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  • Trip Reports Moderator: Xorkoth

MDMA + MAOI - experienced - Straight to the ER

Murple, do you have more info on MDMA/Deprenyl interaction experiences, speccifically the Deprenyl dose and concurrance of administration?
from most literature perused, i understand that it is the MAO-A inhibitors that are responsible for the ss incidences reported, and Deprenyl is a mild MAO-B inhibitor.
a foaf who has been on 5mg Jumex (Deprenyl) for the last ~3 months, taken single dose in morning, is considering an MDMA dose for the evening (10 hours later). he has not done MDMA for the last 8 months, and although a very experienced user, is not looking for a full-blown psychedelic freakout. are there safety concerns or words of wisdom that i should relate to him?
[ 03 May 2002: Message edited by: frqntflyr ]
 
frqntflyer: see the dancesafe bulletin board for discussion on deprenyl + MDMA, or deprenyl.
Murple: how would you explain the physical effects Regulator had (the profuse sweating and ? hyperthermia, agitation and the "convulsions")? I guess the sweating and agitation could possibly be explained by a "freak out", but not the "convulsions". I don't agree that they can be explained by an intense MDMA experience, and believe they support the diagnosis of serotonin syndrome.
Dracon: You should know that both in the role of Mod, and in my day to day life I tend to err on the side of caution. So I am never going to say "go for it" with a potentially dangerous combination, even though others would. I can see why you would want to try this combo again, given that you have had only positive experiences with it. I really can't give you any more advice, as I don't really have any more expertise to share. You may like to read the thread on this in Aus Drug Discussion, or bump your post in Health as we're taking this trip report off topic! I would love to read trip reports from others who have doen the combo and been OK.
 
thanks babydoc. seems the jury is still out on MDMA+deprenyl, for every pro there's a con. some claim unpredictable effects due to unknown mechanisms of action on the dopaminergic system while others maintain it works wonders as a neuroprotector.
given enough research funding and lab rats (uni sophomores?), looks like one can prove just about any hypothesis these days...
 
Anti depressants + Ectasy = More depression.
That's why I quit taking Zoloft. Sorry to hear your story, it sounded like a horrible time.
 
interesting point allthough perhaps pointless:
sobe beverages technechly are not X-head friendly. There are many common MAOIs and SSRIs in sobe bevs. Maybe if u drink sobe whilst rolling u could have a bad exp? Dunno, but after reading this post im going to be X-tra (no pun intended) careful bout what goes in my head. Thanks for sharing this exp because we need to know the dangers.
 
I doubt there are enough chemicals in Sobe to affect anything. They add just enough of those herbals to be able to say "Contains ginseng and elephant cum!" on the labels. Sobe is basically just uncarbonated soda pop being marketed as herbal health crap.
As to the physical symptoms the original poster reported... "convulsions" could be something physiological or it could've been just psychosomatic. None of the physical symptoms he described really fit the MAOI+MDMA overdose profile, nor did he report the symptoms one would expect from such an overdose reaction. If anyone has a copy of Trout's book on cactus alkaloids, theres a long discussion of MDMA+MAOI problems in the chapter on MAOIs and phenethylamines.
 
Hmmm this is interesting...
I never got a diagnosis from the ER staff when I went in so I can't say that it was SS for sure.
It is plausible that the whole nightmare may have just been me wigging out from what was undoubtedly "a hardcore psychadelic trip", if nothing else. While I wasn't experienced in psychadelics when I did this combo I doubt that anything could have prepared me for the effects, and I struggle to comprehend how anyone could do it and enjoy it.
I cannot put into words how FUCKED I was when I was experiencing the peak effects, it was so so incredibly intense. I could describe it as at first, hanging on for dear life (sanity) with every ounce of resolve I had, and then being thrown off the edge and completely losing it.
Having heard that other people have done the same combo and been fine has made me question the reasons for my visit to hospital.
Did I simply get too fucked up and freak out?
Or, was is Seratonin Syndrome?
Murple, if you can find the time to give me a detailed reply, I would appreciate an e-mail.
 
I still think the description you give is that of serotonin syndrome, and therefore feel you were right to go to hospital. There is a continuum of severity of SS, so perhaps you had mild to moderate symptoms. And the diazepam you were given can treat SS, thus halting the progression. Here is some info. on diagnosing SS from Serotonin Syndrome:Recognition and Management:
Martin refers to three categories of symptoms that are present: altered mental status, autonomic dysfunction and neuromuscular abnormalities.1 Sporer indicates that at least three of the following must be present for a diagnosis: mental status changes, agitation, myoclonus, hyperreflexia, fever (hyperpyrexia), shivering, diaphoresis, ataxia and diarrhea in the setting of a recent addition or increase in dose of an agent that raises serotonin levels.
From the Serotonin syndrome Guide:
It is helpful to appreciate that MDMA will produce, amongst other things, a picture which is essentially that of serotonin syndrome. There appear to have been one or two cases where people taking moclobemide have had very severe reactions and I know of one death from cerebral infarction secondary to arterial spasm; although no cases have been reported so far in the literature. This fits with monoamine oxidase having a major role in breaking down endogenous serotonin. It also seems clear that selective serotonin reuptake inhibitors inhibit MDMA action suggesting that it utilises the reuptake mechanism in order to exert its action inside the presynaptic nerve. Which means that as MDMA has serotonin re-uptake properties, and we know that moclobemide with SSRI's has caused fatalities, that MDMA with moclobemide may also be very dangerous.
 
Regulator, I am sorry to hear about your experience, and I hope that you don't again go through such a trip.
Murple -- I am truly SHOCKED after reading some of your (extremely harm minimization oriented) comments in other posts, that you would endorse the combo of ANY MAOI with MDMA or another strong serotonin agonist. I strongly disagree with your statements that combining a MAOI type A with MDMA is not dangerous.
I agree with babydoc_vic -- Regulator sounds very much like he had serotonin syndrome. I have had it myself on one ocassion and it was similar, though I did not freak out as I immediately recognized what it was and it was mild enough that I did not need to seek medical help.
My comment from another thread on this topic:
Pinger said:
------------------------------------------------------------------------
This is an example of drug knowledge gone mad- intentionally combining two chemicals you know are seriously contra-indicated.
Please people- do not chase this high.
------------------------------------------------------------------------
I could not have said it better myself. The combo of a MAOI (in ANY DOSE, whether irreversible or not) and MDMA is one of the MOST DANGEROUS drug combination that I could possibly imagine. Furthermore, combining the two drugs almost definitely increases the neurotoxicity dramatically.
The 'high' from MDMA is ALREADY a very intense, euphoric high. For those considering this combo, ask yourself, do you REALLY NEED to get THAT 'fucked up'? The risk with this combination is JUST TOO GREAT. I estimate a 50% chance, if not more, of serious complications from combining these two drugs. That's like flipping a coin. PLEASE don't take these kinds of risks with your life.
Realize also that if you take this combo and go to the ER, or worse, DIE, that this will have dramatic consequences on the use and availability of MDMA and of moclobemide/MAOIs. The law/gov't will crack down on MDMA even harder and MAOIs could be illegalized, or at least heavily withdrawn from prescription (meaning that sick people who actually NEED MAOIs might not be able to get them). Thus, if you try this combo, and you fuck up, you are going to fuck it up for everyone.
PLEASE PLEASE PLEASE think about what I and other concerned people have said. I cannot emphasize the seriousness of this matter enough.
 
I certainly am not endorsing or recommending mixing MDMA with MAOIs... however, I personally have mixed MDMA with harmala alkaloids, as have other people I know. There were no negative effects whatsoever, and no hints of anything disturbing. The experiences were all quite positive. Not only did it strengthen the experience, but it added a strongly mystical dimension to the experience. Its a very strongly psychedelic experience.
As for the safety of this practice... well, I know of no real studies to establish its safety (or danger). The possibility of real danger therefore can not be ruled out. Also, it must be remembered that the MAOI will potentiate the MDMA and therefore lower the overdose (or serotonin syndrome, I suppose) threshold for the MDMA. However, to my knowledge there have been no deaths from mixing MDMA with harmala alkaloids, nor have I heard of any confirmed deaths involving MDMA taken with any MAOIs. I know of a few hospital trips involving MAO-B inhibitors and MDMA that resulted in frightened patients and doctors, but even in those cases the victims recovered on their own. As for MAO-A inhibitors, I'm not convinced that they are likely to be dangerous with MDMA (other than the lowered overdose threshold). However, as I said, this isn't really well explored territory, so its not something I'd recommend to most people. Also, its quite intense mentally and not really suited for the recreational purposes many people use MDMA for.
That said, my experiences were positive, and I wouldn't rule out mixing MDMA and harmala alkaloids again. Don't take this as an endorsement though. Its not necessarily a fun experience (freaking out is definately possible owing to the intensity of the trip). Its also not guaranteed safe. While my understanding of theory makes me believe reasonable doses of these combos are probably safe, this is just a theory, and its possible that I'm wrong. Consider this a "research combo" and if you are thinking of mixing MDMA and MAOIs, be aware that you are venturing into pretty uncharted territory.
 
I must say Murple, I am SHOCKED by your hypocrisy. How can you urge fairnymph against IVing a small dose of AMT and working up in small increments when you do something as foolhardy as combining MAOIs and MDMA? That said, I am intrigued by the possibility of a "hardcore psychedelic trip" from MDMA + harmine/harmaline. What are the dosages of each drug that you take? Are they anything similar to the reported doses (on here, erowid, lycaeum, etc) that caused hypertensive situations? I HIGHLY doubt that these people were just imagining their symptoms because they were tripping so hard.
---5HT-2
 
Well, injecting AMT is a bad idea for the reasons I've gone over in that thread. Taking MDMA with an MAO-A inhibitor, however, is not something I think is particularly more dangerous than taking MDMA alone. I don't see any hypocrisy. This community badly needs to learn some basic risk evaluation.
 
Just to make it clear Murple - From my reported experience and your own experiences with this combo, why do you think I went to the ER? A simple freak out from the intensity of the trip? or was it SS or some another physical condition?
Thanks in advance...
 
Originally posted by Murple:
Well, injecting AMT is a bad idea for the reasons I've gone over in that thread.
I also think injecting AMT is a bad idea and I would never do it to myself. Nonetheless, I do not think injecting 5 mg AMT, or less, as a first-time dose is "particularly more dangerous" than eating a first-time dose of 40 mg AMT, as I did. Usually the oral:nasal:injected conversion is about 4:2:1, so 5 mg would theoretically be equal to only 20 mg AMT.
Taking MDMA with an MAO-A inhibitor, however, is not something I think is particularly more dangerous than taking MDMA alone.
I'm sorry, but your arguments to support this HYPOTHESIS fall far short of convincing, especially in light of the reports of hypertensive crises. I really don't believe that those people were just imagining their symptoms because they were tripping too hard.
I don't see any hypocrisy. This community badly needs to learn some basic risk evaluation.
In your personal case, the risk evaluation is obvious. You have combined MDMA and MAO-I-A's a number of times with no ill effect, but you have never injected AMT. However, for those of us who have done neither, they are both equally risky. In both cases, I believe the risk is the same one of a hypertensive crisis.
---5HT-2
 
> Usually the oral:nasal:injected conversion is about 4:2:1, so
> 5 mg would theoretically be equal to only 20 mg AMT.
Uhh... what?!?!?! Those numbers come from some guy's trip report for some other drug, and there is certainly no scientific basis for such a ratio, not even as a theory... and even if there were it would not apply equally to every drug.
> I'm sorry, but your arguments to support this HYPOTHESIS
> fall far short of convincing, especially in light of the reports
> of hypertensive crises.
Err... I don't think its really on me to support anything here. The hypothesis in need of support is that there's something intrinsically dangerous about mixing MDMA with MAO-A inhibitors. Where's the evidence?You mention reports of hypertensive crisis... where? The only such report I know of involves MAO-B inhibitors. I've seen reports of freak-outs from MDMA with MAO-A inhibitors... a few incidents that could be MDMA overdoses (remember, the MAOI will potentiate MDMA. You can overdose on MDMA. If you potentiate it, you lower the overdose threshold. This is a real but unconnected risk that I'll go into next.) On a theoretical basis, I don't see how MAO-A inhibitors would cause any dangers such as the hypertensive crises you can get with MAO-B inhibitors.
There is one risk wth MAO-A inhibitors and MDMA, which I've mentioned before. MDMA can be dangerous in overdose. If you take enough MDMA you will have problems, and if you take enough, they could be things like stroke, cardiac arrest, serotonin syndrome, etc. If you potentiate MDMA, that means you're making it more potent. Taking MDMA with an MAO-A inhibitor produces results similar to taking a higher dose of MDMA without an MAOI (though if you use something like harmine for an MAOI, that has mild psychedelic effects of its own, so that will somewhat modify the effects in addition to making them stronger). Since you are in effect multiplying your dose, this lowers the threshold level where problems begin to occur. The problems are identical in nature to the problems you'd get with a larger dose of MDMA and no MAOI. They are not really qualitatively different, its just that they happen with fewer milligrams of MDMA.
If you take the proper dose of MDMA with the proper dose of harmine or whatever, you will not have a hypertensive crisis (do you know what that is and how MAOIs cause them?). It just doesn't work that way. There's no inherent danger that I know of resulting from interaction between MDMA and MAO-A inhibitors.
 
Wow. Very scary experience. Thanks for sharinf with us. And remember kids, Harm Minimisation is NO JOKE. Take this shit seriously.
 
Murple - This may prove impossible to answer, but If I took a 100mg MDMA pill while on a steady dose of moclobomide, what do you think the the MDMA dose would be equilivalent to (just a ballpark figure)?
e.g. MAO + MDMA = MDMA * 10
 
Originally posted by *=Regulator=*:

I cannot put into words how [qb] FUCKED
I was when I was experiencing the peak effects, it was so so incredibly intense. I could describe it as at first, hanging on for dear life (sanity) with every ounce of resolve I had, and then being thrown off the edge and completely losing it. [/QB]
this is EXACTLY how i felt as i succumbed to the power of a (good) DXM trip.. clinging on and then being torn away from sanity. are you certain the pill was actually mdma?
 
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