[mpnagle]

Because of the presence of MAOIs, mixing ayahuasca with other drugs that affect serotonin such as MDMA or anti-depressants such as selective serotonin reuptake inhibitors (SSRIs), may be particularly dangerous.

via https://adf.org.au/drug-facts/ayahuasca/

I imagine what Doblin meant is working with MDMA after an ayahuasca ceremony.

[loceng]

Good thought - but nope, and I've done it. The issue with SSRIs are them being reuptake inhibitors - they actually change how the brain functions vs. MDMA is simply causing serotonin to be released.

I also happen to be taking a dopamine agonist to treat a benign brain tumour I have (prolactinoma) - first line of treatment is adding a dopamine agonist to the system, and not using an SSRI/SNRI/etc that changes the actual function was fine as well for ceremony; a caveat to research or understand/have caution with is that I had done 30+ Ayahuasca ceremonies prior to taking a dopamine agonist - and so my mind/brain was generally already "opened" how it will be. Care/caution may be necessary if a person has never "opened" up their mind/brain yet (after X ceremonies/experiences) and if they are taking dopamine for whatever reason, as maybe once the pathways that get opened from Ayahuasca et al then the impact of the dopamine would shift as well - perhaps then overcompensating for blocks that get cleared by the Aya etc - and the person may then experience undesired levels of effects from the dopamine.

MDMA isn't directly changing the actual function, they're not causing inhibition; the action of how is important, the nuance is important to understand - though like from your comment - there isn't this general understanding that there is a difference, and I imagine most doctors/professionals will jump to the same conclusion without thinking about it - misattributing the different actions instead of critical thinking from foundational principles. It's not the neurotransmitter(s) that are a problem, at least not serotonin and dopamine, it's if the function change of how they're allowed to flow changes that's the problem.

Interview/chat between Dr. K (Healthygamer_gg) and Rick Doblin - https://www.youtube.com/watch?v=1e2h-awLC-s - where he mentions taking half-therapeutic dose; more of a casual conversation where you can also hear a bit of Rick's origin story.

I did fairly deep research on this beforehand, looking into actual pharmacological aspect of interactions with things like dopamine, etc - a few people over the last 20 years have been keeping track of all related research. I don't have the link for the most succinct, detailed writeup I read handy.

[catblast]

> I did fairly deep research on this beforehand, looking into actual pharmacological aspect of interactions with things like dopamine, etc

While you can read about mechanisms and in vitro this and that all day, this is not the same as quality applied clinical research, which frankly just doesn't exist in any meaningful quantity. I am a practitioner, and I am very sympathetic to the movement of alternative treatments counter to established standards of care, however at the end of the day it doesn't change the fact that the controlled research is non-existent or poor, and things like the MAPS manual are essentially woo.

And specifically the problems I have is that ironically, these alternative treatments which are supposedly trying to overcome boundaries of established care are extremely proscriptive themselves.. they're limited, just differently, and the justifications have very little evidence based backing.

[pmoriarty]

"very little evidence based backing"

Many studies have been done, not just in vitro but in real people with just about the most severe mental issues there are: severe depression and PTSD, and the results have been positive, and these studies have been published in peer reviewed journals and been well received by the scientific and medical community.

So can you describe what evidence you're looking for and what would satisfy you?

Also, you say you're a practitioner. I wonder what you are a practitioner of exactly. If it's some sort of traditional therapy you should be aware that for PTSD and severe depression the evidence is that traditional therapy is very ineffective. So what would you suggest for those suffering from these conditions if not psychedelic-assisted therapy, which from my reading is actually far more effective for these conditions than traditional therapy?

[loceng]

Woo? Are you familiar with their clinical research/results and still saying it's woo?

[mpnagle]

Oh, interesting!

I’ve also sat a comparable amount of ceremony — and so of course there’s strictness about SSRIs...but I have never thought about the mechanisms like this. It just wouldn’t have occurred to me to explore in this way.

If you do find the succinct, detailed write up I’d love to see. Thank you for finding the YouTube link, I want to check it out!