How do you know if a weak MAOI or Serotonergic drug is safe to take with an SSRI?

[sekio]

The references linked to in the paper cited as [1] says memantine and diazepam reduce hyperthermia in models of serotonin syndrome.

Saying that a drug "effects serotonin" is pretty close to a meaningless term. There are so many parts of the serotonin system that drugs interact with that you can't neccesarily generalize. As far as I know ketamine binds only weakly to 5ht2a and is not a reuptake inhibitor, so it's fine. PCP and ketamine are not very strong serotonin releasers/agonists anyway. They are primarily NMDA antagonists. PCP is probably obviously more of a risk combining with citalopram due to its high potency and long duration compared to ketamine.

 

[Mycophile]

It means don't take them at all. Put the thought out of your mind.



Look up their mechanisms of action and figure it out. Or ask your doctor. Or do some searching on places like Erowid. It depends largely on dosage, quality of plant material, set, setting, and how you respond to drugs as an individual.

Just go slow with dosing any of these and you should be fine. The only one to be concerned about that you've mentioned is lotus flower, it contains apomorphine and other dopamine receptor agonists that are used as veterinary emetics (make you vomit), if you take too much.

Thanks,

3 questions, though whether or not I ever attempt to use this substances is possibly unlikely but just out of curiosity:

1) you say that most of the substances listed would PROBABLY be safe to mix with Prozac and Klonopin in small dosages but one obscure one I mentioned was Indian Warrior.

So very little seems to be known about this substance.

Do you know it's active ingredients and have any knowledge about how it would react with an SSRI and a Benzo?

Since you didn't make a comment regarding not "safely" experimenting with it in small doses, I am assuming you know something about the way it works...

2) I experimented with Calea in the past when on Prozac, but I was not on Klonopin yet, and had no ill effects. Do you think this substance is safe to mix with my meds?

3) I have always wanted to try Ketamine and never had the chance but IF it is safe, I probably will some day if I get the chance.

You seem to say that MDMA is NOT safe to take with SSRIs (is this true??, opinion seems to go back and forth about this on the board)....but Ketamine is not the same drug.

If I ever got the chance, would Ketamine directly interact in a negative way with Klonopin and/or Prozac?

Thanks

 

[sekio]

You ask too many damn questions that you should learn to answer yourself

Do you know it's active ingredients and have any knowledge about how it would react with an SSRI and a Benzo?

No. I can guess though. Given that it's like most other plants, a mild muscle relaxant etc, it probably had nothing that would interact badly.

I experimented with Calea in the past when on Prozac, but I was not on Klonopin yet, and had no ill effects. Do you think this substance is safe to mix with my meds?

Probably.

If I ever got the chance, would Ketamine directly interact in a negative way with Klonopin and/or Prozac?

Probably not. Why you need to mention that you can't take MDMA is totally irrelevant.

Nobody can hold your hand through all your drug experimenting. At some point in time you have to accept that you are participating in risky behavior and that you need to do your due diligence. If you don't know, then don't take a drug if you are afraid of interactions.

 

[Mycophile]

You ask too many damn questions that you should learn to answer yourself



No. I can guess though. Given that it's like most other plants, a mild muscle relaxant etc, it probably had nothing that would interact badly.



Probably.



Probably not. Why you need to mention that you can't take MDMA is totally irrelevant.

Nobody can hold your hand through all your drug experimenting. At some point in time you have to accept that you are participating in risky behavior and that you need to do your due diligence. If you don't know, then don't take a drug if you are afraid of interactions.

Sorry, I know, but there are simply people who know off hand more than I would if I took days to research something that I should be capable of understanding quickly, especially since I have various difficulties with scientific subjects and always have in school.

That doesn't mean it's cool to bother people, but I'll still end up with a better answer than what I'll probably figure out myself given 3 times the amount of research and I'd probably read a few articles, be like "ok, sounds fine" then just pack a few bowls of an obscure herb and possibly have horrible reactions.

I've engaged in somewhat "risky behavior" for years and managed to be safe without doing the necessary research and just asking others if they managed to be alright with certain combos but I realized it wasn't smart.

I should still do the necessary research, but it's unfortunate that most doctors won't simply answer straight forward questions about which mind altering substances to mix like they would with non-mind altering substances.

My general practitioner probably wouldn't know what the hell "Indian Warrior" is, probably doesn't know what Kratom even is or most of these substances, and even my neurologist wouldn't know and if I ventured to ask my neurologist these questions his answer would be: "and now not only are you NOT getting the answer to your question, but I am taking you off the medications you need for even asking..."

Nevertheless, my lamenting the state of doctor's unwillingness to discuss this stuff will get me no where.

Sorry.

 

[sekio]

Sorry, I know, but there are simply people who know off hand more than I would if I took days to research something that I should be capable of understanding quickly

This is absolutely true, but excuses aside, you teach a man to fish by them doing their own research.

I should still do the necessary research, but it's unfortunate that most doctors won't simply answer straight forward questions about which mind altering substances to mix like they would with non-mind altering substances.
My general practitioner probably wouldn't know what the hell "Indian Warrior" is, [...] Nevertheless, my lamenting the state of doctor's unwillingness to discuss this stuff will get me no where.

PubMed and Google Scholar are open-access, anyone can use them, and there are sites which even let you break paywalls on most articles. (library genesis and the like)

When you can't find anything on a plant, then just proceed with caution. Careful dosage titration should be enough to prevent mishaps with all but the nastiest compounds. Rely on anecdotes and personal experience if you must. Pretend you're a shaman for a minute.

Remember, riding a bike even under ideal conditions is a risky activity, too. That doesn't mean you shouldn't ever ride a bike in the rain, or if you're slightly tipsy, or sick. It just means you need to take care and accept the possibility you could get some skinned knees.

 

[Lightning-Nl]

In short, it's difficult to tell for sure: we lack an adequate and specific theory about development of the disorder. Serotonin syndrome is a rare complication of SSRIs taken alone, and the symptoms of SSRI overdose are very similar to serotonin syndrome. But in general, mixing drugs that increase synaptic serotonin, particularly when they work via different but compatible mechanisms, increases the risk of SS. It is unclear whether direct serotonergic agonists can decrease the margin of safety for releasers or reputake inhibitors, but their contribution is minimal regardless. CBD does exert direct agonism at 5ht1a (I forget whether partial or full), but this effect is weak enough that it doesn't interact with serotonergics dangerously. When we say something is a "weak" SSRI, we mean that its activity is so minor that it's questionable whether it's relevant at all.

There are some unexplained complications to our picture. For the vast majority of SSRIs, their binding affinity is much stronger than common releasers, so they will block entactogens' effects by blocking its ability to bind at SERT. Yet DXM's action blocking activity at SERT can synergize dangerously with MDMA. I'm not sure why this would be.

ebola

You forgot to mention that 5HT1a is an autoreceptor. Activation of 5HT1a induces uptake of Serotonin from the synapses back into the vesicles. So, technically, CBD is an indirect 5HT antagonist.

 

[endotropic]

You forgot to mention that 5HT1a is an autoreceptor. Activation of 5HT1a induces uptake of Serotonin from the synapses back into the vesicles. So, technically, CBD is an indirect 5HT antagonist.

5-HT1A is both an autoreceptor and a heteroreceptor. Activation of the autoreceptor quiets down the 5-HT neurons so they release less 5-HT in the first place, but has no effect on uptake per se.

5-HT1A heteroreceptor activation on the other hand probably contributes to serotonin syndrome.

 

[ebola?]

Regardless, here, CBD exerts direct serotonergic agonism.

ebola