Hacker News new | ask | show | jobs
by el_nahual 403 days ago
What is the best resource for "safer" MDMA consumption? (Like, which SSRI to take and at what dosage).

Also, isn't mixing SSRIs and MDMA a huge no-no, given the potential for a serotonin storm/serotonin syndrome?

1 comments

You should avoid SSRI:s adjacent to MDMA use. The hypothesis is that by blocking the serotonin transporter you'd avoid dopamine getting reabsorbed into serotonin vesicles, but there is very little evidence that this would work and there are obvious risks.

SSRI:s will give you a strong tolerance against serotonergic drugs and it will take a long time to lower that tolerance, months, maybe a year or two. As far as I know it hasn't been studied scientifically but I've seen people get quite uncomfortable experiences from MDMA and 5-HT2a-psychedelics (LSD, psilocybin, mescaline, those) after being off SSRI medication for several months, that I amateurishly attribute in part to downregulation of serotonin sensitivity.

A more acute risk is MAO inhibitors, which are sometimes prescribed as antidepressives. You're more likely to suffer acute damage or die from a combination of MDMA and an MAOI than with an SSRI, though neither is a good idea.

The Bluelight forums are a decent source of harm reduction advice, https://www.bluelight.org/community/forums/. Be aware that some participants in the discussions have problems with risky or abusive use, or give bad advice. Stickied guides tend to be of high quality, however.