The Big & Dandy Dangerous Combinations Thread

[Survived Abortion]

^There are no contraindications that I'm aware of between LSD and clonidine. Their pharmacological profiles suggest that they should be safe in combo.

 

[azzo]

Great job, i didn't know about some bad interactions listed here, very useful!
And btw about MDMA+SSRI i agree with you, its not a dangerous combo, i'm taking SSRI's from 3 years and took MDMA with Citalopram, Paroxetine and Fluoxetine without any adverse effect exept poor effects of MDMA.

 

[azzo]

Btw i took once 21mg of 2C-T-4 when i was taking Paroxetine without any bad effects, but i was taking only 1 pill of paroxetine die, 20mg, maybe i was lucky because i know it's not a safe combo.
Same with AMT and Citalopram, i took 30mg orally and 20mg smoked of amt without any problem, anyway i didn't feel much from those doses of AMT.

 

[azzo]

Could you please explain why DXM is dangerous with SSRIs? I've taken many times DXM, ketamine and MXE with different SSRIs without any adverse effect.

 

[Dr. Rabid]

^There are no contraindications that I'm aware of between LSD and clonidine. Their pharmacological profiles suggest that they should be safe in combo.

Thanks a bunch Survived Abortion! Wow, what an achievement btw.

 

[Jesusgreen]

Could you please explain why DXM is dangerous with SSRIs? I've taken many times DXM, ketamine and MXE with different SSRIs without any adverse effect.

DXM is an SRI in itself. Combining SRIs leads to massive potentiation and can lead to serotonin syndrome which is potentially fatal. Just because you've been lucky and gotten away with something doesn't make it safe.

For reference, MXE also seems to be an SRI but afaik to a significantly lesser extent than DXM so of the two it's far less likely to cause problems, but still should be avoided - Ketamine on the other hand the SRI effect is so insignificant I don't think there's any need to worry there.

 

[azzo]

Yep i wasn't saying it is safe, i just did it many years ago with DXM while i was in treatment with Sertraline and i didn't know that combination was dangerous.
Same with MXE more recently with paroxetine and citalopram, but only 2 or 3 times and not at high doses, i just didn't know they were SRI, next time i need to be more carefull and i have to search better to avoid these risks.
Thanks again for the info

 

[Survived Abortion]

^One of the main reasons DXM can be dangerous in combo with SSRIs and other drugs is because it is a substrate for the CYP2D6 enzyme, which is responsible for one of the major metabolic pathways of these drugs. (CYP3A4 is also involved, which is also a factor in the metabolism of SSRIs and other drugs). This means that if DXM is consumed concomitantly with other drugs competing for this enzyme, the blood levels of both drugs will rise significantly, because there is less enzyme to catalyze the metabolism of both.

 

[RhythmSpring]

Ibogaine/Iboga can't be mixed with opiates! I'm surprised that's not on the list.

Speaking of which, what do you think is a good time-window before and after iboga to take opiates safely?

 

[Survived Abortion]

Yes, the opiates codeine, hydrocodone, and oxycodone, and the opioid tramadol are substrates for the cyp2d6 enzyme which means they are probably contraindicated with normal doses of ibogaine. Thanks for pointing that out - I'll update the OP but this needs to be forwarded to the mods too to make changes in the sticky.

I think it's worth noting though that the above mentioned opiates are subtrates for the enzyme, not inhibitors, so they shouldn't pose a problem per se, only that the dose of ibogaine should probably be less than normal, but much better if they are taken at different times.

Here's what is said in the "Ibogaine in the treatment of heroin withdrawal" pdf found at http://ftp.eboga.fr/Addiction/IBOGAINE-IN-THE-TREATMENT.pdf

The Objective Opiate Withdrawal Scale (OOWS) data were analyzed
from three assessments performed during the period spent in the clinic under
medical monitoring, given that those points in relation to ibogaine administration
were highly comparable among all patients. The attending physician performed
the first assessment following clinic admission an average of 1 hour before
ibogaine administration and 12 hours after the last dose of opiate. A psychiatrist
without knowledge of the admitting OOWS score performed the second
assessment an average of 10 to 12 hours after ibogaine administration and 24
hours after the last opiate dose. The attending physician performed the third
assessment 24 hours following ibogaine administration and 36 hours after the last
opiate dose. Physician’s ratings were subjected to repeated measures analysis of
variance (ANOVA) with treatment phase (pre-ibogaine, post-ibogaine, and
program discharge) as the within-subjects factor.

As you can see, in these clinical trials the last dose of opiate was administered 12 hours before the dose of ibogaine.

Interestingly, whilst I was looking this up I was reminded that a small percentage of people (4-10% in Caucasians, I can't find the figures for other ethnic groups) actually lack activity of this enzyme, meaning that these people don't get the proper effects from some opiates (because this enzyme turns codeine into morphine, hydrocodone into hydromorphone etc). But it also means that the same group of people will be poor metabolizers of ibogaine, and that doses for these people will work out much stronger and longer lasting than those with "normal" enzyme activity. Thus, if you're one of those people who doesn't get effects from opiates (or gets very little from them) it's probably wise to be cautious in dosing ibogaine.

 

[RhythmSpring]

Huh! That's interesting...
Whenever I take an opioid (either percocet or kratom), the effects are extremely slow to come on, and long-lasting. Like, the last time I took Kratom it took more than 12 hours to kick in, but once it did, it was wonderful and lasted for a couple days. Does this mean I might have that CYP2D6 deficiency?

I also have taken Iboga and it's acted normally (comes on within a few hours, lasts for 3 days).

Also, is there any information about taking the safety of opioids AFTER Ibogaine? You have information about opioids BEFORE Ibogaine.

 

[psood0nym]

Ketamine may be dangerous with an MAOI (probably best added to the "unsure but unwise" list). I researched this in the past and came across an article by an emergency room physician who noted a woman prescribed MAOI meds was administered ketamine. He wrote the article because the lady did NOT have an adverse reaction, and thought the incident, or rather lack thereof, notable because of a theoretical contraindication between MAO inhibitors and ketamine.

EDIT: Found it through the wonder of statistically improbable word clusters:

Abstract

A 42-year-old woman taking tranylcypromine, a monoamine oxidase (MAO) inhibitor, was hypovolemic from a ruptured ectopic pregnancy and required an emergency laparotomy. Anesthetic induction with ketamine, an agent with sympathomimetic properties, was used because of her hypovolemia, despite theoretical concerns of precipitating an adrenergic crisis. The patient's hemodynamic course remained unchanged with induction and intubation, and with further fluid and blood administration, satisfactory hemodynamic conditions were obtained. This report is believed to be the first to describe the use of ketamine in a patient taking MAO inhibitors.

So yeah, there's theoretical reason for concern and maybe this lady was just lucky. Worth a mention in any case.

 

[Survived Abortion]

^Thankyou psood! I had always wondered about this combo but no one had ever mentioned anything about it. It's probably quite the surprise to many too, because the generally accepted idea is that ketamine is safe with most things. I'll contact the mods now and get them to include it on the sticky.

I also thought of another combo the other day, but it completely slipped my mind by the time I got access to the computer to post it up. I think I was on 5-MeO-MiPT at the time, and something occurred to me, but I cannot for the life of me remember what it was.

 

[steingalkrs]

Has anyone here any knowledge if a-pvp is to be harmful or dangerous in combination with other drugs? I know from some friends that eat a lot of pills, I suppose they are benzo type, that eye sight was lost for some seconds at two instances and from another one that eyesight was made into "soup" (sounded to me like ketaminish) for some hours.

I know that Miprocin (x-x-mipt) is turned into a wild beast if under the influence of a-pvp, however doesn't seem to be harmful just a wicked photoshop 100% edit mode is unveiled... Im guessing that a-pvp is blocking reuptake of some of the 5-HTx reseptor (especially 5-HT2a reseptor).

 

[Achten]

Just a more general question, I'm sorry if its not appropriate in this thread:

Whats up with people wanting to combine aMT with MDMA or other empathogens ? OK, I get the idea But seriously, 30mg of aMT feels like the best ride ever. I'd save my MDMA for another time. Maybe throw in some shrooms at the 6hour mark of the aMT or some 2C-E at the end but nothing else actually..

Or maybe I'm just sensitive to aMT, in which case I consider myself lucky

 

[SpecialK_]

I was prescribed Propranolol today (80mg daily) and noticed people discussing it in this thread. Is it only really other medications/pharmaceuticals that affect it rather than other drugs? Just checking as I am a regular user of MDMA/LSD/DMT/Ketamine/Speed/Cocaine and the usual others.

 

[Survived Abortion]

It looks like I've missed a few posts.

Has anyone here any knowledge if a-pvp is to be harmful or dangerous in combination with other drugs? I know from some friends that eat a lot of pills, I suppose they are benzo type, that eye sight was lost for some seconds at two instances and from another one that eyesight was made into "soup" (sounded to me like ketaminish) for some hours.

I know that Miprocin (x-x-mipt) is turned into a wild beast if under the influence of a-pvp, however doesn't seem to be harmful just a wicked photoshop 100% edit mode is unveiled... Im guessing that a-pvp is blocking reuptake of some of the 5-HTx reseptor (especially 5-HT2a reseptor).

The only thing I know about the pyrovalerone stimulants is that they are potent dopamine re-uptake inhibitors (and probably inhibitors of norepinephrine re-uptake to some extent). They will be dangerous in combo with MAOIs (think ayahuasca, aMT, and pharms such as tranycypromine), Ibogaine, and possibly DXM if it is metabolized by CYP2D6. They should not be dangerous in combo with classic psychedelics.

Maybe your friend took too much and went a bit loopy. Or, maybe - if it came in pills - it was cut with other ingredients. An odd reaction for a plain stimulant, but not entirely unheard of.

Just a more general question, I'm sorry if its not appropriate in this thread:

Whats up with people wanting to combine aMT with MDMA or other empathogens ? OK, I get the idea But seriously, 30mg of aMT feels like the best ride ever. I'd save my MDMA for another time. Maybe throw in some shrooms at the 6hour mark of the aMT or some 2C-E at the end but nothing else actually..

Or maybe I'm just sensitive to aMT, in which case I consider myself lucky

I agree with you; aMT is such a complete experience on its own, it doesn't need added in my opinion. It certainly doesn't need any more serotonin release - that aspect is taken care of in abundance. There may be some who would want to bump the psychedelia up a notch, but that's just a matter of refining the details for personal taste.

I was prescribed Propranolol today (80mg daily) and noticed people discussing it in this thread. Is it only really other medications/pharmaceuticals that affect it rather than other drugs? Just checking as I am a regular user of MDMA/LSD/DMT/Ketamine/Speed/Cocaine and the usual others.

I used to take this drug, and whilst I have combined it with many stimulants such as MDMA, amphetamines, and cocaine, I am informed that it is quite unwise to do so. I didn't know about it back when I was taking it, but beta-blockers and stimulants are contraindicated. There's a link somewhere in this thread to the NHS page where it is listed as one of the range of substances to avoid.

I'd just like to say, if you have only just started this "medication", I would urge you to reconsider it. Are you taking it for a heart arrhythmia, or for anxiety? If it is for the latter than please tell the doctor to get stuffed. This was prescribed to me alongside the SSRI garbage I took for 10 years up until I quit everything, and it got really out of hand towards the end. My heart was going like fucking crazy in between doses (and I was dosing 3 times per day), and running out of the medication used to send my blood pressure dangerously high and make my heart beat like a jackhammer for days. Horrible shit.

Our hearts are not meant to be suppressed with drugs, they are meant to beat strong and proud and resonate with love. Your heart centre is you, and forcing it into submission with beta-blockers is a horrible thing to do to yourself. If you have panic attacks, you can deal with them by discovering the cause of your anxiety and uprooting it. This takes a lot of courage and personal resolve, but it is infinitely preferable to repressing it with drugs.

If you have anxiety that you feel you need to control through drugs, I would advise you to stop using so much MDMA, speed, and cocaine.

 

[Jesusgreen]

I would certainly not take it with MDMA, while it seems to be selective for MAO-B inhibition at low doses (of < 5-10mg) even that could result in unnecessary overstimulation resulting it hard in finding a good dosage for MDMA, as the ratio of dopamine to serotonin suddenly swung far more in dopamine's favour (due to MAO-B inhibitors stopping the breakdown of dopamine but not serotonin) would make it more akin to something like Amphetamine or Methamphetamine - and if this drug also inhibits MAO-A at higher doses, then it would not be worth the risk of this happening and you suffering serotonin syndrome.

If you're looking to indulge in stimulants and the like, MAO inhibitors really aren't something you want to be taken, even if it's MAO-B inhibitors.

4-HO-MET should be fine, there may or may not be a small increase in potency, otherwise there shouldn't be any differences.

3-MeO-PCP would likely not be be very safe and at the very least uncomfortable and over-stimulating.

 

[Survived Abortion]

There would be a greatly increased risk of psychosis combining selegiline with 3-MeO-PCP, resulting from the inhibition of the breakdown of dopamine by MAO-b combined with the inhibition of it's re-uptake by 3-MeO-PCP.

4-HO-MET will be fine.

MDMA is an absolute no. The potential for psychosis and/or a hypertensive crisis is just too much.

In general, dopaminergics should not be combined with MAOIs, particularly MAO-b inhibitors. This is why selegiline and similar medications cannot be combined with L-DOPA in parkinson's patients.

 

[Lab-Test Monkey]

Ibogaine/Iboga can't be mixed with opiates! I'm surprised that's not on the list.

Speaking of which, what do you think is a good time-window before and after iboga to take opiates safely?

There is a torrent on a well known website for torrents which has extensive documents and videos on the use of Ibogaine, a true wealth of information.