Posted by rod on April 7, 2004, at 5:31:16
In reply to Super LINKAGE - ecstasy+effexor is a NO-NO, posted by PsychoSage on April 6, 2004, at 18:35:51
> > > ..Both times were with meth..
> >
> > Im sorry if this happened to you, but no one is talking amount meth here. The substance discussed here is MDMA not meth. No one said its "safe" with any other drug than MDMA. Any i agree to a certain extend, that an SSRI does not block the effect of MDMA for 100%. It just greatly decreases it. And someone who takes an SSRI can be close to serotonin syndrom by the SSRI alone. Serotonin Syndrome also accurs with SSRI monotherapy in some individulas. And if such a person, close to serotonin syndrom due to SSRI, takes MDMA, the reduced increase in serotonin might be enough to result in serotonin syndrome, in my opinion. Thats at least an psausible explanation and might fit some cases.
> >
> > And the study http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12404538
> > demonstates the theoretical interaction of MDMA and citalopram, an SSRI. And these people were taking pharmaceutical grade MDMA.
> >
> >
> > > ..from her pill, and she was kind of pissed. Then she became incredibly ill with the classic serotonin syndrome symptoms.
> >
> > As I said, you never really know what you get. What did she thought to take? Also meth, or E?
> >
> > > Effexor has been implicated in many serotonin toxicity cases with or without MDMA. MDMA has definitely been implicated in a lot of serotonin toxicity cases. If you take them together, I think they would kick your but.
> >
> > As it has been said before: "serotonin increase by MDMA alone" + "Serotonin increase by SSRI alone" =! (does not equal) "Serotonin increase by SSRI and MDMA coadministered". Its "Serotonin increase by SSRI alone" + "a tiny bit more".
> >
> > And your links *dont* mention anything about (SSRI or Effexor) + MDMA = Death
> >
> > I think we have a tiny problem about comunication here...
> >
> > Roland
>
>
> MDMA is an amphetamine derivative 3,4-MethylenedioxymMETHamphetamine (MDMA)!!! IT IS A METH ANALOGUE, see far below.
>
> DUH!!!!! What a Denialist argument we have here.Wait a moment
I know that its an analogue. Which doesnt neccesarily mean they all have the same mechanism of action. I actually dont know about the exact mechanisms of Methamphetamine.
But obviously you know what its detailed mode of action is. So how does it work? Have any links? Does it also reverse the Serotonin transporter?
I can not read anywhere that it has the same effect on sert like MDMA...
Close structural relation does not mean anythig.
Trimipramine in an close analogue of imipramine. But they are quite different.
Trimipramine can be combined with an MAOI without major problems, while imipramine is a big no no.
Trimipramine:
5-(3-dimethylamino-2-methylpropyl)-10,11-dihydro-5H-dibenz (b,f) azepine acid maleate
Imipramine:
5-[3-( Dimethylamino)propyl]-10,11- ihydro-5H-dibenz [b,1-azepine] Monohydrochloride.
Similar, but...> It's common knowledge that anything that promotes serotonin that is taken with anything else that does so can cause serotonin syndrome.
>Did I doubt that?? In my last post I said it is indeed possible!!
look above:
"Any i agree to a certain extend, that an SSRI does not block the effect of MDMA for 100%. It just greatly decreases it. And someone who takes an SSRI can be close to serotonin syndrom by the SSRI alone. Serotonin Syndrome also accurs with SSRI monotherapy in some individulas. And if such a person, close to serotonin syndrom due to SSRI, takes MDMA, the reduced increase in serotonin might be enough to result in serotonin syndrome, in my opinion."And if I would be mean I would say: DUH!! you didnt read my post at all...
Also scott-d-o said it only *attenuates* the increase of 5-ht by MDMA.
And you dont need to post so much information about serotonin toxicity. No one neglect its existence. But you seem to rufuse to accept the scientific facts about mdma and SSRI interaction.
Just the theory. Which does not say its in any case safe.im done here.
good bye
> http://www.maps.org/mdma/protocol/review6.pdf
>
> Medical Emergencies and Adverse Events in Ecstasy Users {includes serotonin syndrome}:
>
> Signs and symptoms of ecstasy intoxication documented in these reports are similar to those of amphetamines.
>
>
>
> Mechanisms of serotonin syndrome.
>
> (1) Increased doses of L-tryptophan will proportionally in-
> crease 5-hydroxytryptamine (5-HT or serotonin) formation.
>
> (2) Amphetamines and other drugs increase
> the release of stored serotonin.
>
> (3) Inhibition of serotonin metabolism by monoamine oxidase (MAO) inhibitors will increase presynaptic 5-HT concentration.
>
> (4) Impairment of 5-HT transport into the presynaptic neuron by uptake blockers (e.g., selective serotonin reuptake inhibitors, tricyclic antidepressants) increases synaptic 5-HT concentration.
>
> (5) Direct serotonin agonists can stimulate postsynaptic 5-HT
> receptors.
>
> (6) Lithium increases postsynaptic receptor responses. Adapted with permission from Elsevier
>
> Science (Critical Care Clinics 1997;13[4]:763-83)
>
>
>
> http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202764.html
>
>
> Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking venlafaxine, it is especially important that your health care professional know if you are taking the following:
> Buspirone (e.g., BuSpar) or
>
> Bromocriptine (e.g., Parlodel) or
>
> Certain tricyclic antidepressants (amitriptyline [e.g., Elavil], clomipramine [e.g., Anafranil], or imipramine [e.g., Tofranil]) or
>
> Dextromethorphan (cough medicine) or
>
> Levodopa (e.g., Sinemet) or
>
> Lithium (e.g., Eskalith) or
>
> Meperidine (e.g., Demerol) or
>
> Nefazodone (e.g., Serzone) or
>
> Pentazocine (e.g., Talwin) or
>
> Selective serotonin reuptake inhibitors (fluoxetine [e.g., Prozac], fluvoxamine [e.g., Luvox], paroxetine [e.g., Paxil], sertraline [e.g., Zoloft]) or
>
> Street drugs (LSD, MDMA [e.g., ecstasy], marijuana) or
>
> Sumatriptan (e.g., Imitrex) or
>
> Tramadol (e.g., Ultram) or
>
> Trazodone (e.g., Desyrel) or
>
> Tryptophan—Using these medicines with venlafaxine may increase the chance of developing a rare, but very serious, unwanted effect known as the serotonin syndrome; symptoms of this syndrome include confusion, diarrhea, fever, poor coordination, restlessness, shivering, sweating, talking or acting with excitement you cannot control, trembling or shaking, or twitching; if you experience these symptoms contact your doctor as soon as possible
>
> http://www.mja.com.au/public/issues/176_05_040302/prior_letter_fm.html
>
> Serotonin toxicity with therapeutic doses of dexamphetamine and venlafaxine
>
>
> http://www.health.gov.au/tga/adr/aadrb/aadr0402.htm#3
>
> Serotonin syndrome
>
>
> Serotonin syndrome is caused by excessive central nervous system and peripheral serotonergic activity. It most commonly occurs with a combination of serotonergic agents, but may also occur with a single agent. A combination of agents increasing serotonin by different mechanisms, such as by inhibition of serotonin uptake and serotonin metabolism, is associated with a high risk of the syndrome.1 Table 1 lists agents which have been associated with serotonin syndrome.
>
> http://www.dartmouth.edu/~dapa/mdma.html
>
> http://www.show.scot.nhs.uk/gghb/adtc/Medicines%20update/issue2.htm
>
> http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14709765&itool=iconabstr
>
> Since ecstasy is pro-serotonergic, it may also be involved in pharmacodynamic drug-drug interactions when other pro-serotonergic drugs are combined with it, leading to a central serotonin syndrome
>
>
>
>
> http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12869661&itool=iconabstr
>
> The amphetamine derivative (+/-)-3,4-methylenedioxymethamphetamine (MDMA, ecstasy) is a popular recreational drug among young people, particularly those involved in the dance culture. MDMA produces an acute, rapid enhancement in the release of both serotonin (5-HT) and dopamine from nerve endings in the brains of experimental animals. It produces increased locomotor activity and the serotonin behavioral syndrome in rats. Crucially, it produces dose-dependent hyperthermia that is potentially fatal in rodents, primates, and humans.
>
>
> Death by Ecstasy: The Serotonin Syndrome? Mueller PD., et al., Annals of Emergency Medicine,
>
> 1998 Sept, Part I, 32(3), pg 377-380.
>
> Serotonin syndrome, a condition in which there is central serotonin receptor hyperstimulation has been described since the 1950s. Classic findings of severe serotonin syndrome include hypothermia, mental status changes, autonomic instability, and altered muscle tone or rigidity. A number of medications have been implicated in the induction of serotonin syndrome, including those that reduce metabolism (ie, monoamine oxidase inhibitors), increase production (ie L-tryptophan), or inhibit uptake of serotonin (ie. Fluoxetine, clomipramine, meperidine, dextromoethorphan, pentazocine, fenfluramine). MDMA has been shown in animal models to cause massive release of serotonin from pre synaptic vesicles and inhibit its uptake. The following case illustrates that MDMA can induce a toxidrome consistent with severe serotonin syndrome. A 20 year old woman was brought to the emergency department unresponsive and cyanotic. She had ingested 2 tablets of MDMA within the previous 4 hours. She had a negative past medical history, was taking no medications, and had not been previously treated with any antidepressants or other prescription medications. History of previous use of MDMA or other illicit drugs was not available. Toxicological analysis of blood and urine indicated the presence of MDMA. No other toxic substances were present except acetaminophen, barbiturate and benzodiazepine used during treatment in the hospital. Initial anxiety, nausea, tachycardia, and elevated blood pressure are followed by relaxation, euphoria, and feelings of enhanced emotional insight. Tolerance to the psychoactive properties of MDMA develops rapidly with loss of the ability to evolve the desired response with repeated doses within several hours; instead, sympathomemetic effects predominate resulting in anxiety, dysphoria and paranoia. There have been multiple case reports in the medical literature of MDMA-induced morbidity and mortality that fit the diagnostic criteria for serotonin syndrome. This is being increasingly recognized in the medical literature. The Poison Information Services in London has also summarized severe complications and fatalities associated with MDMA use, many of which fit the diagnostic criteria for severe serotonin syndrome. Most cases of toxicity appear to be idiosyncratic and are not associated with massive overdose. Since MDMA has only about one tenth the stimulant effect of amphetamine on the central nervous system, excessive sympathetic stimulation by MDMA seems unlikely in these cases.
>
>
> http://165.112.78.61/Meetings/MDMA/MDMAAbs1.html
>
> Overview of MDMA-Induced Persistent Neurotoxicity: Preclinical Perspective
> Glen R. Hanson, D.D.S., Ph.D.
>
>
> Advances
>
>
> The potential neurotoxic properties of amphetamine-related drugs were suggested by observations in the rat of Gibb and Koda (JPET 185 [1973] 42) and Seiden et al. (Drug Alcoh Depend 1 [1976] 215) that high-dose methamphetamine (METH) treatment causes persistent deficits in the dopamine (DA) system associated with the basal ganglia. Gibb and Hotchkiss (JPET 214 [1980] 257) later reported that similar METH administrations also cause similar long-term declines in the serotonin (5HT) systems associated with the frontal cortex, striatum, and hippocampus. These findings suggested that heavy METH use can be neurotoxic to critical systems in the brain associated with memory, information processing, and motor functions. Because MDMA is a METH analogue, its effects on DA and 5HT systems have also been studied. Moderate-to-high doses of MDMA cause METH-like long-term deficits in brain 5HT, but not DA systems. These persistent serotonergic effects appear to be (1) at least partially mediated by MDMA-related stimulation of DA systems, (2) linked to production of free radicals, (3) dependent on the serotonin transporters, and (4) facilitated by hyperthermia. However, reactive MDMA metabolites do not appear to be necessary for this neurotoxic effect of MDMA. These preclinical findings in rat predict that, in humans, MDMA substantially enhances the activity of DA systems and is a potential neurotoxin to some 5HT systems.
poster:rod
thread:332813
URL: http://www.dr-bob.org/babble/20040407/msgs/333619.html