Are you saying MDMA + SSRI is nothing to worry about? Is this claimed in the study you linked?
Another study:
https://pubmed.ncbi.nlm.nih.gov/24006318/
MDMA, in combination with the widely-prescribed SSRI antidepressant class, can lead to rapid, synergistic rise of serotonin (5-HT) concentration in the central nervous system, leading to the acute medical emergency known as serotonin syndrome.
The study I linked has data from poison control and hospitals, and breaks down calls made for seratonin sydnrome.
What you linked isn't a study, but a review. No new information is brought up, it talks pharmacology that makes sense, but has no actual evidence (such as a case of a person getting seratonin syndrome from the mixture), it just makes a hypothesis that frequent prescriptions of SSRIs along with SSRI users being more likely to be MDMA users as well, which could potentially be responsible for this because it pharmacologically gives some sort of explaination. This is also about primarily about adolescents, who are much more susceptible to seratonin poisoning.
Look up the DOI number on pubmed articles before sharing them, it's irresponsible not to
I will add this by "look up the DOI" I meant "look up the DOI on sci-hub". It will give you the full text of anything on PubMed. Both of these articles we're discussing are not webpages, but 7 page long journals. There's a lot more information than is given on the webpage. If you read something in either of those and disagree with me, I'm more than open to discussing it and changing my comments
But from me reading all the full texts I have, I still haven't found any solid evidence that MDMA and SSRIs will kill you (more than just these two). Will weaken the effects sure, but so far all I can find on the MDMA+SSRI interaction is questions about the pharmacology of it, which makes sense but really doesn't sell me.
So the pubmed page you linked to, titled "Serotonin toxicity of serotonergic psychedelics" looks like a review as well. I got the full paper on sci-hub and it didn't appear to be what you were describing, so I asked for confirmation of the DOI.
What I meant by
This one? https://doi.org/10.1007/s00213-021-05876-x
is "is this the correct DOI?", not "is this page on doi.org the full paper you're referencing?"
To be blunt, it looks like you've mixed up your links, and the one you've been talking about is not the one you linked. Can I please have the DOI or any link about the study you've been talking about?
I just mispoke in our conversation, it's not a study, it's a review. In the post I linked referencing this, I refer to it colloquially as an article. But the point still stands. This review is still more believable because it uses empirical evidence from poison control, along with referencing small clinical trials where the mixture was experimented with and found to be benign, just weakening the roll.
Full quote
Despite SRIs and MDMA (SRA) both being able to
increase intrasynaptic 5HT, several small clinical trials
combining them suggest that it is usually a benign
combination (Fig. 2); it is been documented that while
SRA’s inhibition of vesicular monoamine transporter 2
(VMAT2) disrupts vesicle packaging and leads to carrier-
mediated 5-HT release via SERT, SRIs competition at
the serotonin reuptake transporter (SERT) results in
attenuated subjective and physical effects of the SRA
(Gudelsky and Nash 1996; Hysek 2012; Stein and Rink
1999; Tancer and Johanson 2007; Farre 2007; Liechti
and Vollenweider 2000). These attenuated effects may
also translate to decreased therapeutic benefit since
efficacy response for PTSD was lower for the study
participants who recently tapered off of an antidepressant
at least 2 weeks prior to MDMA-assisted therapy (mean
25.1 days) (Feduccia et al. 2021).
Thanks for clarifying, your skepticism is understandable tbh. Anecdotally, I've only seen one instance of it, a friend of mine who took a bunch of "molly" while on SSRIs and had a really bad time (but didn't die lol).
I was never sure what to make of that. I assumed the risk of death based on the pharmacological explanation, but couldn't be sure of anything. Especially since my friend would take especially high doses, and the stuff was usually untested so it was never confirmed as MDMA.
My hypothesis with that would be due to the reduced euphoria, they were just dealing with more of the side effects of MDMA, which do mirror minor seratonin toxicity. Not being on an SSRI, they'd usually be getting enough euphoria to just tank through those side effects (especially if they're taking irregularly high doses) but with that being reduced they just couldn't really handle it. I could be wrong though, I didn't see exactly what side effects they were dealing with.
I've gotten seratonin syndrome a few times, so I'm very familiar with it (once on accident and once on purpose). Seratonin syndrome makes you think you're going to die, I had a hypertensive crises (extremeties swelling up and starting to pulse with my heartbeat) and seizures both time. It'll make you call an ambulance for someone else if you see it, it's pretty extreme.
I wouldn't be too worried about it. DXM with an SSRI on the other hand is a great way to get seratonin syndrome
Are you saying MDMA + SSRI is nothing to worry about? Is this claimed in the study you linked?
Another study: https://pubmed.ncbi.nlm.nih.gov/24006318/
The study I linked has data from poison control and hospitals, and breaks down calls made for seratonin sydnrome.
What you linked isn't a study, but a review. No new information is brought up, it talks pharmacology that makes sense, but has no actual evidence (such as a case of a person getting seratonin syndrome from the mixture), it just makes a hypothesis that frequent prescriptions of SSRIs along with SSRI users being more likely to be MDMA users as well, which could potentially be responsible for this because it pharmacologically gives some sort of explaination. This is also about primarily about adolescents, who are much more susceptible to seratonin poisoning.
Look up the DOI number on pubmed articles before sharing them, it's irresponsible not to
This one? https://doi.org/10.1007/s00213-021-05876-x
I will add this by "look up the DOI" I meant "look up the DOI on sci-hub". It will give you the full text of anything on PubMed. Both of these articles we're discussing are not webpages, but 7 page long journals. There's a lot more information than is given on the webpage. If you read something in either of those and disagree with me, I'm more than open to discussing it and changing my comments
But from me reading all the full texts I have, I still haven't found any solid evidence that MDMA and SSRIs will kill you (more than just these two). Will weaken the effects sure, but so far all I can find on the MDMA+SSRI interaction is questions about the pharmacology of it, which makes sense but really doesn't sell me.
So the pubmed page you linked to, titled "Serotonin toxicity of serotonergic psychedelics" looks like a review as well. I got the full paper on sci-hub and it didn't appear to be what you were describing, so I asked for confirmation of the DOI.
What I meant by
is "is this the correct DOI?", not "is this page on doi.org the full paper you're referencing?"
To be blunt, it looks like you've mixed up your links, and the one you've been talking about is not the one you linked. Can I please have the DOI or any link about the study you've been talking about?
I just mispoke in our conversation, it's not a study, it's a review. In the post I linked referencing this, I refer to it colloquially as an article. But the point still stands. This review is still more believable because it uses empirical evidence from poison control, along with referencing small clinical trials where the mixture was experimented with and found to be benign, just weakening the roll.
Full quote
Despite SRIs and MDMA (SRA) both being able to increase intrasynaptic 5HT, several small clinical trials combining them suggest that it is usually a benign combination (Fig. 2); it is been documented that while SRA’s inhibition of vesicular monoamine transporter 2 (VMAT2) disrupts vesicle packaging and leads to carrier- mediated 5-HT release via SERT, SRIs competition at the serotonin reuptake transporter (SERT) results in attenuated subjective and physical effects of the SRA (Gudelsky and Nash 1996; Hysek 2012; Stein and Rink 1999; Tancer and Johanson 2007; Farre 2007; Liechti and Vollenweider 2000). These attenuated effects may also translate to decreased therapeutic benefit since efficacy response for PTSD was lower for the study participants who recently tapered off of an antidepressant at least 2 weeks prior to MDMA-assisted therapy (mean 25.1 days) (Feduccia et al. 2021).
Thanks for clarifying, your skepticism is understandable tbh. Anecdotally, I've only seen one instance of it, a friend of mine who took a bunch of "molly" while on SSRIs and had a really bad time (but didn't die lol).
I was never sure what to make of that. I assumed the risk of death based on the pharmacological explanation, but couldn't be sure of anything. Especially since my friend would take especially high doses, and the stuff was usually untested so it was never confirmed as MDMA.
My hypothesis with that would be due to the reduced euphoria, they were just dealing with more of the side effects of MDMA, which do mirror minor seratonin toxicity. Not being on an SSRI, they'd usually be getting enough euphoria to just tank through those side effects (especially if they're taking irregularly high doses) but with that being reduced they just couldn't really handle it. I could be wrong though, I didn't see exactly what side effects they were dealing with.
I've gotten seratonin syndrome a few times, so I'm very familiar with it (once on accident and once on purpose). Seratonin syndrome makes you think you're going to die, I had a hypertensive crises (extremeties swelling up and starting to pulse with my heartbeat) and seizures both time. It'll make you call an ambulance for someone else if you see it, it's pretty extreme.
That is still just an abstract, and it's on a different website so I'm not really sure