SSRIs + 5-HTP

[Adam X]

You really need to stop this personal attach stuff. You have no knowledge of my background, and you don't seem willing to disclose your's.

Seriously though, other than calling your theories on 5-HTP uptake into the brain ludicrous, and then calling you (and immediately retracting) an idiot, where have I attacked you? It may seem I'm attacking you, but what I'm really attacking is your obvious lack of knowledge in this area.

I've worked for the Centers for Disease Control as a contract software engineer for about 8 years. (I've been developing software for scientific and medical applications in research for almost 20 years). One of the project series I've work on was a joint development project to produce several computer models of neurological processes used in antidepressant research.

Congratulations. What does this have to do with your theories?

I may not be a neurophysiologist, but I have worked with quite a few (both MDs and PhDs).

Again, what's your point?

I am also aware that SSRIs are not the 100% safe drug that many drug companies would like us to think that they are.

Are you aware they are acutely neurotoxic?

But public health agencies like the CDC do not succumb to such pressure.

Oh please, spare me the bullshit. If it's funded by tax dollars, it tows the line. What about SARS? CDC was all over that. SARS was about as big of a bullshit scare story as I've ever seen. What about the flu vaccine? The flu vaccine is a joke. Every year the CDC scientists get together and gaze into their crystal balls to try to guess which strain will hit. They pick the three most likely and develop a the vaccine. Then they all but demand that everyone be vaccinated and purport that by getting the shot you will not get the flu. Excuse me, how many flu strains are there? If that's not voodoo science, I don't know what is.

CDC's culture is different from NIH's (NIH tends to be somewhat driven by politics as well as by public health concerns). CDC is solely concerned with public health (which is why many within CDC when out on a limb during the early out break of HIV - in a political climate where doing so was not conducive to doing so). Also, CDC issued a statement contradicting NIH regarding the dangers of MDMA use, based on the lack of clinical data.

Good for CDC. The CDC obviously isn't the FDA, but if you think they're some benevolent entity which is not driven by politics you're blind.

So, my professional background is one of working within public health research. And I am looking at this whole problem from that point of view.

If I were a network engineer (for example) for an appeals court that wouldn't necessarily make me a legal expert. There's no need to show me your credentials, I'm sure not going to show you mine. Pulling out credentials are for people who don't really know what they're talking about but want to be counted among those who do.

Regarding your impressions of SSRIs and their use in conjunction with MDMA: first, no matter what we think, or what we would like people to do, it is already a common practise in the MDMA community.

Do you have statistics to back this statement up?

You can have all of the opinions that you would like, it is NOT going to change the fact that people are actively doing it.

Yes, SOME people are doing it. However, we don't know how many, how much and for how long.

Second, I would like to see some hard scientific evidence illustrating that taking an SSRI in a prophylactic neuroprotective measure with MDMA is hazardous.

I'd like to see evidence that it's beneficial, as you claim, to take an SSRI within 6 hours of taking MDMA.

If you are really a scientist, and not simply someone who reads a lot, you should have no problem producing references (this is how science is done).

Really? Is THAT how science is done? All this time I though it was about speculation without the basic knowledge of the systems we're speculating on. I'm not the one who postulated that the brain shuts out excess 5-HTP...

Third, and this doesn't mean a damn thing except to me, I have been post-loading with Prozac for about 8 years (ever since I became aware of some findings that were made at a primate research lab in La hoya, Ca). From personal experience, it appears to help a great deal. And, this is coming from someone with a 50 year old nervous system (i.e., more sensitive to chemical assaults).

Good for you. Do you have any evidence that you would have been worse off without the Prozac?

That is the kind of thing that I would expect to hear from an armchair "expert," not a true scientist. You really need to get this under control. For one thing, it is a dominance technique, and intimidates people who do not deserve to be treated that way (I've seen you do this on the DanceSafe forum).

Did you not read my immediate retraction? Please quote me a recent example of this on a DanceSafe forum.

Also, science is not something that you can jump up and down and say, "my world view is right so fuck you." Anyone who does that ends up not working in science. Even the assholes are forced to be open minded (except with their grad students who they abuse, but not the rest of the scientific community).

Tell me how my pointed questions are abusive? You're getting defensive here. My one insult, which I will mention for the third time was immediately retracted, came at the very end of my post. You failed to address any of the other points I made and instead chose to focus on the non-scientific aspects of my post and my perceived character attacks on you. If you can't handle a serious biochemical arguement then fine, but don't turn this into a persecution thing. I will officially apoligize for my comment. Can we get on with the science, or do you need to avoid this subject some more?

When I see you say, [EDIT]Personal attack removed - Flex[/EDIT] I conclude, "reads books, doesn't work in science, needs to use science to prove how smart he is."

...redirection...

I'm going to give you the benefit of a doubt. Maybe you are having a bad day? But, I've layed my cards on the table. I've worked around research science for most of my professional life. So what is your background?

Who cares what my background is. I could be a 14 year old pot smoker or a 39 year old PhD. What's your point? The fact is, I know what I'm talking about, everyone here knows I know what I'm talking about, and you, inasmuch as this topic is concerned, have shown a complete lack of understand of the concepts of neuroscience and psychopharmacology, CDC credentials notwithstanding.

Anyway, regardless of what you personally think of me, I am going to continue to try to obtain a clear idea of this practise is dangerous or not. And base it on clinical data, not opinions (this is how it is done in public health). If you would like to help, that would be great. If you don't want to help, that is fine, too. I'm concerned about the impact on folks who may be taking SSRIs and 5-HTP together, not prove to others that I am smart.

Perhaps you would like to explain to me how Prozac is effective for neuroprotection when peak plasma levels are not reached until 9 hours after oral administration in human subejcts?


X

 

[VelocideX]

eh cant be bothered quoting as appropriate, too much effort

You're right about peak plasma levels:
http://www.rxlist.com/cgi/generic/fluoxetine_cp.htm

Systemic Bioavailability: In humans, following a single oral 40 mg dose, peak plasma concentrations of fluoxetine from 15 to 55 ng/ml are observed after 6 to 8 hours.

and also at http://www.nlfd.gov.tw/jfda/content/101/03.pdf

The study to which everyone refers in favour of SSRI neuroprotection is Schmidt CJ "Neurotoxicity of the psychedelic amphetamine, methylenedioxymethamphetamine" J Pharmacol Exp Ther, 1987; 240(1):1-7.

And here's a graph:

(thankyou thedea.org! :D)

i concur that given the plasma levels take so long to peak that the full neuroprotective ability does not kick in til then, though i do believe that partial neuroprotection may occur.

Even if only from personal use, I've tried taking effexor xr (venlafaxine) whilst at the peak. effexor XR's plasma levels peak at around some 7 hours later from memory. a mere one hour after taking the tablet i felt myself being "ripped" down. there is no other way of describing it; i was sobering up MUCH faster than i normally would.

visual effects remained to some extent (probably due to 5-HT2 agonism?) but the high was gone much faster than it normally would be.

moreover I've tried pilling 36-40 hours after admnistration of effexor XR. Most sites list that 87% of effexor XR is recovered in the urine within 48 hours. THe active metabolite has a halflife of ~11 hours.

Consumption of a pill I have previously confirmed to be good produced little to no effect; even two pills only produced a marginal high.

Implication: The blood plasma levels of SSRIs needed to attenuate the effect of MDMA (and thus reduce neurotoxicity) may occur significantly lower than the levels required for antidepressant effect.

This makes some sense in some ways; blocking the SERT is not enough for antidepressant effect... Enough transporters must be blocked to achieve a global increase in serotonin levels that is significant enough to induce receptor downregulation.

case literature on serotonin syndrome is hard to find unless fatalaties are induced.

5-htp induced serotonin syndrome is likely to be short-lived at best, due to 5-htp's plasma half-life of 2-3 hours (NB: the 5+ hours you read in many studies is due to peripheral decarboxylase inhibitors such as carbidopa. administration without this results in much faster conversion).

the serotonin syndrome appears as a problem when it cannot be resolve. Short term instances (which include marginal MDMA overdoses) resolve quickly.... either due to the quick elimination of the causative agent or serotonin depletion (MDMA's case). Only when the serotonin syndrome persists does it usually approach untreatability.

This is why the MAOIs caused so many problems, with clearance rates of ~days. Similarly many cases of serotonin syndrome are reported with prozac, with its extemely long half-life.

I think you'll find this to be a contributing factor to the lack of reported material; 5-HTP induced serotonin syndrome (which would probably only be mild at best due to the dual removal of 5-HT by both reuptake and MAO-breakdown, and consist of vomiting and general feeling like shit) would resolve itself fairly quickly and therefore be unlikely to bring on the larger problems like muscle breakdown, seizures, etc.

 

[VelocideX]

id also suggest that people who order 5-htp don't represent a normal sample group.

the sample size of people who take SSRIs is large, and most are taking it on the advice of their doctor. They don't do much investigation into pharmacology at all. This is why concomitant use of SSRIs is occasionally seen, landing people in the emergency room.

People who take 5-HTP are probably MDMA users or people well-researched enough to feel its an alternative to SSRIs for mild to moderate depression. Thus they're probably more LIKELY to be aware of the dangers of serotonin syndrome.

Most cases of SS aren't induced intentionally; they're by people ingesting stuff with no idea of the possible consequences.

People who take 5-HTP are (likely) a more educated sample group and thus less likely to be afflicted.

 

[Brian Oblivion]

Seriously though, other than calling your theories on 5-HTP uptake into the brain ludicrous, and then calling you (and immediately retracting) an idiot, where have I attacked you? It may seem I'm attacking you, but what I'm really attacking is your obvious lack of knowledge in this area.

I'm not even talking about that, it is the "I know what I am talking about and you don't" which is the problem. You tend to treat science as though it were a religious dogma.

Congratulations. What does this have to do with your theories?

You don't need to congratulate me. I got paid to do it.

I work in the sciences (your example of the network engineer working for an appeals court, is far off of the mark of my involvement in the process). That alone does not qualify me as a research scientist. But I am very comfortable in the capacity of establishing what is true and what is not true, and I constantly do just that in conjunction with developing software for research.

I am also aware that SSRIs are not the 100% safe drug that many drug companies would like us to think that they are.

Are you aware they are acutely neurotoxic?

I am aware that you believe that they are neurotoxic (and not from this discussion). Let's flesh this one out. You are asserting that SSRIs are acutely neurotoxic. The body of evidence that I am aware of says otherwise. If you are correct, then you will have scientific evidence to prove it. So how about presenting authoritative references to prove your assertion? If you are correct then you should have no problem proving your assertion.

Oh please, spare me the bullshit. If it's funded by tax dollars, it tows the line. What about SARS? CDC was all over that. SARS was about as big of a bullshit scare story as I've ever seen. What about the flu vaccine? The flu vaccine is a joke.

[EDIT]Senseless and unnecessary comment removed - Brian [/EDIT]

Let me put it this way, I have worked in that environment which means that I have gotten to see how people inside the CDC treat health problems. I've watched their concerns, and I've watched their reactions both officially and unofficially. The thing that I like about CDC is that the vast majority of folks who work there actually give a shit as to what they are doing.

Regarding SARS, the CDC's response was very muted compared to the WHO's. And given the infection rate and the characteristics of the contagion, I thought their response was rather level headed.

The flu vaccine is a joke. Every year the CDC scientists get together and gaze into their crystal balls to try to guess which strain will hit. They pick the three most likely and develop a the vaccine. Then they all but demand that everyone be vaccinated and purport that by getting the shot you will not get the flu. Excuse me, how many flu strains are there? If that's not voodoo science, I don't know what is.

Do you honestly think that is how the whole process works? That they toss a bunch of coins, look in a copy of the I Chang, and decide what vaccine should be in vogue this year?

Good for CDC. The CDC obviously isn't the FDA, but if you think they're some benevolent entity which is not driven by politics you're blind.

No, but they are driven by budgeting. And the current administration has decimated the CDC's budget in favor of Homeland Security (as though the only public health issues that matters are anti-terrorist related). Don't get me started...

Regarding your impressions of SSRIs and their use in conjunction with MDMA: first, no matter what we think, or what we would like people to do, it is already a common practise in the MDMA community.

Do you have statistics to back this statement up?

At this point I am basing it on what I have seen people claim that they do. On the other hand, we will be able to obtain statistics from one sampling once this survey is completed:
http://users.wmin.ac.uk/~buchant/wwwmdma/blwwwmdma2welcome.html

Second, I would like to see some hard scientific evidence illustrating that taking an SSRI in a prophylactic neuroprotective measure with MDMA is hazardous.

I'd like to see evidence that it's beneficial, as you claim, to take an SSRI within 6 hours of taking MDMA.

I know that you've seen some of the work done on this. OK, here is an example:

Neurotoxicity of the psychedelic amphetamine, methylenedioxymethamphetamine. - Schmidt CJ, 1987, Journal of Pharmacology and Experimental Therapeutics.

The entire report can be obtained in PDF format from MAPS, without the need to subscribe to the American Society for Pharmacology and Experimental Therapeutics.
http://www.maps.org/w3pb/new/1987/1987_schmidt_931_1.pdf

If you are really a scientist, and not simply someone who reads a lot, you should have no problem producing references (this is how science is done).

Really? Is THAT how science is done? All this time I though it was about speculation without the basic knowledge of the systems we're speculating on. I'm not the one who postulated that the brain shuts out excess 5-HTP...

Is that your best shot? :D

The difference is that I'm putting forth an idea, and attempting to determine if it is correct. Part of the reason I arrived at the postulate was the result of not finding any cases where SSRIs used in combination with 5-HTP produced a medical emergency. But I flatly stated that I was not suggesting that it was truth, and it was simply a hypothesis.

You on the other hand are making claims of truth without providing any evidence. I suppose that everyone is simply suppose to take your word for it because you think you know what you are talking about? :lol:

Did you not read my immediate retraction? Please quote me a recent example of this on a DanceSafe forum.

If you really would like me to I will. But I am not talking about your insults, I am talking about behaving as though you are an expert. And making statements "ex cathedra" from the voice of being irrefutable. It intimidates (whether you are aware of it or not), and is dangerous habit because you end up becoming obsessed with your own ideas

I am not questioning whether you are a smart person or not (it is obvious that you are a smart person). I am saying that you have the ability to be wrong, just as anyone else has the ability to be wrong.

 

[Flexistentialist]

This one of the best threads I'v seen in Health Q & A for some time. Let's not have it ruined with off topic personal attacks.

Any more personal attacks will result in a CLAWS warning. Also, can we please stay on topic. Calling someone's experience into question is irrelevant. The arguments stand alone.

SSRIs + 5-HTP -> Continue

 

[Brian Oblivion]

id also suggest that people who order 5-htp don't represent a normal sample group.

the sample size of people who take SSRIs is large, and most are taking it on the advice of their doctor. They don't do much investigation into pharmacology at all. This is why concomitant use of SSRIs is occasionally seen, landing people in the emergency room.

People who take 5-HTP are probably MDMA users or people well-researched enough to feel its an alternative to SSRIs for mild to moderate depression. Thus they're probably more LIKELY to be aware of the dangers of serotonin syndrome.

Most cases of SS aren't induced intentionally; they're by people ingesting stuff with no idea of the possible consequences.

People who take 5-HTP are (likely) a more educated sample group and thus less likely to be afflicted.

On the other hand, there are many alternative health sources which publish claims that 5-HTP is an effective antidepressant. And my suspension is that some people who are on an SSRIs, and read the pop alternative health literature, will try including 5-HTP in conjunction with their antidepressant therapy. In the US 5-HTP is readily available in health food stores. And the people behind the counter will often recommend it for use in treating depression.

All of this together leads me to conclude that there are SSRI patients who are mixing the two (under the guise of "it's only a dietary supplement").

 

[Brian Oblivion]

the serotonin syndrome appears as a problem when it cannot be resolve. Short term instances (which include marginal MDMA overdoses) resolve quickly.... either due to the quick elimination of the causative agent or serotonin depletion (MDMA's case). Only when the serotonin syndrome persists does it usually approach untreatability.

VelocideX, you may very well be on to something with this notion. That is an excellent point.

 

[VelocideX]

face it, whats the main problem with serotonin syndrome? sure nausea is a bitch, but thats not it.
the real problems are
1) hyperthermia
2) rhabdomyolysis
3) organ failure (closely related) including heptaic and renal falilure
4) hypertension

it may very well be impossible to induce serotonin syndrome in its serious version due to the low half life of 5-htp. eat like 2g, feel like shit for a few hours, and yet every 2-3 hrs teh 5-htp in your system halves.... MAO + reuptake should be more than capable of cleaning up the mess within a few hours.

add a long-term serotonergic agent and you may well have a problem. ALL the ssris have a half life greater than12 hrs (venlafaxine's active metabolite is 11 hours, its own is 5 hours, so yeah id say over 12 hours is included). 12 hours is easily long enough to overwhelm the body's temperature control mechanisms, through dehydration or otherwise, and cause serious problems.

THIS is my reason for not recommending 5-htp + ssris in conjunction.... you remove one of the two mechanisms your body has for dealing with excess serotonin. in small doses it would be fine; MAO breakdown and dispersion (loss of 5-HT out of the synaptic cleft) would have no problem dealing with a mild excess. Indeed as 5-HT density goes up so too does dispersion play a more important role. The level of 5-HT outside the synaptic cleft MUST be lower than inside by a significant amount (i wont speculate even as to orders of magnitude, but all medical books list it as a relevant factor in intrasynaptic 5-HT loss and thus it must be at absolute minimum several percent). As the gradient of levels in the synapse and outside increases so too will 5-HT outflow become more important. But this mechanism can only work up to a point...

 

[Brian Oblivion]

I have kids with me all weekend so I won't have much computer time for the next several days.

I've been looking around and it seems that a common recommended dose of 5-HTP by the alternative health community for use as an antidepressant is 100 mgs. 3 times per day (total 300 mgs. daily). So I would expect that anyone using an SSRI for treatment of depression, and would be including 5-HTP, would normally be on a similar regime.

Based on what you've indicated regarding the 5-HTP half life, this would mean that 1/3 to 1/2 way through the 8 hour period, the level of available 5-HTP would be reduced by 1/2. Also, only a percentage of the 5-HTP will actually have made it to the serotonin cells (with the remainder being free in the blood stream, or being converted elsewhere within the body).

I remember reading somewhere on Erowid that serotonin syndrome has not recorded in cases of up to 5 grams. I'm not sure if that is accurate (nor am I sure it was from an authoritative source). I'll find the source, and also try to track down other sources to attempt to confirm if this is in fact the case.

It may be possible that at the 5-HTP dosage regime used to postload after MDMA use, and the dosage suggested by the alternative health community, are both simply too low to induce serotonin syndrome.

One additional factor, in the case of 5-HTPs use as an after MDMA treatment, is that the user is somewhat serotonin depleted. This may further reduce the threshold for serotonin syndrome.

If this is the case, then that would explain why there are an absence of serotonin syndrome cases in antidepressant patients and in MDMA users who also postload with an SSRI.

 

[Brian Oblivion]

Adam,

If you have anything which suggests that using an SSRI 5~6 hours after MDMA is dangerous could you please point to some references?

I'm hoping to establish some kind of recommendation regarding the practise. We have one of three possibilities:

1. Neutral: Using an SSRI 5~6 hours into an MDMA experience has no benefit, but does not produce an adverse effect.
2. Beneficial: Using an SSRI 5~6 hours after MDMA offers some kind of neuroprotective benefit.
3. Hazardous: Using an SSRI 5~6 hours after MDMA produces an adverse effect.
   [/list=1]
   Based on what I have seen thus far, the practise is either beneficial or neutral (i.e., 1 or 2). This would mean in either case that there is no need to advise against SSRI use. And if it is beneficial, recommending against its use would result in placing the user at heightened risk.
   
   I understand that there are some studies indicating that thermal regulation seems to be a factor. But this does not negate the existing studies indicating that SSRI use offers neuroprotective factor.
   
   So, if you have anything that can show that option *3* is a factor then I would very much appreciate any scientifically authoritative references that you may have.
   
   Thanks

 

[superbabydoc]

Adam X said:

I just get really irked when people who HAVE NO IDEA WHAT THEY'RE TALKING ABOUT start speculating about "facts" and start filling in the blanks with absolutely no knowledge of which they speak.

Brainstorming is one of the best ways to work through a problem. Why get irked? Brian Oblivion said he was just throwing out some ideas. Life would be boring if we couldn't throw out ideas for others to discuss and dissect. Let's all relax and keep this thread educational and informative!

 

[monkyfunky]

This is the problem with amatuer pharmacologists. I have never recommended ANYONE take any SSRI, EVER! In fact, I have reason to believe that the usage of SSRIs after MDMA might be extremely damaging to the brain.

What makes you believe this?

What are your opinions of taking mdma whilst actually on an ssri?

Also what do you think of taking mdma when just off a course of ssri? Because whilst the ssri is no longer present in the brain, lots of receptors are downregulated.

 

[Fujicrow]

Second, and this is my hunch, NOT a scientifically proven fact, I don't believe that the brain will absorb more 5-HTP than it requires. My suspicion is that once brain levels of 5-HT reaches a maximum saturation, any additional 5-HTP will remain in suspension in the blood (or will be utilized elsewhere in the body). In other words, taking more 5-HTP will not increase 5-HT concentrations within the brain past a natural saturation ceiling. Again, I could very well be wrong about this, so I DO NOT recommend that anyone stake their health on this opinion. In the absence of solid laboratory data, this is nothing more than a hypothesis.

you obviously haven't taken high doses (like 300mg a day) of 5-htp for long periods of time, then...I remember laying there on my bed just feeling extremely glad to be alive...

 

[Brian Oblivion]

Fujicrow,

For one, who said that this supposed saturation rate was below a 300 mg. level? I didn't

The other is that I was simply presenting that argument as a hypothesis for discussion. Nothing more. If it were true, which is appearently is not, it helped to explain several things which are NOT occurring in the general population.

 

[Brian Oblivion]

Originally posted by Adam X
This is the problem with amatuer pharmacologists. I have never recommended ANYONE take any SSRI, EVER! In fact, I have reason to believe that the usage of SSRIs after MDMA might be extremely damaging to the brain.

What makes you believe this?

What are your opinions of taking mdma whilst actually on an ssri?

Also what do you think of taking mdma when just off a course of ssri? Because whilst the ssri is no longer present in the brain, lots of receptors are downregulated.

This is the exact problem with making statements like that in absence of any supporting evidence. It scares the blood hell out of people.

As far as Adam's comment about being amatuer pharmacologists: we are all talking about a substance (MDMA) which is a drug that is even MDs are restricted from using. Yet we are all making recommendations regarding its consumption. Bringing up the argument against playing pharmacologist is pretty silly in light of the whole issue.


Adam,
you might be all ticked off at me, but you have a real responsibility to anyone else reading this to either disclose any scientifically authoritative evidence supporting your viewpoint, or qualify your statement as pure speculation.


monkyfunky,
I have been going over the available scientific literature for years, and I have not seen one suggestion that there is anything dangerous in this regard. In lieu of no real supporting evidence of Adam's viewpoint, I would suggest to not worry about it. I think it is nothing more than an unqualified opinion.

 

[Brian Oblivion]

Nothing has been submitted indicating that there is any health risk taking an SSRI after MDMA (and I have turned up nothing to support it in the scientific literature). So I'm going to assume that it is purely speculation.

In the next few days I'll start putting together a document addressing the practise of using 5-HTP and SSRIs as a post protective measure after taking MDMA. Anyone who would like to help contribute to the document is invited to join in. I think it would be best to do this in a separate thread. And once it is completed, and put through review, submit it for final review to be added to the drug FAQ collection.

Anyone who thinks otherwise can post their objections to this thread before we begin.

 

[pinwheel]

Not to "play psychopharmacologist," but I highly doubt SSRIs are the key to protecting against "neurotoxicity." Obviously, a depletion of serotonin can't be good for mood, but I highly doubt keeping serotonin levels up "protect" against "brain damage."
Why?
Well, I am brainstorming here, but I can't imagine a lack of serotonin would contribute to any brain damage...just lack of mood.
Now, my last conclusion: I am very uneducated on the topic of MDMA (partially because I try and detract from mainstream media stories) but I just read an article on www.maps.org written by Rick Doblin, and I have to theorize...wouldn't the only way brain damage related to the serotonin system be because of TOO MUCH serotonin, which would be exasterbated by taking an SSRI after MDMA use?
I have a feeling the only thing lower serotonin levels (which HAS been found in MDMA users, albeit that fact is negated by the wide range of serotonin spinal fluid levels in humans) would show is mood differences.
BrianOblivion, I really enjoy reading your posts and I hope to see this FAQ pursued. But I would tell you that we have to look at the very mechanism which causes the brain damage (probably overheating in the brain, which is what most "brain damage" comes from) and see what neuroprotective agents we can apply to reverse the damage.
The only recommendation I can make to try and bridge this gap is the reading I have done on scopolamine poisoning (naturally, for any "poison" to "work," the brain has to be involved) and the neuroprotective qualities of piracetam.
This is the only reading I have done on "neuroprotection," so good luck!

 

[Brian Oblivion]

Hi pinwheel,

The idea of using an SSRI after using MDMA isn't to avoid serotonin loss, it is [in theory] to protect the reuptake receptors from further chemical access.

There is some supporting evidence for this, see:

Neurotoxicity of the psychedelic amphetamine, methylenedioxymethamphetamine. - Schmidt CJ, 1987, Journal of Pharmacology and Experimental Therapeutics.

The entire report can be obtained in PDF format from MAPS, without the need to subscribe to the American Society for Pharmacology and Experimental Therapeutics.
http://www.maps.org/w3pb/new/1987/1987_schmidt_931_1.pdf

Originally, it was suspected that excess dopamine was causing the damage. This theory has since fallen out of favor for an oxidizing agent (possibly an MDMA metabolite) causing damage.

This is basically the reason why people take SSRIs after MDMA.


Although, it isn't my intention to defend or oppose its use in this proposed paper. I simply wish to come up with a safety recommendation regarding the use of 5-HTP with SSRIs taken several hours after MDMA.