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[*] WARNING! - Aurorix/Moclobemide and MDMA - aka "Perma-roll"

B

BigTrancer

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WARNING: Aurorix/Moclobemide and MDMA - aka "Perma-roll"

WARNING to users of MDMA:

It has been brought to my attention that currently in Melbourne there is at least one person, or group of people, selling tablets of Aurorix (150mg or 300mg doses of Moclobemide).

IDENTIFICATION:

Aurorix 150 mg - pale yellow, oval, cylindrical, biconvex, scored tablet, imprinted "ROCHE 150".

Aurorix 300 mg - white to yellowish white, oval, cylindrical, biconvex, scored tablet, imprinted "ROCHE 300".

These tablets are being sold with the purpose of being taken with MDMA to "increase the peak". This is extremely hazardous practice, and I would strongly recommend against taking Aurorix and MDMA in synergy for the following reason:

Aurorix acts a MonoAmine Oxidase Inhibitor.

Strictly speaking, Aurorix - or rather its active ingredient moclobemide - is an antidepressant that affects the monoaminergic cerebral neurotransmitter system as a reversible inhibitor of monoamine oxidase of type A (RIMA). The metabolism of dopamine, norepinephrine and serotonin is decreased by this effect, and this leads to increased extracellular concentrations of these neuroaltransmitters.

From Aurorix information:
In patients receiving moclobemide, the additional use of other drugs that enhance serotonin, such as many other antidepressants, particularly in multiple drug combinations, should be done with caution. This is particularly true for clomipramine.

Hyperthermia, confusion, hyperflexia and myoclonus, which are indicative of serotonergic overactivity, may occur with this combination. Should such combined symptoms occur, the patient should be closely observed by a physician (if necessary hospitalised) and appropriate treatment given.

Moclobemide should not be co-administered with serotonin (5-HT) re-uptake inhibitors (including those which are tricyclic antidepressants, e.g. clomipramine). After stopping treatment with 5-HT re-uptake inhibitors a time period equal to 4 - 5 half-life of the agent or active metabolite should elapse between stopping therapy and starting therapy with moclobemide.
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What this basically boils down to is that the risk of (the potentially fatal) serotonin syndrome is markedly increase with the use of Aurorix - to combine the use of Aurorix with MDMA could undoubtedly increase the peak intensity, however the risk of serotonin syndrome is far too great to accept this as a method of potentiating MDMA effects.

Also avoid taking in combination with SSRI antidepressants or tricyclic antidepressants.

Here is a post from the Australia/Asia/NZ/Middle East Drug Discussion Archive detailing what is IMHO a case of typical non-fatal serotonin syndrome effects related directly to the combination of Aurorix and MDMA: Aurorix & E....WARNING!!

Another post, more recently added to Health Q&A Forum details an experience of serotonin syndrome related directly to the combination of Aurorix and MDMA, and follows on to the longer term effects: Did serotonin syndrome permanently ruin my brain? - update

Continuing the discussion of contraindications:
Cases of severe central nervous system adverse reactions have been reported after co-administration of moclobemide and dextromethorphan [DXM - BT]. Since cough and cold medicines may contain dextromethorphan, they should not be taken without prior consultation with the physician, such that non-dextromethorphan-containing alternatives may be given.
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This means that you shouldn't take Aurorix with DXM either, because doing so increases the risk of severe negative side-effects. DXM is also contraindicated with MAOIs because, once again, combining these drugs brings a massively increased risk of serotonin syndrome.

Please note: Mixed overdoses with moclobemide (e.g. with other CNS-acting drugs) could be life-threatening. Therefore, patients should be hospitalised and closely monitored so that appropriate treatment may be given. Do not be afraid to call an ambulance and tell the paramedics exactly what the person has ingested.

If you choose to blatantly ignore the above advice, and take it upon yourself to experiment with combinations of MDMA and MAOI, please take absolute minimum doses (ie. less than half of a 300mg Aurorix, less than half of a MDMA pill), avoid redosing if you aren't satisfied with the effect, and have a SOBER friend present who is prepared to call an ambulance immediately you notice the slightest difficulty. Often MDMA pills seem to have a large 'safety margin' but this is effectively removed when taken in synergy with MAOIs, making the chance for causing yourself harm far greater.

BigTrancer :)

[Edit: Changed title to include the street term "perma-roll" (29-10-03). Evidently this potentially fatal combination is becoming more popular lately in Melbourne, this warning needs to be spread as much as we can. BT]
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In short: do it and the risk of serious harm is quite high...
Cheers BT! Excelent post! :)
Now, go get some ice on those fingers... ;)
[ 01 May 2002: Message edited by: Pleonastic ]
 
Nice one BT.
These idiots selling Aurorix obviously have not done their homework, or have no regard for what happens to their 'punters'.
Anyone selling Aurorix to be used in conjunction with MDMA needs to be strapped to a ceiling, just above a fan, so we can let their balls hang down and be pummelled by the fan when it is switched on.
F...
 
Nice work BT. I want to emphasise the point I made in the trip report, about why the poster (Regulator) suffered serotonin syndrome while another BL'er Dracon didn't.
Serotonin syndrome is an idiosyncratic reaction, meaning it won't effect everyone who combines moclobemide and MDMA. Nor will it effect everyone who takes SSRI's (another group of people who commonly get SS). But there is no way of knowing whether you will be the unlucky person, or if you'll get away with it. Regulator did a marvellous job of describing the complete terror he suffered as a result of SS, which in his case was the result of his Dr not warning him about the combo.
Serotonin syndrome kills people in an extremely unpleasant manner. Signs of SS are euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, mental status changes were frequent (including confusion and hypomania - a "happy drunk" state), shivering, diarrhea, loss of consciousness and death. (The Serotonin Syndrome, AM J PSYCHIATRY, June 1991). You die either from muscle breakdown (rhabdomyolysis), a blood clotting disorder called disseminated intravascular coagulation or organ failure.
I would suggest people avoid this combo altogether, but if you choose to take the risk, I would say take no more than 75mg of moclobemide (1/2 a 150mg tablet) and no more than half a pill of MD**. If problems arise, get straight to hospital and tell them what you took so a serotonin antagonist called cyproheptadine can be given promptly.
Anyone selling Aurorix or the cheaper brand Arima (which only comes in 150mg tabs, also buff colour) without strict warnings about the potential risks should be given a swift knee to the groin on my behalf. Thank you
 
I have had friends that have done it an recommended to me as well. I have never touched the stuff, it sounded too risky. Particularly well they talked about the increased effects. But, what they did tell me is how long it took them to come down. They said their come downs took longer than a week (when normally they'd be chatty within 24 hours).
They said that Aurorix is a reversable MAOI, which apparently meant it was safe. But it seems it is safe in it's own right only. Sometimes I am really glad I am not too experimental.
Thanks heaps Bluelight.
 
Raving Loony: that's a good point. The REVERSIBLE bit means its safer in general than the older type of MAOI drugs, which were irreversible. This meant after taking a MAOI it was 2 weeks before the MAO enzyme was restored to normal levels. After taking moclobemide, it takes 24-48 hours for MAO to be restored (=reversible). So, yes moclobemide is safer than a true MAOI, but overall still very dangerous with e.
 
Given that there are many in the 'scene' that do things that are a very bad idea already (rolling a few nights in a row, combining chems etc etc), I would presume that there will still be those who will still give this combination a try.
Is there anything that can be done to reduce the risk of damage when these two are combined ?? eg taking 5htp midway through a roll??
 
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Most of these e + aurorix combination reports seem to be from those who have been taking aurorix as medication (I assume daily). So the experiences from those who take 1 aurorix pill with 1 MDxx pill are not going to be in the same order of intensity.
I might also add, if you do try it. Do not try it in the club, rather try it in the safety of a friendly household. Have emergency numbers listed nearby as well. Also expect your comedown to take forever and nasty.
 
Raving Loony: Wrong. The intensity is there like a sledgehammer whether you take them everyday or once.
 
I remember someone shoing me a bag of prescricption drugs at EC that may have been these. The person in question was selling them but asking what the hell they where. Anyway good to know.
 
Soma, that goes against what I was told. I'll have to go back to source (a non-BL'er) and re-clarify what I was told. I have had friends do this combination for quite a few months now and have looked into it a bit.
Will a person who uses a pill-testing kit be able to tell if a suspect pill contains aurorix?
 
No idea about the kit. Very unlikely people are going to readymix the two together.
There are a few factors that contribute to seratonin syndrome, susceptability can be one of them. Because it may not have happened to your friends, does not mean it is less likely to happen to someone else.
I've had first hand experience of mixing these two, it is quite overpowering.
 
Having tried even a low dose combination of Moclobemide and E even after being aware of the consequences I have to admit it was worth it.
I was one of the lucky ones who played russion roulette and won. Fortunatly I measured my timing and dose based on half-life of both substances. I was incredibly high for about 5 hours, I suspect however that the reason I came down was due to the sensitivity downgrading of certain 5-HT receptors. Unfortunatly no ammount of 5-HTP helped lessen the dark effects that were present for over a month afterwards. One week after the dose I had intense suicidal thoughts, I however could not find any reason in my life to act on these thoughts.
If you don't take the low seriously? Should you take the high seriously? Hmmmm.
I just wanted to post my honest opinion. What I did was reckless, however where do you draw the line at being wreckless. Even if I had educated myself on the interaction, was it still irresponsible?
If you do it, it is your choice. I however do not advocate what I did and recommend you not to do it. However the decision you make as to what you do with your body is yours and only yours to make.
Peace,
 
As a user of both (for sometime) I can testify that this is a VERY high risk area. I've never experienced any negative effects BUT the risk is so high that I've desided not to combine the two anymore - I was is pushing my luck - it might run out...
A lot of people I know where really F&^cked when they took the combo and said after it it was a once off for them.
The only problem now is that I will obviously increase my intake of MDMA and maybe combine it with Acid and coke (leaser of 2 evils?)
Know the facts - if you play with fire you can get hurt...
 
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.
 
banana_man said:
Is there anything that can be done to reduce the risk of damage when these two are combined ?? eg taking 5htp midway through a roll?? Taking 5htp in the middle would be about the worst thing you could do. The issue here is that moclobemide will stop the serotonin that gets released by MDMA from being degraded. If you add 5htp to that, theroretically you just increase the risk of serotonin syndrome.
Raving Loony: a moclobemide pill is long and oval shaped - see BT's post for a description of the stamp. I can't imagine anyone would try to sell these as e, as on there own they won't have an effect. But then people do some stupid things.
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thanks BT. ive been pres. Zyban to help give up smoking. each contains 150mg Bupropion hydrochloride x 2 a day. anybody heard of any probs droppin e while on these? Doc said they are antidepresants and release serotonin.
 
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