This is a pretty popular question lately. I can give a bit of insight into this as I am a regular DXM user - as in two or three times a week. Granted, my dose is generally low (300mg, or one bottle of gelcaps), but I do go as high as 900 when I have to get some serious writing done.
I also use a lot of MDMA. Again, I tend to stay below 300mg per session, and usually closer to 200mg depending on what I have. I call a good pill today anything over 70mg MDMA pure. So they're rare, but they are around right now.
Also, I occasionally have the blessing of pure MDMA powder, but this is an extremely rare occurrence, and tends to be the exception rather than the rule.
I know that conventional wisdom says to never, ever mix DXM and MDMA, and as a general principle, I certainly agree. The primary threat imo is liver damage. Seratonin syndrome is certainly a possibility, though in my way of reckoning not a serious one if doses are kept down and taken correctly, with a high level of awareness. Let me explain:
A low dose of MDMA on its own will not cause seratonin syndrome or significant liver damage. Likewise, a low dose of DXM will not cause either. However, depending on the liver's ability to metabolize these drugs concurrently, the effects of either or both could be drastically enhanced. This goes for all effects, good and bad, and there is no surefire way to control which.
Liver damage issues aside, it is possible to actually take this combination and enjoy it, without any apparent - and I stress this term - major side effects. I have taken as much as 600mg DXM within 12 hours of rolling balls and absolutely loved it. Likewise, I have taken 300mg of DXM the day before and gotten almost nothing off the next night's roll. Indeed, the vast majority of times that I have juxtaposed MDMA shortly after DXM - meaning within 24 hours - the empathic effects of the MDMA seem to be greatly diminished. However, the speedy effects almost always seem amplified if the two are juxtaposed.
If taken in reverse order, that is, MDMA followed by DXM, the effects of DXM seem slightly amplified. Again, emphasis seems to be on the speedy feel - and DM can feel speedy at times (those of you who use it frequently know what I'm referring to).
The only way that I consider to be particularly dangerous is taking the two simultaneously, or within a couple hours of each other. In other words, when both are in the body in peak amounts. I've done this inadvertently several times. Indeed, I submit that most of us have felt the effects of this if we've rolled on pressed pills for any period of years, since DXM is a very common adulterant, and the way we correct a bum bean on a party night is to simply find a good bean and pop it right as soon as possible. Do I condone this? Absolutely not. Have I done just that? More times than I care to admit.
Given that a noticeably active dose of DXM for most of us is at least 100mg, and most of us take a second pill if the first one lacks in any way, it's probably safe to assume that most of us have had 200mg DXM in our systems when we finally found that first legit pill of the night and popped it. Think back to the times you may have felt overwhelmed by a single bean, later in the night, when the first ones maybe seemed "trippy" or not as "lovey" as MDMA.
Ring a bell?
Anyway. I've also tried small amounts of DXM at the same time as pills in an (foolhearty) attempt to increase the effects of MDMA. Does it work? Yep. Is it always for the best? Nope. Do I do that now? Nope. I had a frightening experience that involved several drugs at once, including DXM and MDMA, resulting in a very embarrassing trip to the ER. My friends called me DJ ER forever afterward, much to my chagrin.
So. What's my position?
1) That it's not an instant death warrant, contrary to many posts in this forum.
2) It is definitely, without question, very stressful on the liver.
3) It is probably stressful on the kidneys (MDMA breaks down muscle, which itself can cause kidney stress)
4) It is unwise at best, harmful at worst, and the risks far outweigh the benefits.
If you discover that you have taken both in the same night, the most important thing to remember is not to panic. Provided your doses were reasonable and your metabolism is normal, you probably won't suffer any major harm. That being said, major harm is certainly theoretically possible, and if you are in doubt even for one second, proceed to the hospital and tell the truth about what happened.
BTW, the importance of telling the truth about what drugs you took at the ER is critical. Especially with DXM and MDMA. Either of these on their own have major contraindications with many standard hospital treatments, and both together in your system leave very little, if any, wiggle room for an additional bad choice.
Best to wait it out in a supervised location, own up to your decisions and the legal consequences (if any), and live to tell the tale.
My two cents.
