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Tramadol + MDMA + hash = horrible trip

RoboTekTonik

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Aug 17, 2012
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Ive done some research and have a few ideas why my boyfriend experienced pure terror during an unexpected trip from Molly , tramadol, and hash. However Id like to hear others' opinions about the matter. Id guess serotonin syndrome or OD.

My boyfriend and I went to a rave this last saturday night. We both took about 6-7 caps of "molly" at .1 caps throughout the night (10pm-3am). The substance we took was said to be Molly, however, we are in no way sure of its contents.

We started off by taking 2. the come up was intense, yet the peak did not last nearly as long as when we usually roll. Probably about 20-30 mins. We lost track of how many we were taking, and by 3am we did the math and discovered we took 6-7, when our highest amount ever taken was 5 mints (we had never done all molly, usually mix molly and mints or just mints).

So, between 1-4am everything was great. We were mingling, talking with everyone, being goofy, in a complete euphoric state.

Around 4am, we left with a group of people, one of them being the guy that was selling us the caps all night. We went back to their apartment, chilled, and smoked some weed. Everything was going fine. For as many caps as I had taken, i noticed the come down was not as harsh as usual. I was still sociable, in a good mood, only negative side effect was losing my train of thought mid-sentence, or pretty much E-tarded for the night.

We all smoked some hash out of a bong. My boyfriend usually suffers a lot more during the comedown. He goes through a phase during the comedown where he has trouble speaking, or being social in any way. He can barely form coherent sentences for about an hour. then usually snaps out of it.

Well this night was different, and I cannot begin to describe how scary this was to witness. My boyfriend had been taking Tramadol for an injury for about a week. He took one about 4 hours before taking a Molly cap. Once he smoked weed, everything went from mellow to pure insanity for him. I noticed he wasn't talking at all and wasnt responding to people talking to him. He was spaced out staring at these paintings for about half an hour. I noticed the look on his face started changing , and the longer time went by the more frightened he looked. I asked him if he was okay a few times, he said ya and just kept staring.

I figured he was just having a bad comedown, so I just kind of left him alone. Then he became completely unresponsive to everyone, wouldn't look anyone in the eyes, and his face started getting red. After about half an hour 45 mins of this, he finally spoke up. He looked up at me, and I could barely even look at him...his eyes and face full of pure terror. Like he was experiencing hell inside his mind. He said "Theres something seriously wrong with my brain" over and over. "Im tripping. Im hallucinating like I am really tripping".

His voice was full of utter fear, and words cannot describe the look he had on his face. He began to have what I can only describe as psychotic episodes, or delirium. His behavior was similar to that of a schizophrenic. His face was red, eyes bugged out of his head, pupils dilated, shivering, horrible body and leg tremors, unable to respond verbally, unable to look anyone in the eyes. super paranoid, on edge, irritable, super anxious. Jaw and fists clenched shut. He finally stood up and was uncontrollably shaking, almost crying, repeating over and over "There is something seriously wrong with my brain! I dont know whats happening to me please help me!" He insisted he was going insane. This went on in phases for about 2 hours. Hed snap out of it for about 5 mins, able to talk normal, even made funny comments and made us all laugh. then he'd slip right back into insanity.

I had to force him to drink water. I was very soft spoken and calm when talking to him, and tried to assure him it was just a temporary state of mind and that itd soon pass. Every time he'd slip back into the episodes hed get worse and worse. At one point it took everything in me to keep from crying and freaking out.

The part that scared me most was his facial expression. If I had to guess from just looking at him Id say he was literally experiencing hell inside his mind.

I was stuck in a predicament b/c we were an hour away from home, and I didnt want to risk him having an episode in the car. So once his episodes calmed down a bit i drove him home.

Since then, he will barely talk to me about it. He said he felt like he was going insane. " I felt like a vegetable". The past few days hes been having horrible anxiety. He said he felt like he was really scared of something but didnt know what or why. He says theres still something wrong with his brain.

I cant begin to imagine what he was experiencing. My estimated diagnoses are: a REALLY bad trip, serotonin syndrome, or an overdose. From what hes told me and what I saw, Id say he was stuck in a very visual hallucination state, along with a delirious / paranoid state of mind, without the ability to form coherent thoughts in order to evaluate what he was experiencing. He also wasnt expecting to "trip" so I think added to his bad reaction. In my unprofessional opinion, his brain produced too much serotonin, and it sent him into a mental shock.

We both knew that you shouldnt take MDMA with MAOs or SSRI's, but had no idea that Tramadol was equally dangerous to mix.

So, has anyone else had a similar experience? Ive heard similar stories on LSD or 2cb and related chemicals, but never MDMA. Could anyone offer any ideas as to what caused this? Also, besides taking 5htp and vitamins after the fact, is there anything else that could help him back to normality?? I fear he has serotonin syndrome and may suffer long term anxiety or HPPD.

PS....This has been an immense wake up call and we are aware of our stupidity for letting this happen. I read the limit for MDMA should be no more than .5 g. We also really have no idea if what we took was MDMA.

I highly advise everyone: DO NOT TAKE MDMA, MDA, OR ANY DRUG THAT AFFECTS SEROTONIN IF YOU ARE TAKING ANY TYPE OF ANTIDEPRESSANT, SSRI, MAOs, TRAZADONE, TRAMADOL, FENTANYL, OXYCODONE, OR EVEN COUGH SYRUP WITH DXM.. From what Ive read, serotonin syndrome can permanently damage your brain or even cause a coma or death. Always research before mixing ANY type of drugs. If we had done some simple research my boyfriend could have avoided this horrible experience.
 
I highly advise everyone: DO NOT TAKE MDMA, MDA, OR ANY DRUG THAT AFFECTS SEROTONIN IF YOU ARE TAKING ANY TYPE OF ANTIDEPRESSANT, SSRI, MAOs, TRAZADONE, TRAMADOL, FENTANYL, OXYCODONE, OR EVEN COUGH SYRUP WITH DXM.. From what Ive read, serotonin syndrome can permanently damage your brain or even cause a coma or death. Always research before mixing ANY type of drugs. If we had done some simple research my boyfriend could have avoided this horrible experience.

Yeah. All it would have taken is a damn google search of "Tramadol and MDMA" and you would have found the answers extremely quick. Do this before every new drug combo from now on. You might not always find the answer if it's some obscure RC, but it's always good to look first.


and fentanyl, oxycodone and other opiates are fine to take with MDMA, but leads to a diminished roll. It's only tramadol, an opiate thats also an SNRI, that's dangerous to mix with MDMA

I read the limit for MDMA should be no more than .5 g. We also really have no idea if what we took was MDMA.

.5 of MDMA is still WAY too much. 300mg should be the absolute maximum, and even that is pushing it. Also, get a Marquis reagent. It's a testing kit for ecstasy and will tell you if you have MDMA, meth, piperazines, MDPV, methylone, 2C-B or so on
 
Just wanted to say that I too had a very bad comedown after mixing lots of MDMA with weed, even though I've done it many times before and been fine. Your boyfriend may well have just had a REALLY bad stoned trip & in doing so he has scared himself half to death. It will pass in time. The best thing you can do is reassure him that it was JUST a bad trip. Get him out of the house, healthy diet, regular exercise. Beat the post-binge blues that you will both probably be suffering with for a significant number of weeks.

If he can open up about it and tell you what happened it will help him to let it go. He will have seen some of the deepest, darkest most horrendous shit you could possibly ever imagine, but he should realise that this was a combo of the serotonin imbalance and extreme paranoia brought on when he was too stoned. You don't even realise how stoned you are when you are still buzzing off the mdma. But you should know what it can be like when you get a paranoid thought after just smoking weed alone, it can be hard to shake off sometimes.

Is he ever quiet or paranoid when he is just too stoned? Imagine one of them paranoid thoughts intensified more than 10 fold by the vivid hallucinations you can get from the mdma. Scary indeed. Not to mention the Tramadol.

Give it all a long break and if you feel you must revisit these drugs then take safe amounts & don't mix them. I don't know him but the things he seen that night do not reflect his good nature. He just got stuck in a bad place after being a STUPID idiot with drugs. More than anything he is probably feeling very VERY embarrassed that he looked absolutely crazy to everyone, including himself, but the only way he will move on is if he doesn't keep it all bottled in and he learns to let it go.

Wake up to the dangers of taking too much shit!
 
^ Actually.. what he went through was not "just a bad trip".


He went through a very serious and life threatening drug interaction called Serotonin Syndrome, in this case it was caused from using MDMA and tramadol together. That is much worse than a "bad trip", because if not treated properly, it may kill you.

Serotonin syndrome is also called Serotonin Poisoning, among other things. It's basically when you take two drugs that cause complete opposite effects on the serotonin transporters, which obviously causes some problems. It's not just from using drugs too often, this could happen the first time you ever took drugs and be just as serious
 
My apologies if that is in fact the case. I can only tell you that I had most of those symptoms on a bad trip. If the OP wants me to PM her my experience I could go into more detail.
 
Thank you Flynny and Folley for your input. Flynny- my bf and i had to giggle at your response because thats exactly how he felt. super embarrassed because he knew he looked super crazy to all of us who were with him. we had actually been with ppl we had just met that night when it happened and he thought theyd never want to talk to us again after this incident. surprisingly though they texted him the next day askin if he was okay wanting to hang out again. which definitely helped him out psychologically...

And Folley... thats exactly what we diagnosed his "bad trip" as, serotonin syndrome. I did about two days of research to figure out what went wrong. Im a psych major so I was able to understand why the mix of tramadol and mdma affected his serotonin, at least to a certain extent. ...please correct me if im wrong...but from what i understand...

mdma causes your brain to release a ton of serotonin, flooding the synapses. Normally, once the mdma effect wears off, the brain naturally "reuptakes" this serotonin from the synapse, so your brain is no longer flooded with serotonin, which is what leads to the "comedown". however in his case, since he took the tramadol which is a serotonin reuptake inhibitor, it blocked the receptors, and prevented the brain from being able to clear the synapses of the serotonin. so the serotonin was pretty much stuck in the synapses, with nowhere to go, and it was too much for his brain to handle. aka "serotonin poisoning"...im still foggy about a few parts, im sure thats not entirely correct. but ive yet to find a resource that breaks the process down step by step in a way i am able to understand...

i only have a somewhat basic understanding of the neurochemistry aspect ... ive always been extremely intrigued by drugs and neurochemistry, so ever since witnessing my bf go through this experience and how such a simple yet complex chemical reaction in the brain caused this extreme psychotic/paranoid behavior, i cant help but yearn to understand it completely.

So Folley, and anyone else who may read this post... maybe you could help me out. Anything I read on the internet about serotonin syndrome just says it can be fatal, but since my bf obviously survived this experience, is there still chance for it to be fatal later on? like say next time he uses mdma, even at a small amount, his risk of this happening again or worse may be higher? every site says the same stuff and its all pretty vague about long term affects, etc...im just nervous that it affected him permanently, or could again in the future even with an antidepressant or any SSRI .i already suggested that he see a professional about it. But tbh I really dont see what help a doctor could offer besides advising him not to mix drugs or DO illicit drugs again, to drink water, take vitamins, and maybe prescribe him to some xanax. ehhh....
 
Not to worry, if he survived the night he should be fine. Obviously watch him closely, though. Some damage was likely done, but with proper rest from drugs it shouldn't be permanent, or at least not be noticeable.



It's really only fatal in high doses, and when it starts to cause seizures. If he wasn't seizing and blacking out while vomiting and foaming at the mouth, the chances of it being fatal are low. They are still present though, so anyone under suspect of SS or any other neurological condition is at risk and should be monitored for any dangerous looking signs. Never be afraid to get help.


If it ever happens next time, and I'm sure it won't because you'll do research and prevent this from happening again, try giving them a benzo. It should keep them from needing any hospitalization, but of course they still need to be watched.
 
As Folley said, it was (most likely) seratonin syndrome.

Just wanted to note that there are other SNRI opiates.
Tramadol
Methadone
Levorphanol (Levo-Dromoran)
Tarpentadol (Nycunta)
possible Desmethyltramadol

Check out threads in ED and PD on recovering from frightening episodes on hallucinogens. Also if you guys have insurance, go see a neurologist.
Eat right, exercise, lay off the drugs.
 
It sounds like you guys took methylone. The shorter peak and hallucinating are giveaways to me (in addition to getting the stuff at a rave). I've known many people to have difficult and very strong hallucinations when smoking weed after taking .5g+ methylone. I've known a couple ytips to be quite terrifying, and I'm sure for him the tramadol didn't help.

My two cents.
 
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