Using MDMA with alpha- and beta-blockers

[openair]

I just read this abstract: http://www.ncbi.nlm.nih.gov/pubmed/20378736

It says that beta-blockers (I like propranolol and I have a script for it) prevent increases in heart rate associated with MDMA response.

I would like to know if also using an alpha-blocker, which also has more adrenal-reducing effects, would prevent the other unwanted norepenephrine responses they mention in the citation, like hypertension and blood pressure.


Yes or no?
Thanks for your input, and also please provide me with your favorite alpha-blocker, preferably one that hits a lot of receptor sites, like propranolol does for beta-blocking.

love, light
-openair

 

[tweex]

I've done the combo in the past of Propranolol+Phenoxybenzamine+Clonidine for large doses of amphetamines. Clonidine has a higher affinity for Alpha 2 than Phenoxybenzamine, so you end up with Phenoxybenzamine acting more like a selective Alpha 1 blocker, while the Clonidine still works normally.

Labetalol might work well too. I've got some as a standby for MAOI hypertensive crisis, but I haven't really tried it with amphetamines. Saw it mentioned a couple times in literature for this purpose though.

 

[openair]

I've done the combo in the past of Propranolol+Phenoxybenzamine+Clonidine for large doses of amphetamines. Clonidine has a higher affinity for Alpha 2 than Phenoxybenzamine, so you end up with Phenoxybenzamine acting more like a selective Alpha 1 blocker, while the Clonidine still works normally.

Labetalol might work well too. I've got some as a standby for MAOI hypertensive crisis, but I haven't really tried it with amphetamines. Saw it mentioned a couple times in literature for this purpose though.

So since Labetalol is a selective alpha blocker and non-selective beta blocker, I could just take this one pill a few hours before a roll on MDMA? Would this be alright, and I could just forget about the propranolol, and take Labetalol instead?


love, light
openair

 

[MagickalKat777]

Don't beta blockers have paradoxical pressor effects associated with them and are generally contraindicated for stimulant hypertension? I would think clonidine would be the smarter choice.

If you are concerned about heart problems with something as relatively benign as MDMA, you probably shouldn't be doing it at all though IMO. :/

 

[openair]

Don't beta blockers have paradoxical pressor effects associated with them and are generally contraindicated for stimulant hypertension? I would think clonidine would be the smarter choice.

If you are concerned about heart problems with something as relatively benign as MDMA, you probably shouldn't be doing it at all though IMO. :/

I'm not so much worried about heart problems, I just don't like the peripheral side-effects of norepenephrine release that MDMA causes (sweaty palms, hard to piss, anxiety etc)

Why do you think clonidine is a better choice?

peace,
openair

 

[MagickalKat777]

Why do you think clonidine is a better choice?

Purely because of my concern about paradoxical hypertension from beta blockers. As an aside from personal experience with it, clonidine is less likely to cloud the drug that you're on as well. Propranolol has a dysphoric feeling to it for me that I don't like at all when its by itself and so needless to say I've never mixed it with anything.

 

[openair]

Purely because of my concern about paradoxical hypertension from beta blockers. As an aside from personal experience with it, clonidine is less likely to cloud the drug that you're on as well. Propranolol has a dysphoric feeling to it for me that I don't like at all when its by itself and so needless to say I've never mixed it with anything.

Let me make sure I understand your recommendation. Take a low dose of clonidine for alpha blocking, and take nothing else with it for beta-blocking?

I am being sincere, I am simply curious. Like I said, the peripheral side effects of MDMA are what I would like to avoid anyway. I have taken it occasionally for many years, usually in low doses even, but I still have lots of sweat rolling off of me and other side effects I don't like.

Or do you think I should just continue taking MDMA by itself? Do you think it is possible to get the range of effects I want, or should I just be happy with the MDMA by itself?

Thanks for all the advice so far!

-purechem

 

[MagickalKat777]

Honestly, if you have real MDMA, I wouldn't take a chance on ruining it by adding in other drugs.

From reading, it appears that clonidine is not effective with this effect on MDMA anyway: http://www.ncbi.nlm.nih.gov/pubmed/22034656

http://jpet.aspetjournals.org/content/340/2/286.full

Neuroendocrine and Cardiovascular Effects.
MDMA increased the level of circulating NE, an endocrine marker of sympathetic nervous system activation, and elevated blood pressure and heart rate compared with placebo (Figs. 1a and 2, a and b; Table 1). Clonidine prevented the MDMA-induced increase in plasma NE (Fig. 1a; Table 1). It also attenuated the blood pressure response to MDMA, although reflected only by the AUEC and not Emax (Fig. 2a; Table 1). Clonidine also decreased the level of circulating NE and blood pressure compared with placebo to a similar extent as the reduction in NE and pressure elevations induced by MDMA (Figs. 1a and 2; Table 1). Additional ANOVAs with the two drug factors, MDMA and clonidine, yielded significant main effects of MDMA and clonidine on Emax values of MAP (F1,15 = 106.1 and 18.1, respectively; both p < 0.001) but no MDMA × clonidine interaction (F1,15 = 0.2; p = 0.7), which is consistent with an additive effect of the two drugs. Likewise, the ANOVA of NE levels showed significant main effects of MDMA and clonidine (F1,15 = 41.5 and 34.2, respectively; both p < 0.001) but no MDMA × clonidine interaction (F1,15 = 0.0; p = 1). The circulating levels of epinephrine were not significantly altered by the drugs, and clonidine did not affect the increase in heart rate produced by MDMA (Fig. 2b; Table 1).

Also, BilZ0r recommended against propranolol and MDMA specifically:

http://www.bluelight.ru/vb/threads/183013-beta-blockers-and-MDMA?p=2728399&viewfull=1#post2728399

 

[tweex]

The problem with taking just a beta blocker with an adrenergic stimulant is unopposed alpha 1 agonism. Still only a problem at fairly high doses. If you take alpha and beta blockers, this isn't an issue. Also clonidine is an alpha agonist for the alpha 2 receptor, not an alpha blocker.

 

[endotropic]

The problem with taking just a beta blocker with an adrenergic stimulant is unopposed alpha 1 agonism. Still only a problem at fairly high doses. If you take alpha and beta blockers, this isn't an issue. Also clonidine is an alpha agonist for the alpha 2 receptor, not an alpha blocker.

This is accurate.

Clonidine can be used to reduce adrenergic symptoms due to its alpha-2 agonism, as the alpha-2 receptor hyperpolerizes adrenergic neurons, and thus reduces nor/epinephrine release. MDMA causes norepinephrine release directly, so alpha-2 agonism will have little if any effect on MDMA induced adrenergic side effects.


All of that said, I would recommend that you don't use any adrenergic drugs in combination with MDMA. Most people never really know what's mixed with their MDMA, or whether they even have MDMA at all. It's impossible to predict how the drugs will interact if you can't be sure what they are in the first place.

 

[ebola?]

Case closed up there. If the peripheral effects are unpleasant enough to warrant pharmacological intervention, the dose is too high. If such a high dose is needed for desired effects, a long break from stimulating drugs is necessary. All this said, clonidine is a pretty safe choice, and people have had good experiences with the combo.
...
However...can anyone provide clear evidence that unopposed alpha-agonism truly becomes an issue with combination of beta-blockers and moderate to high but SANE doses of stimulants? I have seen only isolated anecdotes and learned speculation on the matter so far.

ebola