Exception to "waiting period" between doses?

[harshx]

I know that a "cooling off" period is recommended between rolls in order to allow serotonergeric activity to return to normal, but I'm curious if this applies to my situation....

My MDMA experience last night was entirely nonexistent because I'd forgotten about my recent SSRI therapy and did not wait long enough between SSRI cessation and my MDMA dose. Since I had no experiential effects, does this do anything in the way of minimizing the need to wait to dose again (obviously in order to have a pleasant experience)? I plan to wait several more days for the Zoloft to be depleted to less than 0.5mg (based on a half-life of 26 hours), but is this long enough? In the past (without SSRI therapy), I would often wait only two weeks between MDMA trips and never detected any decrease in its effects....would less time be sufficient when no effects were exhibited? Or will the brain still behave as though it has already had a full-out, balls-to-the-wall all-nighter (even though this didn't happen)?

 

[Bsiren]

I am not extremely schooled on the SSRIs + MDMA topic, but our directory has a pretty thorough guide if you haven't checked that out: http://www.bluelight.ru/vb/threads/72530-FAQ-Antidepressants-and-Recreational-Drugs-(long!)

It's important to be very careful when attempting to roll after discontinuing SSRIs (or worse, still on SSRIs) because there are certain dangers and risks this combination presents, including a higher risk for Serotonin Syndrome.

"No effects" unfortunately do not mean that you do not need to wait and "got away with a freebie" unfortunately- MDMA still attempts to do it's job regardless of your medication inhibiting the ability for you to feel the rolling sensation of MDMA. No fun does not = no damage done.

 

[First Bad Comedown]

In a way it does.
Competitive affinity of an SSRI often prevents all neurotoxicity even with known toxic doses of MDMA.
I do not know to what extent that serotonin is still released, but I imagine it would be greatly reduced.
SSRIs actually reduce serotonin supply in advance!

However, you are correct about Serotonin Syndrome risk.
SSRIs are not nearly as risky as other SRAs or MAOIs, but it can happen.

Because of this risk, I agree that you should be waiting LONGER than two weeks.
In fact, two weeks is the MINIMUM waiting time.
Many SSRIs take MONTHS to withdraw from, and a minority of users experience extreme anxiety/anhedonia and even 'brain zaps' coming off SSRIs.

I strongly disagree with the use of SSRIs due to the evidence that shows limited efficacy of treatment and substantial side effects, including loss of libido and sexual sensation.

Considering MDMA is a serotonin neurotoxin and SSRIs are arguably a dangerous pharmaceutical treatment in the first place, I would highly recommend a very long spacing in between. Six months.

But no less than three months.
And this is the spacing I always recommend between rolls anyways.
It takes up to 90 days for tryptophan hydrolase, the enzyme that synthesis serotonin, to be replenished.
And that is in NON SSRI users.

Take solace in the fact that MDMA probably did no you no harm.
But SSRIs might.
About half of SSRI patients show a WORSE HPA function after treatment than before.
Some treatment...

 

[MazDan]

"No effects" unfortunately do not mean that you do not need to wait and "got away with a freebie" unfortunately- MDMA still attempts to do it's job regardless of your medication inhibiting the ability for you to feel the rolling sensation of MDMA. No fun does not = no damage done.

This is very true.

Further to that, many people who have spent time on SSRIs have noted that even years afterwards they still cannot get any or very limited affects from MDMA use.

SSRIs affects appear to make some permanent changes for some if not most.

 

[harshx]

Well, despite the conflicting information (which is what I have found everywhere else I look as well), I do appreciate the feedback. I guess this is why people often disclaim their comments by stating things like 'your mileage may vary'-- in this case it should probably read YMMV significantly.

Unfortunately there is no way I am going to wait another six months...I have already waited 3 years. I know for a fact (from exp) that for me, a brief period of repeated MDMA dosing, say once a week for 6 weeks, has no noticeable effects, nor is the effectiveness of the drug decreased. Also, I know that in the past I have waited as little as 2 weeks after SSRI cessation before rolling, and had full-on, amazing experiences. So I must say that I strongly disagree with such inflated recommended waiting periods.

As for my SSRI use, I have used these medications on AND off for many, MANY, years, so I know exactly what it feels like to stop taking. I get so tired of hearing people say things like "people who are on SSRIs should NOT be using MDMA" and giving advice to NOT stop taking the SSRI...I have plenty of experience here, as I have gone on and off of SSRIs a dozen times in my life. What I am looking for help with is understanding MDMA's mechanism of action, and more specifically, how this action is affected by a drug that blocks the serotonin transporter.

 

[First Bad Comedown]

MDMAs primary action is at the transporter (SERT).
The transporter protein is seen as an indication of high axonal density - it serves to remove serotonin from a number of receptor types.
The most important receptors for most psychedelic drugs are 5HT-1a, 2a, and 2c.

MDMA fits into the receptors and causes the SERT to respond by pumping serotonin INTO the synapse!
This is a REVERSAL of normal function - something that SSRIs do NOT do.
It takes a potent serotonin releasing agent to do this.

It is the massive DUMP of serotonin stores into the synapse that result in such impressive serotonin levels.
This is KNOWN to be toxic to axons and transporter proteins.
There is no debate about this among researchers anymore, it is only the level of axonal and SERT destruction that occurs at a given dose that is unknown.
Therefore your attitude about people telling you not to take MDMA needs some maturity.
Technically speaking NOBODY should take it, especially in higher or REPEATED doses.
Since it is a proven neurotoxin...

It just so happens that SSRIs stop the release of serotonin from occurring at the SERT.
The main mechanism of action is blocked.
Serotonin Syndrome is not very common in long-term SSRI users taking MDMA, but a blunted or absent effect from MDMA is.
For about 18% of patients in one zoloft trial, akithisia occurred which is a sign of dopamine inhibition and is a risk factor for suicide.
It is likely in the more sensitive patients that MDMA poses a real risk of Serotonin Syndrome.

There is no way to overcome the blocking effect, other than to withdraw from the zoloft.
Exercise and healthy diet will probably speed the process.
Zoloft appears to have a short half life, but some of the lingering effects upon serotonin activity can take several weeks or months to occur.
Even if you enjoy rolling two weeks after withdrawal, you are likely experiencing a lower endocrine response than you would at a later time.

I'm glad to hear that you don't like people who recommend staying on the SSRI.
Those who say 'don't stop taking it' are indeed sending the wrong message.
The fact that you have gone on and off SSRIs so many times is CLEAR evidence that they are not effective at treating depression.
Depression, along with other psychological conditions, cannot be treated with medication long-term.

If you want more detail than this about Zoloft vs. MDMA, I suggest you start reading for yourself about the brain's most intricate and complicated neurotransmitter system.
Even your doctor is unlikely to understand, and a true neurologist would sound like gibberish to you.
Coming to BL hoping for a blessing is pretty hopeful.
We are only going to tell you what we know - which is that you cannot roll until withdrawal is underway or complete.
Most BL members that have tried say it is a completely wasted dose of MDMA.

And several have claimed that SSRI treatment following MDMA toxicity cost them precious recovery time or made them worse!
MDMA can indeed damage serotonin transmission much more quickly than an SSRI.
If you use it repeatedly, you are likely to experience a loss of effectiveness from Zoloft or other SSRIs in the future.
Good luck.