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Combinations - Ecstasy and SSRIS

Discussion in 'Drug combinations' started by bendacorna, Jul 10, 2008.

  1. bendacorna

    bendacorna Newbie

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    Okay, I'm new to this whole subculture so to all. Hello. I thought about joining for general purposes, but I actually signed up today to find out something that's making me wonder, which is...

    I used to take a lot of ecstasy. I'd say two pills every week for about a year. I have been off the stuff for about a year now as well. Thing is, I'm wondering if it is the right move to make by now taking prozac. I know they do the same thing in the serotonin department, and my brain is still working on recovering from the abuse of E. Would it be helpful, harmful, and would it even matter at all to start taking prozac now?
     
  2. Bricker

    Bricker

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    Swim had been a regular user of MDMA (and other psychedelics) for almost 20 years. A couple of years back swim ended up with some non-drug related depression and anxiety. He was upfront with his physcian about previous drug use and both agreed that it would be helpful to begin taking SSRIs. Swim went through 4 different brands of SSRIs before he found one that worked with his body. Since going on the the SSRIs he has done MDMA and Mescaline each once. He had no side effects other than the MDMA not being near as intense and lasting a much shorter duration. SWIM strongly recomends that people not mix alcohol with SSRIs. He hasn't drank in 9 months and feels that this has had a huge impact in the overall effectiveness of the Meds he is prescibed. SWIM says he is currently taking 40 mg Citalopram with no annoying side effects. Sleeps well, no sexual side effects etc.
     
  3. drug-bot

    drug-bot

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    mixing the 2 could potentially cause a potentially life threatening condition known as syrotonin syndrom (google it), its not very common but its a real possibility, its like playing w/ fire, swim would advise against mixing the 2.
     
  4. Bricker

    Bricker

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    Swim would respectfully disagree with that assertion. After talking with his psychiatrist at length on the subject she never mentioned a safety issue. She did mention that the fact that he was on an SSRI indicated that he was depressed and that a depressed person shouldn't be fucking with drugs.

    There are many links that support what I previously stated. A google search of ecstacy and ssris pulls alot of good information without suggesting a seratonin syndrome reaction occurring from the use of the two drugs.
     
  5. drug-bot

    drug-bot

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    you have no idea what your talking about, and stop spreading dangerous mis-information, just because you personally didnt experience it doesnt mean others wont!!!
    http://en.wikipedia.org/wiki/Serotonin_syndrome

    http://www.mdma.net/serotonin-syndrome/index.html
    http://www.nlm.nih.gov/medlineplus/ency/article/007272.htm
    http://www.goaskalice.columbia.edu/0202.html
    ^go ask alice is a program Columbia University started, so dont look down on it because of its name.

    there are many, many more reputable links i could add, but i hope you get the jest mdma and ssri's arent safe when used in conjenction. just because everyone who mixes the 2 doesnt develope it doesnt mean many other people could and have.

    i have no idea what search criteria you used on google (if you actualy did) but the overwhelming consensces amoung wikipedia, university sites, goverment health sites, and even sites dedicated to mdma (which view the drug positivly) all acknoledge the risk of mixing mdma and ssri's. may i suggest your psychitrist didnt know what he was talking about.

    may i also say if you felt snything i posted as offensive, i didnt mesn it as a personal attack against you, only an attack on the issue.
    -peace
     
    Last edited: Oct 25, 2008
  6. Bricker

    Bricker

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    I don't think you need to go and say that I don't know what I'm talking about. We haven't even formally met nor do you know anything about my background, educational level or anything else. So please don't flame.

    Thanks by the way for posting the links. However, I still don't see anything in your links that says SSRI+MDMA = seratonin syndrome.


    Here is a post from Drug Dustbin off of bluelight that is very helpful and very much coincides with what my doctor was saying.

    >SSRI's work by stopping the seratonin reuptake in the brain.
    SSRIs will prolong the effects of transmitter in synaptic cleft by interfering with
    the transporter protein. They doesn't completely block reuptake.
    >The idea is for those that are depressed is that by reducing the amount of seratonin
    >reabsorbed back into one's neurochemical system (and thereby increasing the amount of
    >seratonin present), an increased amount of seratonin will help people feel better
    >(With the help of therapy, of course. Very rarely will SSRI's work without the will
    >and help of both the user and his/her doctor.)
    Antidepressants require on average couple of weeks to exert an effect, so the
    increased synaptic serotonin can't explain solely their antidepressive effects.
    It has been suggested that the antidepressive effects are due to decreased responsiveness
    of somatodendritic 5-HT1A autoreceptors and decreased function of terminal 5-HT
    autoreceptors. So, whatever it is, it's most likely due to adaptive changes.
    >Okay, now for the role of Ecstasy. Ecstasy works by flooding the synapse in the brain
    >with seratonin. (again, as we all know.) Because Ecstasy uses the actual reuptake
    >transporter mechanism to cause seratonin release, obviously any sort of chemical
    >(Like an SSRI) blocking that mechanism (Which SSRI's do,) with a higher affinity
    >for it (Like Ecstasy) will severely reduce or completely eliminate the affects of the
    >Ecstasy.
    You must remember that the biochemical interactions between the receptor and the
    substrate(s) are concentration-dependent (in the case of competitive substrates).
    In _In vitro_ test MDMA can displace paroxetine from its binding sites.
    >Ecstasy (beyond the threshold dose of ~40-60mg) without the presence of SSRI's
    >generally drains a large amount of the brain's seratonin for 12-24 hours, and the brain
    >has generally not reached full seratonin levels for up to a week afterwards.
    Please, give me some journal references about this serotonin draining in humans.
    There is one new study about chronic MDMA use on striatal serotonin levels, but
    I haven't been able to read that study yet, and I assume you neither have read it.
    I'll include the abstarct here:
    "The authors found that striatal levels of serotonin and those of its metabolite
    5-hydroxyindoleacetic acid were severely depleted by 50 to 80% in brain of a chronic
    user of methylenedioxymethamphetamine (MDMA) whereas concentrations of dopamine were
    within the normal control range. Our data suggest that MDMA exposure in the human can
    cause decreased tissue stores of serotonin and therefore some of the behavioral effects
    of this drug of abuse could be caused by massive release and depletion of brain serotonin".
    >SSRI's "downregulate" (inhibit the efficiency & the ability) of seratonin reuptake
    >transporters. This means SSRI's affect your brain's seratonin system in a negative
    >way as well as a positive way; the idea is that the positive effects outweigh the
    >negative i.e. higher seratonin levels outweight the fact that your brain isn't using
    >it as efficiently. Basically this means that even for MONTHS after one quits taking an
    >SSRI, the brain is less efficient at using seratonin. Those who go off SSRI's and take
    >E, even MONTHS later, will most likely have a REDUCED roll, regardless of the amount of
    >E you take.
    There is some evidence that serotonin transporter (SERT) binding is decreased
    in some brain regions in animals treated continuously with SSRIs. I would like to see
    some references about the long-term effects of SSRIs on SERT function. Do you have
    them? It is interesting to notice, that according to one recent study, the SERT
    and DAT binding is significantly increased in acutely absistent cocaine-dependent
    patients, suggesting compensatory up-regulation of SERT and DAT (dopamine transporter).
    You said, "the fact that your brain isn't using it [serotonin] as efficiently".
    Can you clarify this comment?
    And get the latest issue of Neuropsychobiology, it's dedicated to MDMA. It contains
    lots of interesting topics.
     
  7. chillinwill

    chillinwill

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    so you trust another post on another drug forum verse lots of other articles, especially medical ones? doesn't make sense to me but then again, what do I know
     
  8. Bricker

    Bricker

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    Chillinwill, please allow swim to clarify. Swim doesn't place credence in the quoted post over anything that drug-bot posted. In fact, swim concurs with drug-bot that the two substances pose a risk. In fact swim believes that there are risks associated with using either drug by itself. Swim just doesn't see where MDMA + SSRIs lead to serotonin syndrome.
    Swim merely mentioned that article because it coincided with the discussions that swims psychiatrist and him had had and it directly correlated with his experience in using the two substances together. ie diminished mdma effects. Swim was always up front with his doctor about past and present substance use and abuse and she was always up front about the consequence of his choices. Swim would also like to say that she was very knowledgeable in respect to the licit and illicit substances that were in his diet at the time. Swim would trust her professional opinion over anything on a forum.
    Swim feels that if a person were to look at world wide mdma consumption and worldwide SSRI consumption and then look at the population that are using the two together that seratonin syndrome would be no greater in the third group than in the two previous groups. Unfortunately it would be hard to do because people who use mdma also tend to use other club drugs. But that is an opinion and only an opinion.
    Here is another excerpt from the MDMA site that drug-bot mentioned. This is under the heading
    MDMA: neuroprotection
    Some studies suggest that possible MDMA-induced neurotoxicity to the serotonin system can be largely prevented by taking a double dose of fluoxetine (Prozac) or another SSRI shortly after starting to "come down". Post-E Prozac in particular mitigates the oxidative stress and consequent risk of serotonergic axon damage caused by reactive products of dopamine deamination. The long-acting SSRI Prozac/fluoxetine, and it's even longer-acting metabolite norfluoxetine, apparently prevents the uptake of dopamine (and any toxic metabolite(s)?) into the serotonergic nerve terminals by binding to the serotonin reuptake transporter with higher affinity than MDMA or serotonin. Unfortunately, although liquid refreshment is now freely available at most MDMA-propelled raves, most chill-out rooms don't offer Prozac. Two days and more after taking MDMA, heavy recreational users are typically more irritable, subdued, unsociable and subtly less empathetic than before their weekend binge: the "Terrible Tuesday's" syndrome of midweek blues. So with cruel irony, two or three days after communing on Ecstasy and declaring their undying love, couples are more likely to have rows and split up. Other heavy regular MDMA users, even those who aren't self-medicating for a pre-existing malaise may experience depression, anxiety, emotional burnout, rejection-sensitivity, fatigue, insomnia, aching limbs, subtle cognitive deficits, immune system dysfunction, body temperature dysregulation, and a sense of derealisation or depersonalisation for several weeks or months afterwards. This litany of woe sounds a high price to pay even for the peak experience of a lifetime.
    Alas, adopting a prophylactic SSRI regimen isn't a realistic long-term option for frequent MDMA users either, or at least not if they intend to continue using their hugdrug of choice. This is because a sustained regimen of SSRIs largely blunts MDMA's empathogenic and entactogenic effects. SSRIs inhibit the binding of MDMA to the serotonin transporter. Thus pre-treatment with SSRIs prevents MDMA-triggered serotonin-release; and this in turn reduces dopamine-release in the striatum. Some SSRI users who like to rave nonetheless continue to take MDMA. They consume abnormally high quantities of pills to gain the desired E-like effect. At this dosage range, the persistence of metabolite-induced MDA-like states of consciousness the next day is not unexpected. In practice, the after-effects are often modulated by cannabis and alcohol.
    Tolerance to MDMA itself develops quite rapidly with steady use. If MDMA is taken several days in a row, amphetamine-like and eventually dysphoric effects start to predominate. Monoamine neurotransmitters, most drastically serotonin, are depleted from the axon terminals; serotonin synthesis is choked off following oxidative inactivation of tryptophan hydroxylase; and the nerve-cell receptors re-regulate. Thus MDMA is not addictive in the conventional sense. Taken chronically, it soon ceases to be rewarding. Even dedicated ravers typically don't binge more than once a week. Wiser heads save the drug for "special occasions". Yet MDMA's non-addictive profile is no guarantee that (as was once fondly hoped), "once you get the message you hang up the phone." The mind/brain isn't built like that. If you really like a drug-delivered message, you want to hear it again and again. But with MDMA, the message can subtly change with time; and its primal magic gets sullied or forgotten.

    As a final statement, swim believes that moderation, especially with mdma and other club drugs, is the key.

    I did forget to add that the reason that I even mentioned swim taking mdma while on his ssri was to reinforce the fact that his physician was aware of his past and present albeit occasional drug/mdma use and she felt like his being on an ssri was the right thing for him at the moment. Swim also believes that bendacorna should be frank with his/her physician to determine what is best for them.

     
    Last edited: Oct 25, 2008
  9. e4rolls

    e4rolls

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    SWIM has been on SSRI's for a long time and has used ecstacy many times in combination with SSRI's without experiencing serotonin syndrome. SWIM knows that SSRI's block reuptake of serotonin which also inhibits the MDMA molecule from entering the neuron. This greatly reduces the MDMA's effect on serotonin. SWIM needed many times more of the MDMA to feel the desired effects.
    It's funny that SWIY list information but don't fully comprehend that SSRI's block MDMA from releasing large amounts of serotonin into the synapse. It has also been said that SSRI's lessen neurotoxicity of MDMA on the brain.

    The time course of damaging events in rats can be seen by administering SSRIs, such as fluoxetine and citalopram, after MDMA. Pretreatment with fluoxetine (Prozac) or citalopram (Celexa) has been shown to block the neurotoxicity of MDMA (Battaglia, 1988; Schmidt 1987; 1990; Shankaran, 1999a), probably by blocking interactions of MDMA with SERT. More interestingly, fluoxetine remains almost fully protective if given 3 or 4 hours after MDMA. By 4 hours, most of the MDMA-induced release of 5-HT and DA has already occurred (Gough, 1991; Hiramatsu, 1990) and increases in extracellular free radicals (Colado, 1997b; Shankaran, 1999a) and lipid peroxidation (the alteration of fat molecules by free radicals) (Colado, 1997a) can be measured. Nevertheless, the administration of fluoxetine at this point decreases subsequent extracellular oxidative stress (Shankaran, 1999a) and long-term 5-HT depletions (Schmidt, 1987; Shankaran, 1999a). Fluoxetine will still be partially protective if given 6 hours after MDMA but has no protective effect 12 hours after administration (Schmidt, 1987). This shows that neurotoxic MDMA regimens initiate a series of events that become increasingly damaging between 3 and 12 hours after drug administration in rats.

    SWIM believes MDMA and SSRI's are safe together but someone who is on an anti-depressant is unstable and should'nt be useing MDMA in the first place.
    SWIM no longer uses MDMA because of the severe depression it caused him after use. :thumbsdown: