Dissociatives Using ketamine as a substitute for DMT in ayahuasca

[red22]

The Physicality of Psytrance: An Experience with Ketamine & Syrian Rue. arionthemoon. 2018-03-20. Erowid, exp111110

Have you used ket and harmalas together? Ive always thrown up when I dosed them together, but I think I could do a better job of fasting beforehand.

Brother_Nature178, 2023-10-28, reddit

Ketamine isn’t really potentiate by harmalas in my experience. If anything it just makes the experience feel a little better and more smooth, and maybe more stimulating. I never combined the two in large doses though so be careful.

Bardy, 2024-10-22, https://www.shroomery.org/forums/showflat.php/Number/28995221#28995221



MAOI info:

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Clinical doses of ketamine for used for induction of anaesthesia, maintenance of analgesia, or treatment of depression, do not result in serotonin re-uptake inhibition (SRI). Peak concentrations of ketamine when used for induction of anaesthesia may result in inhibition of norepinephrine reuptake and might theoretically result in exaggerated hypertension when used in the presence of MAO-A or non-selective MAO-AB inhibition; safe concurrent use has been reported in a small number of cases[23-25]. It is clearly prudent to continue monitor such combinations closely.

23. Hopwood, S.E., et al., Effects of chronic tramadol on pre- and post-synaptic measures of monoamine function. J Psychopharmacol, 2001. 15(3): p. 147-53.

24. WHO, Ondansetron and serotonin syndrome. WHO Pharmaceuticals Newsletter, 2012. 3: p. 16.

25. Anon, Can 5-HT3 antagonists (e.g., ondansetron etc.) really contribute to serotonin toxicity? Hunter Drug Information Service. HDIS Fact Sheet. Hunter New England Health District., 2014.
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MAOIs and Anaesthesia. Ken Gillman M.D. 2019, 2025. PsychoTropical Research

Someone on reddit asked, "Is it safe to take an MAOI alongside spravato?" Someone replied, "Absolutely. Though, a watchful eye on BP during treatments is wise for the sake of a little extra bit of caution." And then he elaborated thus:

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I am a Parnate + Ketamine/Spravato patient myself (for over 1.5+ years) and have had zero issues with blood pressure or haemodynamics during treatments. Heck, this was even with Vyvanse on top of it!

I started Spravato at the same time as Parnate, as per the Spravato newly-initiated oral antidepressant model, and funnily enough the hypotension in the first few weeks of starting an MAOI was more of an issue than any of the perceived risks surrounding excessive hypertension. The idea that this combination has any potential for inducing serotonin toxicity is completely ill-founded.

We have a number of members in the International MAOI Expert Group who have had experience and success with Ketamine and MAOIs in combination. One particular case is documented in a recent paper I co-authored, An Expert Roundtable Discussion on the Use of Classic Monoamine Oxidase Inhibitors in the Treatment of Depression – Part Two.

There are a number of other publications attesting to the safety and efficacy of combined MAOIs and Ketamine:

Veraart JKE, Smith-Apeldoorn SY, Kutscher M, et al. Safety of Ketamine Augmentation to Monoamine Oxidase Inhibitors in Treatment-Resistant Depression: A Systematic Literature Review and Case Series. J Clin Psychiatry. 2022;83(6):21m14267. Published 2022 Oct 24. doi:10.4088/JCP.21m14267

Wang, Jay Ching Chieh MD, ISAM; Swainson, Jennifer MD, FRCPC. The Concurrent Treatment With Intravenous Ketamine and an Irreversible Monoamine Oxidase Inhibitor for Treatment-Resistant Depression Without Hypertensive Crises. Journal of Clinical Psychopharmacology 40(5):‍p 515-517, 9/10 2020. | DOI: 10.1097/JCP.0000000000001244

Bottemanne, Hugo MD; Bonnard, Emilie MD; Claret, Anne MD; Petit, Anne-Cécile MD, PhD; Gaillard, Raphaël MD, PhD; Fossati, Philippe MD, PhD. Ketamine and Monoamine Oxidase Inhibitor Combination: Utility, Safety, Efficacy?. Journal of Clinical Psychopharmacology 40(6):‍p 36-638, 11/12 2020. | DOI: 10.1097/JCP.0000000000001281

Katz RB, Toprak M, Wilkinson ST, Sanacora G, Ostroff R. Concurrent use of ketamine and monoamine oxidase inhibitors in the treatment of depression: a letter to the editor. General hospital psychiatry. 2018 Sep;54:62. doi:10.1016/j.genhosppsych.2018.05.007

Bartova L, Vogl SE, Stamenkovic M, Praschak-Rieder N, Naderi-Heiden A, Kasper S, Willeit M. Combination of intravenous S-ketamine and oral tranylcypromine in treatment-resistant depression: a report of two cases. European Neuropsychopharmacology. 2015 Nov 1;25(11):2183-4. doi:10.1016/j.euroneuro.2015.07.021
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IrreversibleReuptake, 2023-12-13, reddit

 

[JackARoe]

No takers on this one eh Red ? Until we find a substance in nature that mimics ketamine I don’t think it could be used for anything other than what it does itself.

Just my opinion, of course. But I will say that was a good read.

 

[red22]

Edited a comment into the post.

 

[Esperighanto]

CYP3A4 and CYP2D6 both alter ketamine's metabolism according to this article, linked here. I'd imagine that inhibitors or inducers of those enzymes would be more impactful as to altering the metabolism of ketamine.

 

[dopamimetic]

Until we find a substance in nature that mimics ketamine I don’t think it could be used for anything other than what it does itself..

As a disso lover I had to investigate this and there are indeed some natural dissociatives. Of course ibogaine but also kratom contains traces of one. The caveat is that all I found were just in traces so one would have to acquire a lot of plant matter and do an extraction, I am both too poor and unskilled chemically to do this unfortunately. I also forgot the chemicals name but I posted it in NSPD.

But seeing that some guys made 7-OH mitragynine then I wonder why not a dissociative. Maybe opioids generate more sales.

 

[red22]

To the topic, are MAOIs and ketamine safe to use together? My hunch is that there might be an increase in blood pressure but this is not based on any data.

Second half of post.

 

[Esperighanto]

As a disso lover I had to investigate this and there are indeed some natural dissociatives. Of course ibogaine but also kratom contains traces of one. The caveat is that all I found were just in traces so one would have to acquire a lot of plant matter and do an extraction, I am both too poor and unskilled chemically to do this unfortunately. I also forgot the chemicals name but I posted it in NSPD.

But seeing that some guys made 7-OH mitragynine then I wonder why not a dissociative. Maybe opioids generate more sales.

The dissociative alks in kratom are a bitch to extract and purify, and you get VERY little out in total. In addition to that, 7-OH isn't extracted from the plant, mitragynine is extracted and then further oxidized, making 7-OH "semi-synthetic" like how THC-O is just THC mixed with the chemist's version of pure vinegar (glacial acetic acid, aka pure vinegar whereas normal culinary vinegar is like 5-10% glacial acetic acid, remainder water).