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How deadly is DXM with MDMA?

robE

Bluelighter
Joined
Apr 17, 2001
Messages
460
Does anyone know how deadly DXM is for someone when mixed with MDMA???!
There seems to be more and more of it showing up in pills.
I have noticed that about 30 mgs of DXM's in Lemsip Flu strength. So be carefull if taking these and then taking E.
 
on this topic, just wondering how a pill that had dxm and mdma show up on the ez-test?
 
I can't say how deadly this combo would be but think I understand why it is. The isozyme P450 2D6 is the normal route for most people in metabolising E. Other routes also exist, using other isozymes. DXM also uses the 2D6 route but has a higher affinity for binding with 2D6 than MDMA.
DXM also affects other isozymes, possibly the alternatives your body would normally turn to if 2D6 was 'unavailable'
The result of all this is that
1) MDMA plasma levels go up
2) An alternative pathway to the 2D6 and associated isozymes is initiated.
It is thought the alternative pathway your body chooses if these principle routes are inhibited, produces toxic metabolites.
This is nothing new really. Many pharmies work the same way. It is said around 70% of prescribed drugs all use the 2D6 route of elimination (as the body's first choice)
As around 1 in 20 people have a deficiency in 2D6, certain combinations of prescribed drugs for some people can also have disastrous results. This could also mean that amounts of DXM / MDMA producing toxicity may also be dependant on the availability of 2D6. i.e. do you have lots or none?
A blood test for identifying 2D6 deficient people is available. http://www.specialty.com/education/download_PDF/tn_1163.pdf
If you take E it’s probably not a bad idea to ask your GP about it.
 
In terms of personal experience, i know people who have chugged a bottle while peaking on MDMA and lived to talk about it, but this was before they knew of the contraindications.
They took large doses of each and came out fine, but i think they may have been very, very lucky.
 
Is there anything i can take to boost my 2D6 levels? any vitamins? i usually take a multivitamin every day, and a antioxidant tablet every week.
rob.
 
rob-E not that I know of. A low 2D6 level is more a pre disposing condition than a result of depletion. From what I understand the cause of deficiency is a genetic one. I guess severe mineral / vitamin depletion may reduce your body's ability to restore levels. I haven't anything on this so I couldn't say for sure.
Cytochromes are iron containing proteins that have an amazing ability to hydroxylate (add an OH to) organic molecules in an effort to make them less toxic. It doesn't always work however. Adding the OH makes the molecule water soluble so the body can then eliminate it. Some polycyclic aromatics, found as chemicals in cigarette smoke, actually are more poisonous with the OH group attached. Many carcinogens are activated as such after the OH is added.
I don't know whether levels go up or down substantially AFTER heavy drug use, but the amount of available cytochromes may go up or down in response to your body's needs while rolling
Cytochromes such as the P450 family, are not fully understood. The basic mechanisms are known but other parts have yet to be completely modeled.
 
I am one of these people with low levels of the liver enzyme p450 2d6 and i have to be carefull and usually only need half as much of somthing for the same effects as others. I found that every time i dropped I was throwing up so i cut my doses in half getting a more desirable effect without been sick. The effects also seem to last longer in me an easy way to put it is that i am a slow metaboliser. As for dxm i avoid it totally It makes me violently ill k.os me infact then when i come to i spew for about an hour or so. Since i stopped smoking dope the problem has become less making me believe i was poisining my self with tobacco. If you have any worries u should see a doc. Everyone should read up on the effects of mdma as well I find erowid a great source for this kind of thing. Care is the key. Know your body ,know your drugs
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It is necessary to cultivate some disiplne of mind,for an undisiplined mind always finds excuses to act selfishly and thourghtlessly. When the mind is undisiplined the body is also and so is speech and action.
 
RobE - this is in regard to your question regarding nutrients being able to bolster detoxification in the liver.
Detoxification in the liver is broadly categorized into "Phase 1", and "Phase 2" pathways. Both these pathways utilize enzymes to neutralize undesirable compounds. Phase I detox employs a group of enzymes (about 50-100), collectively referred to as "Cytochrome P450". Isozyme P450 2D6 that Phase Dancer referred to is part of this system. P450 enzymes are sometimes able to directly neutralize the toxin (as is the case with caffeine), and other times they must convert the substance to other chemically reactive forms which are then metabolized by Phase II detox pathways.
Despite these pathways being very effective, a problem arises when we bombard our liver with toxins, whether they be MDMA, alcohol or various other drugs. Phase I detox in particular, generates large amounts of free radicals - molecules which have the potential to inflict cellular damage. If your Phase II systems aren't working effectively, these toxic intermediates persist for much longer, and cause more damage.
As Phase Dancer said, the efficiency of the detoxification pathways, such as in the 2D6 instance, can be dependent on genetic factors. There are two other crucial factors however, and they are:
1. The person's level of chemical exposure.
2. The person's nutritional status.
The importance of nutritional status can be exhibited by the following example.
The most important liver antioxidant enzyme for detoxifying Phase I metabolites is "glutathione peroxidase", which is made from the amino acids cysteine, glutamic acid and glycine. Phase II detox is heavily dependent on glutathione, so if your toxic load (i.e. drugs) is very high, it is depleted radidly, and Phase II grinds to a halt. Now, glutatione is actually dependent on the trace mineral, selenium - which is why you find selenium in antioxidant formulas. No selenium = no glutathione = problems.
As Phase Dancer pointed out, the problem is that everybody varies. Some of us have very effective Phase I, and not so effective Phase II - others, it's the other way around. But the one thing we can control is our nutrient intake - and this is vital, if we wish to remain in good health. While the jury is still out on neurotoxicity (at least in regard to how it occurs), we can safely consider MDXX as hepatotoxic - i.e. not good for your liver. When your consider all the other crap you might ingest on an average night (alcohol, cigarettes, speed, and all the other dubious chemicals in pills) looking after yourself between rolls becomes paramount.
So what does our liver love? Well, the key nutrients for Phase I detox are:
* Copper
* Magnesium (also good for mad jaw disease, as we know)
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* Zinc
* Vitamin C
These are all involved in Phase I detox at different levels, some in enzyme synthesis, others as direct antioxidants. Certain other substances are highly effective in inducing effective Phase I detox. These include:
* Indole-3-carbinol - This is found in broccoli and cabbage, and is a powerful anti-cancer compound - (eat your greens!)
* Limonene - A phytochemical found in oranges and other citrus, that induces both Phase I and Phase II detox.
Phase II -
Phase II employs a biochemical process called "conjugation", where nasty metabolites are neutralized. However - and this is important - certain substances inhibit this process.
In grapefruit, there is a compound called "naringenin" which decreases your cytochrome P450 activity by up to 30%(!) This is a problem, especially as lots of people advocate drinking grapefruit juice just before rolling... now, it won't kill you, but it has the potential to significantly increase the toxicity of any novel chemical such as MDMA. But - you can actually increase the efficiency of the Phase II pathway also, by taking certain nutrients:
* Lipotropic Factors - This is a collective term for Vitamins B6 and B12, folic acid, choline, betaine and methionine. They can be supplemented individually, or obtained as a complex from Naturopaths etc. Together, they increase levels of glutathione, and another compound called
S-adenosylmethionine, or SAM-e for short.
The other major liver detoxifier/protector is a herb called Milk Thistle. This contains a complex of flavonoid compounds referred to as "silymarin", which exhibit some of the most powerful pro-liver effects known. Taken supplementally (as a standardized herbal extract), both before and after rolling, can dramatically reduce the damage to your liver. It actually helps to prevent the depletion of glutathione, and appears to form a protective "shield" around liver cells, allowing them to escape free radical damage.
Anyway, sorry this is a bit longwinded. Hope this is of some help to you - just remember, anything you can do to offset the damage caused by pills, and other drugs, your body will thank you for. To me, this is what "harm-minimisation means".
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Thanks for the input sneak2! Nice work.
BigTrancer
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Load universe into cannon. Aim at brain. Shoot.
 
wow thanks for all the help ppl.
Hey sneak2 that was a great help. I have access to pretty much everything you mentioned, including the vitamins, antioxidants and samE. They only think im unsure of is Milk Thistle. I'' run this message by my mum, she used to be a natropath(spelling?) so she knows all the vitamins and things.
Well its lucky i love broccoli and cabbage
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Rob.
PS: I wanted to find out about this sortof thing(detox) cause i had a dodgy pill a little while ago. i was told on the night by a paramedic that it probably contained ketamine, although i now think it contained either DXM or PMA. So i wouldn't mind giving my liver a helping hand
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[This message has been edited by robE (edited 01 September 2001).]
 
RobE-
In regard to the Milk Thistle, there's an excellent brand of herbal supplements from the US which have recently been launched in Australia, called "Solgar" - they come in gold bottles, and you should be able to get them from a good health food store.
Their Milk Thistle product is standardized to contain 147mg of silybin per capsule (silybin is one of the main components of silymarin). Currently, this is probably the best off-the-shelf product available in Australia, being of guaranteed potency.
Just for the sake of interest, and to illustrate the potentcy of Milk Thistle as a liver protector, I'll mention a landmark study conducted by European researchers into the herb.
In investigating Milk Thistle, they fed animals with a poison from the amanita mushroom, otherwise known as the "Deathcap" mushroom. Amanita contains one of the most powerful liver toxins yet studied, and usually results in death (in humans also) from massive liver failure.
The animals were also given silymarin complex, in the lead up to the administration of the toxin. In 100% of the animals, they not only survived, but their livers were largely protected from damage. Experiments have also exhibited that Milk Thistle (also known as St Mary's Thistle) can protect against chemicals as toxic as carbon tetrachloride, galactosamine and praseodymium nitrate. Now, if silymarin can protect against these, its chances of offsetting MDXX's damage is excellent.
Anyway Rob, happy detoxing! Let us all know how you go.
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Sneak2
 
wow thats impressive about feeding the animals.
I will definately go visit the local health food store.
Only question... how will milk thistle affect a roll?
Also, it sounds like you take loads of vitamins etc to help you body each day..how are your rolls?
i have had roughly 20 pills before and still get really big hits even off 1/2 a pill.
Would someone usually start to become immune if not taking vitamins etc? i usually leave atleast 2 weeks between going out.
Also i NEVER get comedowns...even when my GF or friends have a bad time the next week im right as rain. I don't take 5-htp although i do eat atleast 1 banana a day and loads of fruit and veg. Maybe i just always have enough 5htp in my system to produce seretonin after a big night. I would have thought, though, that ALL seretonin is dumped, maybe only half of mine is being dumped each time or something?? i hope im making sence.
Rob.
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I said....nice one brova!!
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[This message has been edited by robE (edited 01 September 2001).]
 
All good questions, Rob. Much of the information regarding MDMA and its various effects appears to stem from certain misunderstandings about pharmacology, and pharmacokinetics (how drugs are absorbed and metabolize in the body).
A lot has been written about pre and post-loading, most of it sound (IMHO). There's still confusion reigning though, as to what happens to the drug when it's absorbed. For example, there are threads asserting that when E is plugged, it somehow bypasses the liver! This is not the case, and it can be misleading.
Most of the speculation has been on how to prevent neurotoxicity, by supplementing with 5-HTP, Alpha-Lipoic Acid and other substances. This is important, because we still know so little (relatively) about the long-term effect of MDMA on the brain, particularly with regard to the serotonergic receptors and reuptake transporters. To parallel this, let's take another (much better studied) psychoactive substance, caffeine. In assessing how caffeine works, especially over the long term, researchers have determined that it actually alters brain chemistry, quite profoundly. It appears that receptors for caffeine in the brain become dependent on its Central Nervous System stimulating effects, and come to rely on it to function "normally". This explains coffee's addictive qualities - i.e. people who drink a lot of coffee find it difficult to get going in the morning, as their CNS is effectively waiting for the input of caffeine. Although MDMA works differently on a biochemical level (it is a more profound psycho-stimulant, being of the amphetamine family), this highlights how little we know. None of this changes the fact that amy of us take ecstasy however, so how do we do it in the safest way possible?
1. First, we attempt to minimize neurotoxicity.
This has been discussed in detail elswhere, but currently involves taking 5-HTP to provide the fundamental serotonin precursor, and antioxidants with a specific affinity for the brain (such as ALA), to counter the free radical production induced by MDMA. One compound that deserves specific mention is the herb, Ginkgo Biloba. Ginkgo contains complexes called ginkgo flavonglycosides and terpenoids, which exert powerful antioxidant effects in the brain. Now, Ginkgo is special, and here's why:
A study published in the Journal of Pharmacy and Pharmacology in 1994, demonstrated that ginkgo extract could counteract the changes in brain chemistry that occur with aging. One of these major changes, is that the number of serotonin receptor sites on neurons declines as we age. This gives rise to symptoms as diverse as insomnia, impaired mental function and depression.
The researchers attempted to determine whether Ginkgo extract could halt, or even reverse this decline in serotonin receptor numbers. In studying the extract, and it's effect on aging rats, they determined that the extract produced a statistically significant increase (some 33%) in the number of serotonin binding sites. Though scientists are not entirely sure of the mechanism behind this effect, they theorized that ginkgo appeared to:
*- Address impaired receptor synthesis - it did this by increasing protein synthesis in the brain.
*- Protect cerebral neuronal membranes from free radical damage - being a neuron specific antioxidant, is slowed neural degeneration.
The net effect is improved serotonin binding mechanisms in the brain. So, extrapolating this to MDMA usage, we can safely say that ecstasy causes a type of "accelerated aging" in the brain, specifically of the serotonin mechanism. The "speeding up" this system, consistently, over many years, could theoretically result in advanced brain degeneration and all the associated problems. Ginkgo may offer a degree of protection in this regard.
2. Second, we attempt to minimize liver toxicity.
I feel the best way of achieving this, is to utilize nutrients as outlined in the previous posts. So, to (finally!) answer your question - will this type of "liver preloading" lessen the effects of a roll - I don't believe so. MDMA will still be metabolized, and efficiently reach your brain (the area for which it has the highest affinity), but by taking liver protective nutrients, it's cellular impact is lessened. The effects of MDMA are secondary, meaning that in itself it is not responsible for the euphoric qualities - that is the domain of Mr Serotonin! In my personal experience, such a nutrient regime (utilizing 5-HTP always) doesn't lessen my roll - it only enhances it. I come down cleaner, I feel less toxic, and tolerance is lessened. However, the MDMA experience is fairly subjective, and will vary for everyone.
My area is nutrition, not hardcore biochemistry, so anyone please feel free to contradict and offer new insights. It's good that we talk about these things - make it safer and happier for everyone
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that was some great reading mate
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well i guess what i need to buy is Ginkgo Biloba and Milk Thistle. This should help protect against ruining my brain and liver.
I ordered some 5-htp only a few days ago so that should help too.
I try taking antioxidant tablets which you can buy at health food stores. I am hoping this will help combat the oxidants produced from a night out. Eg hopefully it combats the peroxide produced when dopamine is reuptaken by the seretonin transporters and broken down. Cause this CAN'T BE GOOD FOR THE BRAIN!
yeah its great that everyone can discuss this sort of thing over the net. Otherwise there would just be sooooo many ppl risking their health/lives through lack of knowledge
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thanks everyone
KNOWLEDGE IS KING!!!!!!!!!!!!
be safe,
Rob.
 
Fab post sneak2... more of the same please.
Off the subject a bit but do you know of any neuro benefits associated with ornithine /Orthinine? Are they infact the same substance? I took a preparation called GH4 for 2 months last year and couldn't beleive the apparent improvements in memory.
I understand the roles ornithine plays in vivo; amino acid sythns the urea cycle etc. but I don't know by what mechanisms this compound affects brain activity.
 
Hi, Phase Dancer.
As far as I can determine, ornithine and orthinine are the same thing, though "ornithine" is considered the more correct term.
L-ornithine is an amino acid, though not an essential one. It's not often referred to in nutrition texts, as it's biochemical role is a little unclear, apart from in the urea cycle as you mentioned. What some studies have indicated though, is that when combined with L-arginine and glycine, it stimulates the production of Growth Hormone, or somatotropin, in the anterior pituitary gland.
I believe that GH4 - the product you mentioned, (and the successor to the famous European GH3) contains L-ornithine. By stimulating Growth Hormone (the "GH" in GH4), it may account for your improvements in memory. GH is known to stimulate intracellular protein synthesis, and this may be one of the ways in which it exerts a nootropic, or neuro-enhancing effect. The hormone has been attributed to all sorts of miraculous changes in people, hence the popularity of the product, especially throught multi-level marketing.
Some studies seem to have shown only modest improvements from supplementation with the above amino acids, but that may be due to inadequate dosages. The other approach, (that some athletes take), is synthetic Growth Hormone, which can be extremely dangerous - it's powerfully anabolic.
Also, ornithine and arginine are necessary for proper immune system and liver function. That's all I know, but if anyone else is cluey on this area...?
[This message has been edited by sneak2 (edited 01 September 2001).]
 
I answer to your actual question, DXM combined with e is very dangerous. This is because DXM will stop you from sweating, while MDMA and dancing will raise your temp. So if you can't sweat you can't cool down.
There is plenty of info about this around the place - both here and at erowid, so have a look around.
 
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