cause theres a large population out there who will not take psychedelics for this very reason (those on ssri's)

I am not saying all anti depressants are like this (like MAOI's) but I am saying SSRI's do not kill you when on psychedelics.

I have not tired MDMA on SSRI's but have heard the same, diminished effects, but no serotonin syndrome.

This is Bluelight, a harm reduction forum, so lets bust this myth or have a good conversation as to why it would/would-not cause serotonin syndrome.

You may not personally have experienced SS, but it's definitely real. I've had it (mildly) before.
My doctor had me on high doses of Zoloft, Amitriptyline, Trazodone and Tramadol at the same time (same doctor prescribed them all, too).