Psycho-Babble Medication Thread 17636

Shown: posts 1 to 17 of 17. This is the beginning of the thread.

 

ecstacy and ssri's

Posted by Greg on December 28, 1999, at 23:35:43


I couldn't bring up the reply to the previous thread on this topic, but I was wondering if it would be safe to use ecstacy while also taking an SSRI. Would it produce any sort of "seratonin syndrome" or serious side effects? Or would a person not feel any affect whatsoever because of the AD? Any knowledge or experiences on this topic would be greatly appreciated.

greg

 

Re: ecstacy and ssri's

Posted by Cindy W on December 29, 1999, at 11:10:02

In reply to ecstacy and ssri's, posted by Greg on December 28, 1999, at 23:35:43

>
> I couldn't bring up the reply to the previous thread on this topic, but I was wondering if it would be safe to use ecstacy while also taking an SSRI. Would it produce any sort of "seratonin syndrome" or serious side effects? Or would a person not feel any affect whatsoever because of the AD? Any knowledge or experiences on this topic would be greatly appreciated.
>
> greg

Greg, I would be very cautious if I were you, combining drugs. In addition to possible drug interactions, I would worry that continued use of drugs to artificially heighten your mood would exacerbate your depression by a contrast effect (when the drug wears off, you will likely be more depressed than you started). I hope this doesn't sound "preachy," but just is something to ponder.--Cindy W

 

Re: ecstacy and ssri's and an answer

Posted by The DEA (we're here to help) on December 30, 1999, at 1:26:18

In reply to Re: ecstacy and ssri's, posted by Cindy W on December 29, 1999, at 11:10:02

Just for informational purposes...
(Can't speak to credability of this source)

see:
http://ecstasy.org/qanda/q70.html
http://ecstasy.org/qanda/q46.html
http://ecstasy.org/qanda/index.html (overall list)

> I would worry that continued use of drugs to artificially heighten your mood would exacerbate your depression by a contrast effect (when the drug wears off, you will likely be more depressed than you started). I hope this doesn't sound "preachy," but just is something to ponder.

Cindy, that's a rational concern but also does sound moralistic. We don't know that Greg is referring to 'continual use' or what 'continual' means (and one would become tolerant to frequent use), nor do we know that it would be used specifically to modify mood -- as an 'antidepressant.' Further your warning could apply to clinical antidepressants themselves.

I was just waiting to see a response of pop morality appear absent an answer to one of these questions.

Well, better get back to frying some eggs...

 

Re: ecstacy and ssri's and an answer

Posted by Bruce on December 30, 1999, at 7:39:15

In reply to Re: ecstacy and ssri's and an answer, posted by The DEA (we're here to help) on December 30, 1999, at 1:26:18

> Just for informational purposes...
> (Can't speak to credability of this source)
>
> see:
> http://ecstasy.org/qanda/q70.html
> http://ecstasy.org/qanda/q46.html
> http://ecstasy.org/qanda/index.html (overall list)
>
> > I would worry that continued use of drugs to artificially heighten your mood would exacerbate your depression by a contrast effect (when the drug wears off, you will likely be more depressed than you started). I hope this doesn't sound "preachy," but just is something to ponder.
>
> Cindy, that's a rational concern but also does sound moralistic. We don't know that Greg is referring to 'continual use' or what 'continual' means (and one would become tolerant to frequent use), nor do we know that it would be used specifically to modify mood -- as an 'antidepressant.' Further your warning could apply to clinical antidepressants themselves.
>
> I was just waiting to see a response of pop morality appear absent an answer to one of these questions.
>
> Well, better get back to frying some eggs...


Hmmm..... I'll take a stab at a rational answer. Ecstasy depletes the synaptic vesicles of serotonin. SSRI's prevent the reuptake of serotonin. Sounds like a perfect combination for the serotonin syndrome.

Of course, I could be moralistic here. Perhaps Greg is *seeking* the serotonin syndrome. He is welcome to do anything he wants, as long as he accepts the consequences of his actions....

Bruce

Bruce

 

Re: ecstacy and ssri's

Posted by brian on December 30, 1999, at 8:50:27

In reply to ecstacy and ssri's, posted by Greg on December 28, 1999, at 23:35:43

sure there are going to be a few risks when you take illegal drugs but that is why they are illegal. Personally when I tried X and was on Paxil it almost completely negated its effects. From various sources I've found that you need to be off of the ssri for 5 or so days. You wont feel it as much as if you were not taking the medication but you will get the majority of the effects. Also I've read that you should take an ssri a few hours after rolling to help prevent some of the possible damaging side effects of X on the brain.

 

Re: ecstacy and ssri's and an answer

Posted by Cindy W on December 30, 1999, at 11:08:28

In reply to Re: ecstacy and ssri's and an answer, posted by The DEA (we're here to help) on December 30, 1999, at 1:26:18

> Just for informational purposes...
> (Can't speak to credability of this source)
>
> see:
> http://ecstasy.org/qanda/q70.html
> http://ecstasy.org/qanda/q46.html
> http://ecstasy.org/qanda/index.html (overall list)
>
> > I would worry that continued use of drugs to artificially heighten your mood would exacerbate your depression by a contrast effect (when the drug wears off, you will likely be more depressed than you started). I hope this doesn't sound "preachy," but just is something to ponder.
Hey, I'm not trying to be moralistic. Fry all the eggs you want. When I was 28 years younger, I did my share of experimenting and part of that was probably trying to "medicate" away my depression. Just be careful of serotonin syndrome, and best wishes.--Cindy W
> Cindy, that's a rational concern but also does sound moralistic. We don't know that Greg is referring to 'continual use' or what 'continual' means (and one would become tolerant to frequent use), nor do we know that it would be used specifically to modify mood -- as an 'antidepressant.' Further your warning could apply to clinical antidepressants themselves.
>
> I was just waiting to see a response of pop morality appear absent an answer to one of these questions.
>
> Well, better get back to frying some eggs...

 

drug sins and serotonin syndrome

Posted by Drug Czar on December 30, 1999, at 13:50:08

In reply to Re: ecstacy and ssri's and an answer, posted by Bruce on December 30, 1999, at 7:39:15


> Sounds like a perfect combination for the serotonin syndrome.
>
> Of course, I could be moralistic here. Perhaps Greg is *seeking* the serotonin syndrome. He is welcome to do anything he wants, as long as he accepts the consequences of his actions....


All I saw that Greg was *seeking* was information. Most of what he was offered was information he didn't ask for.

As for consequences, you are right that serotonin syndrome is a relative risk. But think about this before you respond next time...

1. Since he would discontinue the SSRI at least SEVERAL DAYS previous to doing MDMA, this should be no special risk -- unless you have new info on the half lives of SSRIs. It is like MDMA alone.

2. Any SSRI that might remain (very minimal) also inhibits entry of MDMA into the neuron, and interferes with its release of serotonin.

I find it curious you don't offer these warnings when people ask for information about SSRIs and MAOIs for example.

Here's some true/false statements for Cindy:
-- Marijuana causes aggression.
-- LSD causes chromosone damage.
-- This is your brain on drugs (eggs frying).
-- The ends justify the means.

The real danger of misinformation is that people learn to distrust the source -- in this case valid warnings also.

 

Re: drug sins and serotonin syndrome

Posted by Elizabeth on December 31, 1999, at 4:23:46

In reply to drug sins and serotonin syndrome, posted by Drug Czar on December 30, 1999, at 13:50:08

Hey guys, just from clinical experience it's *MAOIs*, not SSRIs, that can cause the central serotonin syndrome if you take MDMA with them!

> 1. Since he would discontinue the SSRI at least SEVERAL DAYS previous to doing MDMA, this should be no special risk -- unless you have new info on the half lives of SSRIs. It is like MDMA alone.

Actually this isn't true; while the SSRI goes away after a few days (exception: Prozac), it has longer-lasting effects that persist for a while after the drug is out of your system. Hence the lengthy wait between quitting an SSRI and starting an MAOI.

> 2. Any SSRI that might remain (very minimal) also inhibits entry of MDMA into the neuron, and interferes with its release of serotonin.

Yup, that's my understanding of why SSRIs tend to block the effect of MDMA.

> Here's some true/false statements for Cindy:
> -- Marijuana causes aggression.
> -- LSD causes chromosone damage.
> -- This is your brain on drugs (eggs frying).
> -- The ends justify the means.

Don't forget "post hoc ergo propter hoc." :)

> The real danger of misinformation is that people learn to distrust the source -- in this case valid warnings also.

"Wolf!"

 

Re: drug sins and serotonin syndrome

Posted by Bruce on December 31, 1999, at 19:47:52

In reply to drug sins and serotonin syndrome, posted by Drug Czar on December 30, 1999, at 13:50:08


> All I saw that Greg was *seeking* was information. Most of what he was offered was information he didn't ask for.
>
> As for consequences, you are right that serotonin syndrome is a relative risk. But think about this before you respond next time...
>
> 1. Since he would discontinue the SSRI at least SEVERAL DAYS previous to doing MDMA, this should be no special risk -- unless you have new info on the half lives of SSRIs. It is like MDMA alone.

Prozac's main metabolite (norfluoxetine, which is a potent SSRI) has a half-life of 9-14 days according to Lilly literature. Using the rule-of-thumb that one should wait 5 half-lives to ensure total elimination, Greg should wait , of, 5-6 weeks. With Zoloft it is 2 weeks. Etc.

>
> 2. Any SSRI that might remain (very minimal) also inhibits entry of MDMA into the neuron, and interferes with its release of serotonin.
>

The combo of MDMA & SSRI seems to be SSRI dependent. A quick literature search shows Proxac can (sometimes) potentiate MDMA effects, Zoloft negates it. But you are right, generally speaking, SSRi's do offer protection against Ecstasy. Or reduce its effects if protection is the wrong word.


> I find it curious you don't offer these warnings when people ask for information about SSRIs and MAOIs for example.

I haven't been asked. But if I were, I sure would offer the warning.

In general, this bulletin board is about depression, and the effectiveness of various palliative measures. As such, most people would, I think, naturally want to warn off someone like Greg from experimenting with MDMA. This warning results not from the prudish point of view, but from the standpoint of not further exacebating his depression (which is presumably why he is reading this BB in the first place). He wanted info on any dangers, he got info.

Bruce


>
> Here's some true/false statements for Cindy:
> -- Marijuana causes aggression.
> -- LSD causes chromosone damage.
> -- This is your brain on drugs (eggs frying).
> -- The ends justify the means.
>
> The real danger of misinformation is that people learn to distrust the source -- in this case valid warnings also.

 

bruce, sins and serotonin

Posted by Harry Anslinger on January 2, 2000, at 19:24:51

In reply to Re: drug sins and serotonin syndrome, posted by Bruce on December 31, 1999, at 19:47:52


> > All I saw that Greg was *seeking* was information. Most of what he was offered was information he didn't ask for.
> >
> > As for consequences, you are right that serotonin syndrome is a relative risk. But think about this before you respond next time...
> >
> > 1. Since he would discontinue the SSRI at least SEVERAL DAYS previous to doing MDMA, this should be no special risk -- unless you have new info on the half lives of SSRIs. It is like MDMA alone.
>
> Prozac's main metabolite (norfluoxetine, which is a potent SSRI) has a half-life of 9-14 days according to Lilly literature. Using the rule-of-thumb that one should wait 5 half-lives to ensure total elimination, Greg should wait , of, 5-6 weeks. With Zoloft it is 2 weeks. Etc.

Actually the washout recommendations refer to ongoing administration of another serotonergic drug. I assume Greg is *asking* about a single dose of MDMA.

However, if we talk about washout recommendations, you are correct about fluoxetine. But using the '5 half lives rule', the other SSRIs have a washout of 5-7 days. see: http://www.cma.ca/jpn/vol-23/issue-4/0264.htm


> > 2. Any SSRI that might remain (very minimal) also inhibits entry of MDMA into the neuron, and interferes with its release of serotonin.
>
> The combo of MDMA & SSRI seems to be SSRI dependent. A quick literature search shows Proxac can (sometimes) potentiate MDMA effects, Zoloft negates it. But you are right, generally speaking, SSRi's do offer protection against Ecstasy. Or reduce its effects if protection is the wrong word.

But interestingly, the SSRI can be taken 4-6 hours after the MDMA, thus permitting most of the MDMA experience but blocking much of the toxicity.

> > I find it curious you don't offer these warnings when people ask for information about SSRIs and MAOIs for example.
>
> I haven't been asked. But if I were, I sure would offer the warning.
>
> In general, this bulletin board is about depression, and the effectiveness of various palliative measures.

This bulletin board -- this site -- is oriented primarily to psychopharmacology. This includes but is not limited to depression and its treatment. Anxiety and attentional disorders are about as frequent topics as depression.


> As such, most people would, I think, naturally want to warn off someone like Greg from experimenting with MDMA.

Read Greg's message again. Where does he say he plans to take MDMA?


> This warning results not from the prudish point of view, but from the standpoint of not further exacebating his depression (which is presumably why he is reading this BB in the first place).

The purpose of this board is dialogue about issues in Psychiatry and Psychopharmacology.

I'd hoped we could just respond to his question directly with too presuming too much.

OK, ecstasy could reportedly exacerbate the condition he's taking the SSRI for. (Not necessarily depression.)

Ecstacy also reportedly has psycotherapeutic action and can foster beneficial personality changes.


> He wanted info on any dangers, he got info.

Many doctors have been well warned about the dangers of narcotics. Meanwhile patients in severe, chronic pain go undermedicated. Fears of addiction supercede appropriate analgesia in patients with terminal illnesses.

BTW, Dr. Peter Breggin wants people to have information too. Go take a look at www.breggin.com . This is what morality breeds...

 

Re: drug sins and serotonin syndrome

Posted by Harry Anslinger on January 2, 2000, at 19:44:52

In reply to Re: drug sins and serotonin syndrome, posted by Elizabeth on December 31, 1999, at 4:23:46

> Hey guys, just from clinical experience it's *MAOIs*, not SSRIs, that can cause the central serotonin syndrome if you take MDMA with them!
>
> > 1. Since he would discontinue the SSRI at least SEVERAL DAYS previous to doing MDMA, this should be no special risk -- unless you have new info on the half lives of SSRIs. It is like MDMA alone.
>
> Actually this isn't true; while the SSRI goes away after a few days (exception: Prozac), it has longer-lasting effects that persist for a while after the drug is out of your system. Hence the lengthy wait between quitting an SSRI and starting an MAOI.

You didn't mention what that effect is. There is a lengthy wait but that is limited to Prozac(fluoxetine). Other SSRIs have a washout period of 5-7 days. (see reference in previous message)

Don't confuse action and effect. An SSRI action begin with the first dose but the antidepressant effect is delayed. Similarly, neural changes responsible for the antidepressant effect generally persist -- at least for a period of time -- after the SSRI is discontinued (and eliminated from the body). Normalization of 5-HT receptors is not the same action or risk factor as 5-HT reuptake inhibition, re serotonin syndrome.

> > 2. Any SSRI that might remain (very minimal) also inhibits entry of MDMA into the neuron, and interferes with its release of serotonin.
>
> Yup, that's my understanding of why SSRIs tend to block the effect of MDMA.
>
> > Here's some true/false statements for Cindy:
> > -- Marijuana causes aggression.
> > -- LSD causes chromosone damage.
> > -- This is your brain on drugs (eggs frying).
> > -- The ends justify the means.
>
> Don't forget "post hoc ergo propter hoc." :)
>
> > The real danger of misinformation is that people learn to distrust the source -- in this case valid warnings also.
>
> "Wolf!"

Just Grandma!!!

 

Re: bruce, sins and serotonin

Posted by Bruce on January 2, 2000, at 21:19:54

In reply to bruce, sins and serotonin, posted by Harry Anslinger on January 2, 2000, at 19:24:51



> > In general, this bulletin board is about depression, and the effectiveness of various palliative measures.
>
> This bulletin board -- this site -- is oriented primarily to psychopharmacology. This includes but is not limited to depression and its treatment. Anxiety and attentional disorders are about as frequent topics as depression.
>
>
> > As such, most people would, I think, naturally want to warn off someone like Greg from experimenting with MDMA.
>
> Read Greg's message again. Where does he say he plans to take MDMA?

He doesn't. He asked "...but I was wondering if it
would be safe to use ecstacy while also taking an SSRI. Would it produce any sort of
seratonin syndrome or serious side effects?"

My initial take was that it wasn't safe (probably the wrong answer). But that is what he asked for - information.


> > This warning results not from the prudish point of view, but from the standpoint of not further exacebating his depression (which is presumably why he is reading this BB in the first place).
>
> The purpose of this board is dialogue about issues in Psychiatry and Psychopharmacology.
>
> I'd hoped we could just respond to his question directly with too presuming too much.
>
> OK, ecstasy could reportedly exacerbate the condition he's taking the SSRI for. (Not necessarily depression.)

Then he should be warned of that - because he ASKED for info on deleterious effects. That is all that I and Cindy W (the first responder to the post)are saying.
The response to her post accused her of being 'moralistic' (prompting my reply), but her reply seemed reasonable to me, given that Greg had asked for just such info...


> Ecstacy also reportedly has psycotherapeutic action and can foster beneficial personality changes.
>
>
> > He wanted info on any dangers, he got info.
>
> Many doctors have been well warned about the dangers of narcotics. Meanwhile patients in severe, chronic pain go undermedicated. Fears of addiction supercede appropriate analgesia in patients with terminal illnesses.
>
> BTW, Dr. Peter Breggin wants people to have information too. Go take a look at www.breggin.com . This is what morality breeds...


A non-sequitur. Greg asked for info - he got info. He *asked* about dangers, he got info on dangers. My reply is "it looks dangerous". My reply is *NOT* "this is wrong, you shouldn't do it."

 

Re: ecstacy and ssri's-Here's the poop

Posted by Clubber on January 4, 2000, at 18:23:09

In reply to ecstacy and ssri's, posted by Greg on December 28, 1999, at 23:35:43

Not to sound pompus, but here's the poop Greg (or at least my two cents worth), morlality aside...

I try to avoid ecstacy when I'm not medicated b/c the euphoric effects have gone away and it brings me more anxiety than pleasure. Plus, I feel my brain chemistry is too seretonically (a word?) fragile for the drug and usually feel despair later...(this sucks because there's a barier between friends now)

Previously on Prozac and now or Serzone, X is a waste of money and doesn't work (bad side), but nor do I have to deal with aftereffects (good side). This is consistent with what other patients and doctors have told me. Nothing really to fear, only money to waste.

One extra observation: taking ketamine (K) after a failed ecstacy (due to ADs) can trigger some of the X effects, I've found to be true for myself. not worth the money, however.

For those who will respond I have been immoral or have advocated illicit drugs -- that argument has been had in the threads above. Greg is surely an adult and probably knows the club scene well enough to make his own decision. I'm just speaking up as someone whose been there.

 

Re: ecstacy and ssri's-Here's the poop

Posted by nowrist on January 16, 2000, at 12:44:23

In reply to Re: ecstacy and ssri's-Here's the poop, posted by Clubber on January 4, 2000, at 18:23:09

> Not to sound pompus, but here's the poop Greg (or at least my two cents worth), morlality aside...
>
> I try to avoid ecstacy when I'm not medicated b/c the euphoric effects have gone away and it brings me more anxiety than pleasure. Plus, I feel my brain chemistry is too seretonically (a word?) fragile for the drug and usually feel despair later...(this sucks because there's a barier between friends now)
>
> Previously on Prozac and now or Serzone, X is a waste of money and doesn't work (bad side), but nor do I have to deal with aftereffects (good side). This is consistent with what other patients and doctors have told me. Nothing really to fear, only money to waste.
>
> One extra observation: taking ketamine (K) after a failed ecstacy (due to ADs) can trigger some of the X effects, I've found to be true for myself. not worth the money, however.
>
> For those who will respond I have been immoral or have advocated illicit drugs -- that argument has been had in the threads above. Greg is surely an adult and probably knows the club scene well enough to make his own decision. I'm just speaking up as someone whose been there.


i have been on ssri drugs for about about 5 years, and have several times tried x since then. i can tell you it hardly had any affect on me at all. the first time i hadn't heard anything about ssri drugs rendering x inert or ineffective, but having since tried it two more times, i am inclined to believe it true. i'd done x maybe ten times before taking ssri's, and while sometimes i'd taken 'bad x' i still felt something. my advice, all helath concerns aside, is to save your money and don't buy x.

 

Re: ecstacy and ssri's-Here's the poop

Posted by michael on January 16, 2000, at 22:59:43

In reply to Re: ecstacy and ssri's-Here's the poop, posted by nowrist on January 16, 2000, at 12:44:23

> > Not to sound pompus, but here's the poop Greg (or at least my two cents worth), morlality aside...
> >
> > I try to avoid ecstacy when I'm not medicated b/c the euphoric effects have gone away and it brings me more anxiety than pleasure. Plus, I feel my brain chemistry is too seretonically (a word?) fragile for the drug and usually feel despair later...(this sucks because there's a barier between friends now)
> >
> > Previously on Prozac and now or Serzone, X is a waste of money and doesn't work (bad side), but nor do I have to deal with aftereffects (good side). This is consistent with what other patients and doctors have told me. Nothing really to fear, only money to waste.
> >
> > One extra observation: taking ketamine (K) after a failed ecstacy (due to ADs) can trigger some of the X effects, I've found to be true for myself. not worth the money, however.
> >
> > For those who will respond I have been immoral or have advocated illicit drugs -- that argument has been had in the threads above. Greg is surely an adult and probably knows the club scene well enough to make his own decision. I'm just speaking up as someone whose been there.
>
>
>
>
> i have been on ssri drugs for about about 5 years, and have several times tried x since then. i can tell you it hardly had any affect on me at all. the first time i hadn't heard anything about ssri drugs rendering x inert or ineffective, but having since tried it two more times, i am inclined to believe it true. i'd done x maybe ten times before taking ssri's, and while sometimes i'd taken 'bad x' i still felt something. my advice, all helath concerns aside, is to save your money and don't buy x.

You might want to check out maps.org (multidisciplinary assoc for psychedelic studies)

You can run querries on "serotonin receptors", etc. It can get a little technical, but there are articles & rsch prjoects that go into which receptors seem to be more significant for psychedelic experiences (5-HT 2, i think?), and which receptors are predominantly involved with which antidepressants...

I haven't done a lot of rsch, but I think it may make a difference which antidepressant you're using.... & which other "meds" (x, psilocyban, lsd, etc)

It's interesting to get a little insight on how it all works, if nothing else.

good luck.

 

Re: ecstacy and ssri's-Here's the poop

Posted by Dave B on January 23, 2000, at 20:40:56

In reply to Re: ecstacy and ssri's-Here's the poop, posted by nowrist on January 16, 2000, at 12:44:23

Although slightly comparable in chemical stucture, comparing MDMA and SSRI's are like comparing apples and oranges. $35US for a Zoloft tab? And I've seen fewer psychiatrists hanging around seedy nightclubs selling them too. :)

Please, let's not turn this into a place for chat about illicit substances. Theres more appropriate places for that other than here. And re: Ketamine use; you're really risking your health a lot by allowing your brain to be used as a chemical cocktail punch bowl.

-=- my 2 cents worth :)

Dave

 

Re: ecstacy and ssri's

Posted by icharus5678 on May 29, 2000, at 14:03:41

In reply to Re: ecstacy and ssri's-Here's the poop, posted by Clubber on January 4, 2000, at 18:23:09

> I am Bipolar Type I. I have been seeking treatment for this disorder for five years, trying over 30 medications as well as ECT.

My depression has been best treated with Serzone and Welbutran.
I have to say that MDMA is a Miracle drug. It brought me back to the real world in no small way. Up from a couch, and back to living.
I believe that my individual condition responds better to those meds that affect Dopamine and norepinephron, for I have had nothing but Mania and Anxiety from any for the SRI's.
In my particular case, MDMA has cleared most of my obsessive and circular thought. It has broken my fixation on death and religion, and has actually allowed me to become HAPPY TO BE ALIVE, which was something I was not for the past 18 years. I do not generally advocate self-medication because it is generally foolish, however, with the AMAZING change in my mental state, MDMA is something that I do take advantage of carefully and periodically. I do inform my doctor of the frequency and dosage, I do have the X (as it is known) tested to ensure I am not taking something harmful or counterproductive.

I can not tell you the relief and WONDERFUL experience MDMA has provided me in words that people could fully comprehend. But I feel that MDMA has brought me back from the dead to the living.

But different people have different body chemistries and "wiring" if you will, and for those who respond to SRI's, they should definitely listen to their doctor's.


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