The Big & Dandy Dangerous Combinations Thread

[Survived Abortion]

I suggest this goes no where near a sticky until it's finished...

But as I've already pointed out, it's never finished. I don't see why it "shouldn't go near a sticky" in it's current state - the quicker the information available is up for all to see, the quicker people can benefit from what is there. It can be continuously updated whilst it is up, but procrastinating for the perfect opportunity when it becomes "complete" will make it get forgotten, because it will never be complete.

Send it over to ADD. They can work it all out, and come up with reasons and explanations for each one. Then, when it's complete it can be copied and have a full list of dangerous drug combos from all the categories in each forum, stickied appropriately.

Involving the guys at ADD is a good idea, but it doesn't necessarily need to be moved over there for them exclusively, rather it could be copied and pasted there. Or if you'd like to start a thread in ADD for all other drug combos, go for it. I'm just putting my contribution here regarding the drugs I know best (psychedelics), but if you have anything to add which relates to drugs outside of the scope of PD, feel free to make another thread in the appropriate forum.

I mean, don't be selfish... this isn't just relevant to PD, it could be a forum-wide project

I don't think I'm being selfish at all. I frequent this forum (PD), so it makes sense that the original post with all the information in is written and edited by someone who is regularly checking the forum for updates, and who knows about the drugs in question. I have very little time to spare these days because I am busy with real-life pursuits, so my Bluelight time is much less than it used to be. Again, if you know more about drug combinations involving "other drugs" or cannabis (and of course "ecstasy"), and you frequent those forums, go ahead and make the thread.

 

[Dunno]

Why is atenolol not to be taken with the stims mentioned?

 

[shishigami]

Why is 2C-X + MAOI not safe?

Can we try to cite some reports/medical literature on each of these? Or just give a reason (depressant + depressant kinda deal).

 

[dmtlunatic]

This thread should be stickied!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[Folley]

But as I've already pointed out, it's never finished. I don't see why it "shouldn't go near a sticky" in it's current state - the quicker the information available is up for all to see, the quicker people can benefit from what is there. It can be continuously updated whilst it is up, but procrastinating for the perfect opportunity when it becomes "complete" will make it get forgotten, because it will never be complete.



Involving the guys at ADD is a good idea, but it doesn't necessarily need to be moved over there for them exclusively, rather it could be copied and pasted there. Or if you'd like to start a thread in ADD for all other drug combos, go for it. I'm just putting my contribution here regarding the drugs I know best (psychedelics), but if you have anything to add which relates to drugs outside of the scope of PD, feel free to make another thread in the appropriate forum.



I don't think I'm being selfish at all. I frequent this forum (PD), so it makes sense that the original post with all the information in is written and edited by someone who is regularly checking the forum for updates, and who knows about the drugs in question. I have very little time to spare these days because I am busy with real-life pursuits, so my Bluelight time is much less than it used to be. Again, if you know more about drug combinations involving "other drugs" or cannabis (and of course "ecstasy"), and you frequent those forums, go ahead and make the thread.

Well I don't think this is anywhere near complete so far... and a hastily made thread detailing dangerous drug combos could be more dangerous than none at all!!

I frequent this forum

I understand that.. I frequent Ecstasy Discussion, that's my expertise. But a thread like this could benefit a lot more than just those two sub-forums... hell, I'd like to see a forum wide sticky that would have every known bad drug combo in a concise, easy to read format. Obviously that would take some serious work though

 

[25I_am_so_wonderfu]

Never smoke meth while high on MXE, bath salts and 2C-I also called "smiles". It can get sort of uncomfortable

 

[pofacedhoe]

^So you didn't feel as if the two were a dangerous combo?

I don't see how it can be a dangerous combo pharmacologically. It's just that the 5-HTP gives the MDMA or similar compound a lot more serotonin to work with, which is probably why some people are reporting overwhelming experiences. Perhaps it should be taken out of the 'definite' list and put in to an 'unsure but unwise' list.

EDIT: Done.

not for me anyway but some people are different, for example 50mg of 5htp made my mum feel like she was going to vomit (she said it felt awful) whereas 100mg for me doesn't cause any nausea. also i have combined mdma and tramadol with no problems though i am aware thats a dangerous combo. my point is that some people are going to be more susceptible to SS than others.

 

[Survived Abortion]

Why is atenolol not to be taken with the stims mentioned?

It was included in the "unsure but unwise" box at the bottom of the list; zn13bt mentioned it but considering I hadn't had chance to fully research it I wasn't confident putting it in the list of certain interactions. You will find on the NHS drugs website that it lists sympathomimetics as being a possible contraindication with atenolol. Seeing as it's listed as possible, rather than certain, I think it can stay in the "uncertain" box.

The subcategory is also for all beta-blockers including propranolol, which again includes sympathomimetics as being a potential contraindication, as well as ergoloid compounds derived from ergotamine. This would include LSD/LSA, and I will update the post accordingly now.

Having said that, I spent 10 years on propranolol up until 2011 and I didn't have any problems in these combos (that I was aware of), but it probably wasn't the best idea either. My body feels infinitely healthier now I have come off of it.

Why is 2C-X + MAOI not safe?

Can we try to cite some reports/medical literature on each of these? Or just give a reason (depressant + depressant kinda deal).

You're right, there is no medical literature to cite regarding the 2C-x vs MAOI combo. I was going on a presupposition based on theory, anecdotal reports and one personal experience with 5mg 2C-C in combo with Rhodiola. The theory was based in the fact that the 2C class of psychedelics can exert significant dopaminergic action, both as dopamine agonists and by increasing levels of dopamine.

Behavioral, neurochemical and pharmaco-EEG profiles of the psychedelic drug 4-bromo-2,5-dimethoxyphenethylamine (2C-B) in rats.
Páleníček T, Fujáková M, Brunovský M, Horáček J, Gorman I, Balíková M, Rambousek L, Syslová K, Kačer P, Zach P, Bubeníková-Valešová V, Tylš F, Kubešová A, Puskarčíková J, Höschl C.
Source

Prague Psychiatric Center, Ústavní 91, 181 03, Bohnice, Prague 8, Czech Republic, [email protected].
Abstract

RATIONALE AND OBJECTIVES:

Behavioral, neurochemical and pharmaco-EEG profiles of a new synthetic drug 4-bromo-2,5-dimethoxyphenethylamine (2C-B) in rats were examined.

MATERIALS AND METHODS:

Locomotor effects, prepulse inhibition (PPI) of acoustic startle reaction (ASR), dopamine and its metabolite levels in nucleus accumbens (NAc), EEG power spectra and coherence in freely moving rats were analysed. Amphetamine was used as a reference compound.

RESULTS:

2C-B had a biphasic effect on locomotion with initial inhibitory followed by excitatory effect; amphetamine induced only hyperlocomotion. Both drugs induced deficits in the PPI; however they had opposite effects on ASR. 2C-B increased dopamine but decreased 3,4-dihydroxyphenylacetic acid (DOPAC) in the NAc. Low doses of 2C-B induced a decrease in EEG power spectra and coherence. On the contrary, high dose of 2C-B 50 mg/kg had a temporally biphasic effect with an initial decrease followed by an increase in EEG power; decrease as well as increase in EEG coherence was observed. Amphetamine mainly induced an increase in EEG power and coherence in theta and alpha bands. Increases in the theta and alpha power and coherence in 2C-B and amphetamine were temporally linked to an increase in locomotor activity and DA levels in NAc.

CONCLUSIONS:

2C-B is a centrally active compound similar to other hallucinogens, entactogens and stimulants. Increased dopamine and decreased DOPAC in the NAc may reflect its psychotomimetic and addictive potential and monoaminoxidase inhibition. Alterations in brain functional connectivity reflected the behavioral and neurochemical changes produced by the drug; a correlation between EEG changes and locomotor behavior was observed.

http://www.ncbi.nlm.nih.gov/pubmed/22842791

Combining dopaminergic drugs with MAOIs is not a very good idea at all, and with careless dosing can easily lead to hypertensive crisis and psychosis, and this is why I included it. Of course, I'm not suggesting it's going to be dangerous with 2C-x, but it seems better to be safe then sorry.

Nevertheless, since it is unproven it may be better of in the box at the bottom. If this is the consensus I will move it there instead. As to citing medical literature for each one - give me a bit of time and I will do my best without making the list unreadable. (It may take a while because I don't have time to sit here all day. Feel free to chime in and help to expedite this!) For those without citations I will either move them to a different category or give a proper explanation. If y'all wanna tear it to shreds afterwards that's up to you, but I'll try and make it as accurate as possible.

also i have combined mdma and tramadol with no problems though i am aware thats a dangerous combo. my point is that some people are going to be more susceptible to SS than others.

Yes, well it's been mentioned a couple of times over the years but I haven't seen enough to include it in the list. The main issue with tramadol is the lowering of the seizure threshold. There is more info on it here http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

 

[shishigami]

You're right, there is no medical literature to cite regarding the 2C-x vs MAOI combo. I was going on a presupposition based on theory, anecdotal reports and one personal experience with 5mg 2C-C in combo with Rhodiola. The theory was based in the fact that the 2C class of psychedelics can exert significant dopaminergic action, both as dopamine agonists and by increasing levels of dopamine.

I just don't think the dopaminergic action of them is great enough in typical doses to warrant that label. I've combined 2C-C with an MAOI safely. Obviously 2C-T-x shouldn't be but that's a whole nother boat.

 

[Survived Abortion]

Updated for beta-blockers vs Atropine etc. (belladonna alkaloids)

I just don't think the dopaminergic action of them is great enough in typical doses to warrant that label. I've combined 2C-C with an MAOI safely. Obviously 2C-T-x shouldn't be but that's a whole nother boat.

Out of curiosity, what dose of 2C-C did you use and which MAOI? I believe you, I would just like to see what others are experiencing with combos like this. Remember, it depends whether the MAOI is inhibiting MAO-a or MAO-b. The latter is applicable to dopaminergics.

 

[DawgTheHallMonitor]

Does anyone have anything bad to say about 4-aco-dmt and ambien together? Or will i be fine?

 

[thoughtsUnThought]

The most subjectively toxic feeling combo I've done was a strong dose of morning glories with maybe two hundred mg of dxm. Puking and not with it for 24 hr at least...slept and puked after the trip. Actually kind of faded out and maybe passed out right when the dxm came on, then came to hours later and started puking at the tail end of the exp.

Not meaning to bounce around random suggestions, I like this thread idea and want it to stay concise and as objective as possible. But years ago I asked around on here and I thought it was confirmed to me that that combo was asking for serotonin syndrome or something. Worth double checking I figured.

 

[shishigami]

Out of curiosity, what dose of 2C-C did you use and which MAOI? I believe you, I would just like to see what others are experiencing with combos like this. Remember, it depends whether the MAOI is inhibiting MAO-a or MAO-b. The latter is applicable to dopaminergics.

It was about 55 mg 2C-C with a smoked extract of B. Caapi.

 

[Survived Abortion]

Does anyone have anything bad to say about 4-aco-dmt and ambien together? Or will i be fine?

You'll be fine with this combo. Ambien (zolpidem) is very much like a benzo with some small differences in pharmacodynamics (the GABA receptors it targets are different). Although zolpidem can make you hallucinate by itself, it is medically as safe as benzos when it comes to combining with psychedelic drugs. The worst you'll find is that it will blunt the trip.

The most subjectively toxic feeling combo I've done was a strong dose of morning glories with maybe two hundred mg of dxm. Puking and not with it for 24 hr at least...slept and puked after the trip. Actually kind of faded out and maybe passed out right when the dxm came on, then came to hours later and started puking at the tail end of the exp.

Not meaning to bounce around random suggestions, I like this thread idea and want it to stay concise and as objective as possible. But years ago I asked around on here and I thought it was confirmed to me that that combo was asking for serotonin syndrome or something. Worth double checking I figured.

DXM is a strange one in that the subjective reactions reported from combos with other drugs doesn't really seem - on face value - to match up with its apparent pharmacological profile. It inhibits serotonin and norepinephrine re-uptake, but that doesn't itself explain its interactions with MDMA and similar drugs. I believe most of the reports of intense reactions to other drugs whilst on DXM largely originate in the fact that DXM hogs the cyp2d6 enzyme for its metabolism, of which other drugs including MDMA are also substrates. But even this doesn't fully explain it, since many other drugs are also both inhibitors and substrates for this enzyme (such as SSRI drugs and amphetamines) which have been combined successfully with MDMA.

Although there doesn't seem to be any literature specifying LSD as a substrate for cyp2d6, it's not impossible; 5-MeO-DMT is partially metabolized by this enzyme. LSA-containing seeds are powerful enough on their own, causing significant nausea in many during the come-up phase, and a peculiar lightheadedness. I can certainly imagine that the two drugs could be very synergistic if nothing else. The main thing is that DXM has such a broad and complex pharmacological profile, and so it is probably quite difficult to pin down the exact reason for some of its interactions. And of course the dose required to get high is very large, meaning there is more compound to interact with CYP enzymes than with other drugs.

Thanks for the heads up anyway.

It was about 55 mg 2C-C with a smoked extract of B. Caapi.

I see. Well the thing is that Caapi (harmala alkaloids) only inhibit MAO-a (I think), but it is MAO-b which de-aminates phenethylamine. The "reaction" I had was pretty mild at best and could easily have been all in my head or due to the fact that I took a dose of 5-HTP with it at the time, but there are others who have reported interactions between MAO-b inhibitors and phenethylamines. I don't know where the thread is, but I remember reading of someone who combined a low doses (something around ~7-8mg) of 2C-T-2 with a dose of selegiline and he said he was tripping his face off with lasers coming out of the walls etc. He said it was almost too intense or something along those lines.

In theory it makes sense. Can we please get some more input on this? I don't want to leave it off the list if it is indeed a dangerous interaction, but I also don't want to put false information in there either.

Anyway, your combo must have been a powerful trip regardless . 55mg 2C-C is a moderately strong dose of 2C-C for me on its own.

 

[shishigami]

I see. Well the thing is that Caapi (harmala alkaloids) only inhibit MAO-a (I think), but it is MAO-b which de-aminates phenethylamine. The "reaction" I had was pretty mild at best and could easily have been all in my head or due to the fact that I took a dose of 5-HTP with it at the time, but there are others who have reported interactions between MAO-b inhibitors and phenethylamines. I don't know where the thread is, but I remember reading of someone who combined a low doses (something around ~7-8mg) of 2C-T-2 with a dose of selegiline and he said he was tripping his face off with lasers coming out of the walls etc. He said it was almost too intense or something along those lines.

In theory it makes sense. Can we please get some more input on this? I don't want to leave it off the list if it is indeed a dangerous interaction, but I also don't want to put false information in there either.

Anyway, your combo must have been a powerful trip regardless . 55mg 2C-C is a moderately strong dose of 2C-C for me on its own.

For me 55 mg is my minimum dose, where stuff just starts to get interesting but isn't all that cool. The B. Caapi gave some boost but smoked extracts usually aren't that intense.

I think the 2C-T-x series should not be considered the same as the 2C-x series as far as reactions go, they do have some supposed MAOI activity on there own and people's responses at particular doses are very varied.

 

[Limpet_Chicken]

I should include-MAOIs and the opioids pethidine (as its known in the UK, meperidine in the US) has in the past proved lethal, as pethidine also has a serotonergic action (as well as being a DARI), the same would go for tramadol.


The problem with adrenergic stimulants and beta blockers, is that with beta adrenoreceptors blocked, the released (nor)adrenaline has nowhere to go but alpha receptors, resulting in severe vasoconstriction. To combat vasoconstriction from stimulants, clonidine, or tizanidine, which agonize the alpha2 adrenoreceptor, are the safer option. Alpha2ARs are what are called 'autoreceptors', autoreceptors when activated, provide a negative feedback mechanism, stepping on the brakes and halting/reducing the (nor)adrenaline release.

Also, triptan migraine medications can cause serotonin syndrome in combination with an SSRI. I have personally known this to happen, suddenly, in a person who was taking fluvoxamine and sumatriptan, this had been done many times before without interaction, until it hit the person concerned with a nasty case of serotonin syndrome, and hit her pretty hard at that. She turned out ok though, but had to ride it out, muscle rigidity caused by the serotonin syndrome completely immobilized her.

Presumably, extrapolating from that unfortunate incident, MAOIs inhibiting MAO-a are also likely to present a potential danger for serotonin syndrome in combination with triptans.

 

[Survived Abortion]

^Thanks for that info man, some good nuggets of wisdom there. With that in mind about the beta-blockers, should they be included in the "definitely" list?

I've got the opioids you mentioned covered for the MAOIs aMT, ayahuasca, and 2C-T-7. I'll update the list to include the triptans. Thank you!

EDIT: Also updated the list for alphabetical ordering.

 

[Survived Abortion]

Why has this not been stickied yet?

 

[Sweetshare]

MXE+MDMA = really danger combo? I took a bit of MDMA after MXE yet alive

 

[Survived Abortion]

You're right - it's uncertain and it might actually be safe, but in my opinion enough people seem to have reported it to have been a highly unpleasant combination to warrant putting it in the unsure box, unless there is a clear objection to it. Those combinations which have been highlighted as of concern but unsure need to be investigated further.

Did you have any negative effects at all, or was it just a normal empathogen + dissociative combo?