Silk Road forums
Discussion => Drug safety => Topic started by: sugarfree11 on October 16, 2012, 01:56 am
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Hopefully this is the right section!
I've got a friend who showed interested in trying MDMA, as she has rolled a few times 15 years ago. She's 37, 180lbs, and recently under disability due to a car wreck. As a result, she takes a handful of medications, but stated she's willing/able to do without all of them besides the perc/neurotin, if she was advised to stop taking them for a week or so prior to her doing MDMA; to prevent interactions/decreased experience.
These are her current medications;
Opana 15mg BID
Neurotin/Gabapentin 400mg TID
Percocet 10mg PRN
HCTZ/Hydrochlorothiazide 25mg QD
Tizanidine/Zanaflex HCL 4mg PRN
I personally told her that I didn't believe it to be a good idea, but I'm looking for additional opinions. If you believe she could successfully try MDMA without negative consequences, why is that? If so, is 175mg an acceptable dose? Why shouldn't she? Links, first-hand experiences, and pretty much anything would be very much appreciated. Thanks!
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Regardless of the meds, is she depressed or lonely? If so then that's reason enough not to use MDMA in my book. It can easily make it worse.
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Regardless of the meds, is she depressed or lonely? If so then that's reason enough not to use MDMA in my book. It can easily make it worse.
I don't believe she's depressed/lonely, and she said she wasn't. More than likely her husband will take it with her. The environment she'll have is suitable.
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The Hydrochlorothiazide (HCTZ) is a diuretic which at first is concerning because fluid retention is just an issue with MDMA already. However, it is a pretty weak diuretic. She might even be taking it for blood pressure and if so they in my non-medical-professional opinion she should keep taking it when she takes the MDMA since MDMA can raise blood pressure. I recommend Gatorade/Powerade to anyone using MDMA myself though.
The Opana and Percocet of course are opioids that people use to get high all the time. She shouldn't need it when using the MDMA or if she does then that's troubling as either her pain is very severe or she's started to form an addition to the opioid (very easy to do). Last Friday I was rolling on MDMA and I did something that pulled my big toenail up. I looked at it and I knew it hurt but I didn't care. Later, I noticed lots of blood under the nail haha.
The Neurotin is indicated for nerve pain but I don't know about its method of action. I wouldn't think that one would be an issue though.
Tizanidine/Zanaflex is a muscle relaxer. I don't know its method of action but vaguely it may mute the effects of MDMA since it is probably something of a depressant.
I'm probably just making things even more confusing here and I'm only a pretend doctor on the Internet, anyway. Still, I don't anything that grossly contradicts MDMA except for possibly counteracting the effects of MDMA.
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she should be fine, but i would recommend continuing to use her medication as normal especially if she routinely takes them, the worst thing would be to start going into withdrawal from one of them
tizanidine is an alpha-2 adrenergic agonist which will likely mute some of the sympathetic responses but shouldnt really affect the roll too much, just make it less physically stimulating and more relaxed feeling, especially with any muscle tension
in a similar way gabapentin will mellow out part of the stimulating aspect and make it more relaxed - less clenching of teeth and seating, but for most people it shouldnt alter the though processes and mood push too much, especially not like preventing rolling. however, there are some people who have idiosyncratic reactions where they seem to experience potentiation or even a more trippy experience (and loss of memory potentially so make sure its in a safe environment with a sitter/others to watch out for her just in case) but these seem to be in people who are not used to gabapentin and take a large dose of both
some people prefer the combo of opiates + mdma and some find it mutes it slightly - but there shouldnt be a dangerous interaction, if its anything like using psychedelics and opiates it just makes the experience more relaxed and enjoyable as well. maybe avoid the opana because of how potent it is and just to use percs unless she is dealing with really bad pain that day just to avoid overpowering the experience (just fyi, make sure you mention to your friend not to drink whenever she takes opana - it can lead to overdose)
i dont know how it will work with all three of these potentially 'relaxing' drugs. id say just take her minimal dose of each, or else much of the stimulating aspect may be muted but i would probably prefer that personally - a much more relaxed enjoyable experience without effecting the strong positive mood push
since you are not positive about how she will react given all these drugs i would recommend starting with a lower dose, and then maybe taking a bit more to boost up if she isnt where she wants to be... generally for really pure mdma a good starting dose is around 125 mg
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if she was on SSRIs or other anti-depressants the MDMA would have little to no effect on her.
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which none of those are, and thats not necessarily 100% accurate anyway
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which none of those are
right.
and thats not necessarily 100% accurate anyway
"Studies using pretreatment with an SSRI to block the ability of MDMA to release serotonin in volunteers suggest serotonin release is necessary for most effects of MDMA in humans."
and
"Presumably, MDMA primarily exerts its effects through acting on serotonin reuptake transporters. Researchers postulate that it may act on these transporters, causing them to run in reverse and pump serotonin into the synapse.
Because SSRIs (selective serotonin reuptake inhibitors) block serotonin reuptake transporters, some infer that SSRIs significantly abate the effects of MDMA by blocking its action on the reuptake transporter molecules."
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"right" - and so the point of your answer was?
you said anti-depressants, not all of which are SSRIs
you dont have to quote anything about pharmacology for me, i am well aware of the mechanisms
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"right" - and so the point of your answer was?
you said anti-depressants, not all of which are SSRIs
you dont have to quote anything about pharmacology for me, i am well aware of the mechanisms
i accidentally said "other". my mistake
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Thanks guys. :)
Anyone else have some helpful input?
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Sugarfree:
To be completely honest no one here can give you an honest answer concerning drug interactions with the list you specified as the research simply hasn't been done. An educated guess is about the best you can get and I would never base a life or future quality of it on a guess. Drugs that are very unrelated can have unpredictable results when they or their metabolites interact.
On a side note, Neurotin is nasty stuff, In addition to reports overstating its potency it has also reportedly caused cancer in mammals. I would suggest your friend find a way to replace that with other, safer pain killers.
Your friend should abstain from all of the meds. Do a little research on each drug and it's relative half life in an otherwise healthy person. Be sure to exceed each half life by a factor of at least 2, 3 is better. The percs should be avoided too as they are particularly hard on the liver due to the paracetamol. If your friend needs the percs to get through the day do a little research on cold water extraction and prepare a few doeses ahead of time and at least give the liver a rest from the paracetamol.
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Opioid dependence is a bitch. I personally would pull myself off the pain meds and then reward myself with MDMA.
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if she is used to taking each of them every day - abstaining completely for the experience is a horrible idea imo. one should not just stop taking a drug immediately if their system has become accustomed to its frequent administration. that would be more dangerous than using the mdma in combination in my opinion
i did not just completely guess that the combinations of each of those drugs and mdma would be safe - i specifically searched with each one to look for reports of dangers with the combination of each with mdma and reported the main potential interaction is a rare one of potentiation with gabapentin. nothing unusual was reported with any other. plus i know the combination with opiates is safe from personal experience.
i also ran the entire list through a drug interaction checker, although substituting MA for MDMA because its only pharmaceutical, but the pharmacology of both are similar enough to get a relatively decent idea of any danger. absolutely no interactions with MA were found between any of them - the main interactions were between the tizanidine and HCTZ, as well as the multiple CNS depressants obviously but that is not of pertinence since they are already being used together
i would mention though if the HCTZ is for blood pressure - then the actual condition rather than the medication may make taking mdma potentially dangerous... this would be one reason why it would be an especially poor decision to stop taking the HCTZ and tizanidine before using, because with the rebound increase in blood pressure plus the mdma increase it could result in extremely dangerous hypertension.
i do agree that it may be a good idea to look into getting off the gabapentin because of potential nasty side effects, but it is necessary to do this slowly and taper the dosage as to avoid withdrawal. also, the recommendation of cold water extraction is good advice - but in general for everyday use, not specifically just because of taking mdma... opana is extremely potent and should be used only when absolutely necessary for extremely intense pain - after that their arent many stronger pain killers to go to. (getting off the opioids is not necessarily completely reasonable if one is experiencing certain pain they are needed just to function...) also if one is going to mention these dangers though, it would be biased not to warn of the potential toxicity from mdma use - which definitely needs to be used in moderation as well
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+1 on the HCTZ. Administration should not be stopped. Also, a very smart idea running methamphetamines throught the drug interaction DB. Great post micro. I suppose mine was not as well thought out as I would have liked, especially concerning the HCTZ.
My main concern would be mdma effect on bp in combination with HCTZ.
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if she is used to taking each of them every day - abstaining completely for the experience is a horrible idea imo. one should not just stop taking a drug immediately if their system has become accustomed to its frequent administration. that would be more dangerous than using the mdma in combination in my opinion
you're right. I guess if it was me I would start weaning myself off the opiates if at all possible. Stopping abruptly and using MDMA would be a mistake I agree.