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  • BDD Moderators: Keif’ Richards | negrogesic

MAO-A/B inhibitors (Seligine) w/ 3MeoPCP Diphenidine or SSRIs nearly killed my friend

Marauder

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Not sure of the exact cause but this should be reported!

Hanging out at close friend's house (let's name her Stacy), an otherwise healthy female with high tolerance for diphenidine (she can take 200 mg oral with no effect) and did not take any during this TRAGEDY but it must still be in her system.

Freebased and vaped 3-MeO-PCP. Daily regimen of 20mg Lexapro (Escitalopram). On this day she decided to down 20 mg Seligine a few hours after the 3-MeO-PCP (which she vaped maybe 20 mg of with a slight buzz) and maybe 24 hours after dosing Lexapro.

Got into a very vivid dream. Woke up in the hospital confused and with mild visuals (as you'd get from a low dose of any Mescaline analogue, not the tryptamine kind), confusion and excruciating pain in her back, chest and arms.

I came from a cig break to find her babbling and breaking down everything in her room, her flailing her arms caught beneath a door, caused severe carpet burns. In the hospital she was asked mostly questions to rule out bipolar. Blood work showed "mixed drugs" which is not news to me nor her with tobacco, weed, alcohol, diphenidine probably always in her system to some level, along with lexapro and its metabolites, and she don't know what 3-MeO-PCP will show up as, plus the introduction of Seligine (MAO-B inhibitor)—I'm not quite sure what cocktail was the result. she just wanted to be out of that hospital as it was uncomfortable. If I get hold of more concrete details on the actual blood work I'll post back. She is doing OK now.

Tests for everything, MRI, etc came out fine but she could have died easily. I suspect serotonin syndrome or a hypertensive emergency (aka "malignant hypertension") but these are guesses on my part. The least idiotic thing she did with regard to taking more chemicals was ingesting about 1mg of clonidine spaced out before/during this experience. This could have probably saved her brain from some damage but again, I'm not a doctor.

Some points to reiterate:

* Not freebasing the 3-MeO-PCP (which she suspects comes mostly as an HBr salt) has no effect when vaped.
* Diphenidine was not consumed but likely still high concentration in her blood
* Very little tobacco/cannabis/alcohol was used but worth nothing
* She may be going through a slight benzo w/d deals with it right now by taking dizlazepam every night (long half life IIRC.)


TL;DR;

Avoid mixing any MAOI inhibitor, be it patch, sub-lingual, or any of the ones people say may be "safer" than traditional MAOs. Avoid interaction with medications that inhibit enzymes that break down certain compounds. i.e., Bupropion (wellbutrin) may interact with DXM if I recall correctly. Grapefruit juice/extract also has an enzyme inhibitor I believe.

Titrate up VERY slowly and with 1-2 sober sitters. This is no joke. In fact, avoid mixing any enzyme inhibitors for the sake of potentiation, experimentation or any reason. If you're on these for medicinal reasons, thinks thrice before doing any other drug and ASK YOUR DOCTOR, even if you have to admit to illicit drug use. DOCTORS HELP YOU!

Failure to heed this advice: again: TITRATE SLOWLY SLOWLY WITH SOBER SITTERS NEARBY! Monitor blood pressure and heart rate before/during/after and keep an eye out for signs of a fever, confusion, nausea, etc.
 
3-meo-pcp aside, she mixed an SSRI (Lexapro) with an MAOI... not really a surprise that she developed serotonin syndrome 8(. Why did she think it was a good idea to take the selegiline with an obscure RC and an SSRI in the first place? The true take away from this is to look up any interactions before taking a cocktail of drugs... something that should be done instinctively. Glad she made it out with her life though, this could've possibly had a more sinister outcome.
 
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