MDMA a bad idea for someone with a history of depression?
February 28, 2012 8:28 AM   Subscribe

Is it a terrible, horrible, no good, very bad idea to try ecstasy if I have a history of depression?

I've always wanted to try ecstasy once - I've never had any intention of making it a regular thing. However, I have a significant history of depression, and I'm afraid of the "come-down" that's supposed to happen afterward. Also, I'm on a few antidepressants - specifically, Lamictal, Celexa, and Abilify. I know that some antidepressants can attenuate the effects of ecstasy, but that's not really my concern - I just want to make sure that I'll make it out of the experience in one piece.

Opinions welcome from everybody, although I'd love to hear from anyone with depression who's had experience with this sort of thing. Thanks!
posted by anonymous to Health & Fitness (40 answers total) 5 users marked this as a favorite
 
Do not do ecstasy if you have a history of depression.
More comprehensively, it is probably best not to do any drugs at all if you have a history of depression.
posted by Stagger Lee at 8:32 AM on February 28, 2012 [3 favorites]


This is a very dangerous idea. You will not react the same as any other individual, especially with the other drugs you're taking.

Also, you're going to get confirmation bias from anyone with personal experience, since anyone who hasn't made it out in one piece is not very likely to be on the Internet.
posted by DoubleLune at 8:36 AM on February 28, 2012


Not a doctor, not medical advice, though I've got a lot of experience with MDMA.

SSRI's basically make MDMA not work at all -- there used to be studies showing that SSRI's taken after MDMA might lessen neurotoxicity, but I don't know how up to date those are (especially since the neurotoxicity of MDMA is in some doubt now).

However, and this is Very Important -- MAOI's with MDMA are incredibly dangerous to mix.

My friends that were on anti-depressants that took MDMA took a vacation from their SSRI's a week in advance, took MDMA, then went right back on SSRI's. They seemed to handle it okay.

I guess it depends on how well you deal with going off your meds for any length of time, because you're basically going to have to for MDMA to work.
posted by empath at 8:37 AM on February 28, 2012 [7 favorites]


Considering you're not just on an SSRI, but an anti-convulsant and an anti-psychotic as well, I'd avoid it. There have been experimental clinical trials using MDMA for treatment of, among other things, depression, but that's with lab-grade MDMA which is not what you're getting when you buy ecstasy. Between whatever the ecstasy has been cut with and your chances of getting something that isn't ecstasy at all and may interact poorly with the cocktail you're on, it's dangerous territory.
posted by griphus at 8:38 AM on February 28, 2012 [10 favorites]


Try once and have one fun night, maybe yeah. But any millimeter you step toward self-medication with said drug is a step you will probably come to regret.

While the use of some recreational drugs may not seem outright to worsen your condition in a alarming way, they can cause subtler problems over time like reducing the effectiveness of your prescribed meds.

Lord knows I am not a doctor, but if you committed yourself to the word 'once' I would guess you'd be alright.
posted by TheRedArmy at 8:39 AM on February 28, 2012


Going off your meds for a week just so you can get high, however, is altogether a bad idea.
posted by TheRedArmy at 8:41 AM on February 28, 2012


Also, if you insist on doing this, please use a testing kit before taking anything you're told is ecstasy.
posted by griphus at 8:41 AM on February 28, 2012 [7 favorites]


I just want to make sure that I'll make it out of the experience in one piece.

Also, there's no guarantee of this. Your serotonin system is already out of wack, and you're going to be giving it a gigantic kick, basically. It might be no big deal, you might have terrible mood swings for weeks afterwards. If you do it, make sure you have resources (friends, therapy) readily available for you if things 'aren't right'.
posted by empath at 8:42 AM on February 28, 2012 [2 favorites]


If your situation allows, it might be worth going to a drop in clinic or family doctor and asking them.

It's the only place you'll get an honestly reliable answer, you're better off basing your decision on medical advice and not anecdotes from other people that have done it.

I understand all the reasons why that probably won't happen, but it is (IMHO) the only way to go into that with any confidence.
posted by Stagger Lee at 8:44 AM on February 28, 2012


(Actually, with the anti-psychotics and anti-convulsants in the picture, I would highly recommend talking to your doctor about what the possible interactions are, because I have no idea, and I'd be really afraid of mixing them myself).
posted by empath at 8:45 AM on February 28, 2012


Do not use MDMA whilst on medications for any type of mental illness. There are real complications and MDMA ostensibly does not work when you are on an SSRI.

I have a significant history of depression and I am on medication as well. I took MDMA once for a few months whilst I wasn't on medication. The come up and feeling was pretty good. The come down made me cry non-stop.
posted by jjmoney at 8:50 AM on February 28, 2012 [2 favorites]


I know a couple of people who tried that, and ecstasy was basically the same as water in terms of ecstatic effects. Anti-depressants do not mix well with the drug. And yeah, they were lucky, it could be dangerous. Nowadays, most ecstasy (around here, anyways) is mixed with speed (amphetamine) so you've got an ugly picture for mixing and you could be having a pretty bad trip added to the gloomy comedown.

I know people who got off their meds to do ecstasy, but lots of anti-psychotics and anti-depressants take something like a month to leave your body completely.
posted by TheGoodBlood at 8:55 AM on February 28, 2012


The SSRIs will weaken the effects sufficiently for it not be a worthwhile experience, IMO (and extensive experience). I would not do this, if I were you. The benefit is low, so the risks would have to be very low indeed for it to be worthwhile.

empath: there used to be studies showing that SSRI's taken after MDMA might lessen neurotoxicity

I'm pretty sure the last time I looked at this, the studies suggested that they needed to be taken at the same time - basically weakening the impact of the MDMA, while at the same time protecting the user from neurotoxicity.
posted by Infinite Jest at 8:56 AM on February 28, 2012 [2 favorites]


What Stagger Lee and especially Griphus said. A stunning amount of drugs are not even close to being what they are sold as. ("Ecstacy" is often cheap speed.)

If you have issues that require medication to keep you in the right place, why would you mess with that?

Random drug use, even once, is not a good idea for someone who is on meds for mental health issues. This is the thing about managing a condition - you don't get to do everything everyone else does. If you have history of depression or a congenital heart problem or chronic kidney disease or whatever, then you play that hand. Life is just not fair.
posted by Lesser Shrew at 9:01 AM on February 28, 2012 [3 favorites]


Don't do it. You have no idea what the interactions might be with the prescription drugs you are already taking. Lots of others here have already given good advice, just seconding them. You have enough to deal with already, this will not help and could hurt.
posted by mermayd at 9:11 AM on February 28, 2012


If AskMetafilter was all of America, and pro-recreational drug use was wealth, I'd be in the 1%. But I still agree with the majority of the advice in this thread that this is a bad idea.

It sucks for you, and I'm sorry you won't get this experience. But at best, given the interactions with the meds you are on, it would be a waste of your money and time, and at worst, could really mess up what you've got going that works for you.

If you insist on it, I would talk to your medical provider first to discuss any interactions or a medicine holiday, and if you can't be honest with your medical provider, I think you might have your answer right there.
posted by MCMikeNamara at 9:41 AM on February 28, 2012 [2 favorites]


FWIW I am a retired heavy recreational drug user, I love the idea of ecstasy, and as someone who has dealt with depression my entire life I am way, way, way too fucking scared to ever try it, meds or no meds. I encourage you to be similarly freaked out by this idea.
posted by DarlingBri at 9:47 AM on February 28, 2012


Dude, don't take recreational drugs that claim to fuck with your serotonin if you are on anti-depressants. Just don't.
posted by beefetish at 9:49 AM on February 28, 2012 [3 favorites]


I'll add another "don't do it" to the mix. And I too am not anti-drug. I'd describe my knowledge of it as the high being great but not some sort of great that is unlike anything ever experienced and worth f*cking yourself over for. The low is already pretty dark for most non-depressed people, VERY dark for depressed "I take a single SSRI to manage my depression" people, and logarithmically darker and bleaker for "I've tried many different meds/med combination and can barely get my depression under control" type people. For the last category I only have an n of 2, (and I am one of those two), but the resulting experiences were bad enough to firmly believe that it is just. not. worth it.
posted by ArgyleMarionette at 10:01 AM on February 28, 2012 [2 favorites]


Before it became a party drug, Exctacy was actually used as a treatment for depression, in the context of therapy; the idea of taking it for depression is not a terrible one. There are some rogue therapists who still treat patients with it on the downlow.

The danger here lies with the fact that you are already on SSRIs. When you take exctasy, you ae basically dropping a serotonin bomb on your system. If you combine it with an SSRI, you are risking Serotonin Syndrome, which can be fatal. Same reason you don't want to take St. John's Wort concurrently.

It couldn't hurt to see what your therapist thinks about MDMA (in the abstract) but don't try taking it on your own.
posted by esmerelda_jenkins at 10:09 AM on February 28, 2012 [6 favorites]


Personal anecdote: I have depression and used to do ecstasy about once a month and my emotions the next day were so bad that after a few tries I decided never to do ecstasy again. Plenty of other people have more scientific advice, I just wanted to let you know it affected me much worse than other (non-depressed people) and there's no way of knowing what it is doing to your brain chemistry long term. Memail me for more details.
posted by thankyouforyourconsideration at 10:23 AM on February 28, 2012 [2 favorites]


MDMA does not mix well with the medications you're on, to say the least, and the medications you're on are not ones you can discontinue without horrible side effects. So I think it would be pretty fucking risky to try it at this point.

I wouldn't even consider it while I was on meds. If you get to a point where you're not using any meds, that's another question. For myself--someone who has had terrible depression since early childhood, and who has cycled on and off meds for the past 25+ years--I actually didn't have any bad experiences with ecstacy when I took it during an off-meds phase.
posted by Sidhedevil at 10:46 AM on February 28, 2012


I know that some antidepressants can attenuate the effects of ecstasy, but that's not really my concern.


In my personal experience, if you're on an SSRI and take MDMA (or LSD, or Psilocybin mushrooms), the intensity and longevity of the trip is seriously muted, and it's really not worth the expense or the inherent risk that comes with procuring illegal drugs. There have been times when I have felt all the negativity associated with the comedown without any of pleasure that comes from tripping when I have experimented with MDMA.

You could be fine, or you could not. There is really no way for you to tell. It’s a gamble you will be the only person responsible for whatever repercussions this may have on your life.

Tons of useful and well organized information over at Erowid – a fantastic resource for any budding psychonaut.

Good luck, be safe.
posted by OsoMeaty at 10:53 AM on February 28, 2012 [1 favorite]


If you do decide that it's safe and you do take some, you may want to first peruse "Pill Reports". They test so-called Ecstasy and publish results from all over the world, often with photos of the pills and descriptions beyond the 'name' of it. Much of what's sold as Ecstasy isn't pure or isn't Ecstasy at all.
posted by VioletU at 11:12 AM on February 28, 2012


I am not a doctor or pharmacist, but my father is a research scientist who does a lot of brain PET imaging. He shared with me some of the brain studies from long-term ecstasy users, along with information about how MDMA can interact with antidepressants and mental illness. Long story short: Lab-grade MDMA is not that bad for you as recreational drugs go, but it is a stunner of a bad combination with SSRIs or serotonin-related mental illnesses. And a lot of what's sold as MDMA on the street can make "a stunner of a bad idea" look like a walk in the park.
posted by KathrynT at 11:47 AM on February 28, 2012 [1 favorite]


IMO the far more serious danger here is the potential for drug interactions. MDMA is already an unreliable substance without adding three medications to the mix. Don't risk it.
posted by vanitas at 11:57 AM on February 28, 2012


I can only share my personal data point that doing ecstasy felt, although ecstatic, weirdly fake. Even while I was feeling unbelievably good, I was aware of the fakeness of that feeling. And afterwards I felt like completely shit - mostly emotionally - for about 2 days.
posted by latkes at 12:52 PM on February 28, 2012


I came of age before Ecstasy was made a Schedule I drug, so I'm surprised that I didn't encounter it. But knowing then what I know now -- about the challenges I face maintaining my mental health -- I'm sort of grateful that weed and cheap vodka were my substances of choice. Oh, how I miss them. (Well, not the cheap vodka.) I had no choice, though. Like you, I take an antidepressant and an anticonvulsant. Now, one drink or joint leaves me feeling like I've been on a three-day bender.

In The Noonday Demon, Andrew Solomon's survey of depression (his own and other people's), discusses his Ecstasy experiences in a drily tongue-in-cheek way that made me laugh:
When I have taken E, I realize that I can save the world and I get excited about doing it. ... The solutions to all my problems become clear. Unfortunately, the solutions I devise usually turn out, when I come back down, to be rather unsatisfactory. It would not solve all my problems (or theirs) for me to marry into the British royal family, nor would there be any expedient way of accomplishing that objective.
But then there's the comedown:

He also talks to David McDowell, M.D., psychiatrist and co-founder, Columbia University Substance Treatment and Research Service: "Freshmen love (Ecstasy); sophomores like it; juniors worry about it; and seniors are afraid of it. ... Depressed patients who use the drug? I say to them, 'In twenty years, do you want to be on three medications or on ten?' "
posted by virago at 1:18 PM on February 28, 2012 [1 favorite]


If you do decide that it's safe and you do take some, you may want to first peruse "Pill Reports". They test so-called Ecstasy and publish results from all over the world, often with photos of the pills and descriptions beyond the 'name' of it. Much of what's sold as Ecstasy isn't pure or isn't Ecstasy at all.

Using Pillreports is great advice, but just to be clear, they don't test pills. It's all user-generated content, and there's no vetting of the users. This can, and does, mean that unscrupulous dealers post glowing reviews of their pills, and that idiots who don't know anything about drugs post reviews. On the other hand, if you see a bad review, that can be useful.

You may be thinking of ecstasydata.org, which is a site that lab-tests pills that are submitted by users.
posted by Infinite Jest at 1:35 PM on February 28, 2012 [1 favorite]


Yeah, wow. Take a look, OP, at all the things that are sold as ecstasy and either aren't, or are mixed with another drug with a completely disparate pharmacology. I doubt anyone can tell you what'll happen if you -- as in, you, who is depressed and on a pretty significant drug regimen -- take a 5-MeO-DiPT pill you thought was MDMA.
posted by griphus at 1:54 PM on February 28, 2012


Only you can decide whether to try it. If you do, though, it's ESSENTIAL to have at least one person with you who's experienced, reliable, and doesn't get high along with you. It's like a designated driver at a cocktail party. The first time for anything is a step into the unknown, and if it goes bad, you need someone to be with you who can take care of the problem.
posted by KRS at 2:17 PM on February 28, 2012


With regard to ecstasy, a wise friend once said to me that whatever it gives to you, it then takes away. Meaning, if you do experience an incredible high, you can expect to experience an equally dark and horrible low on the way down. If you're already susceptible to this due to depression, I would hate to find out how much worse that low could be. Please don't do this.
posted by Jubey at 2:25 PM on February 28, 2012 [1 favorite]


nthing everything else said above. But if somehow it did work that'd be as dangerous. Avoiding chemical romance is a challenge even for nondepressed people. But for you, the inevitable return of depression may make it irresistible to break the promise of trying it once. If this is people around you who represent the opportunity to let you try it (not saying that's what motivated the question) then there's a social dynamic which again makes the try-once thing harder.
posted by yoHighness at 2:48 PM on February 28, 2012


Do it. Just be with people you trust in a fairly safe place.

It'll only suck for a day or 2 after (unless you die or go into a coma).
posted by coolguymichael at 4:14 PM on February 28, 2012 [1 favorite]


Really, really, really bad idea, both short-term (drug interaction, E spiked with or entirely made of Bad Things), medium-term (horrible depression afterwards) and long-term (messing up your serotonin levels even more).

semi-relevant anecdote: in a freshman class on drug use, the professor told us that E is the absolute worst drug you can take as far as permanent brain damage goes. no idea if that's actually true, but it stuck with me.
posted by randomnity at 5:56 PM on February 28, 2012


With regard to ecstasy, a wise friend once said to me that whatever it gives to you, it then takes away. Meaning, if you do experience an incredible high, you can expect to experience an equally dark and horrible low on the way down. If you're already susceptible to this due to depression, I would hate to find out how much worse that low could be. Please don't do this.

I agree with this 1000%. MDMA is not magic, it is an amphetamine. In a very non-scientific (but correct enough for our purposes) way of putting it, amphetamines increase the rate at which your neurotransmitters squirt out. Different amphetamines work on the different neurotransmitters in different proportions and at different rates, and MDMA works on all three, but (apparently) especially on the serotonin ones.

Here is the problem: at the dosages required to get high, it will "burn off" all the serotonin you have. Because more or less, our bodies can only manufacture neurotransmitters at a certain rate. When you run out, you are out for a long time, because your brain is still trying to use them for normal operations. In the case of regular speed, this means you want to sleep until you are caught up. In the case of serotonin, this means you will feel miserable, dysphoric, the opposite of "well being", and have little to no will to do anything. This is bad enough for someone not suffering from depression, but it will likely be terribly unpleasant for someone prone to depression.
posted by gjc at 6:15 PM on February 28, 2012 [1 favorite]


I don't really know what would happen to someone with depression or how your drugs will affect the outcome, but know this: as a person without depression, i have take ecstasy on three occasions. The day-after come-down made me feel so depressed and lonely and awful and desperate that that feeling is 100% of the reason i haven't done it a fourth time, and probably never will.
posted by Kololo at 7:53 PM on February 28, 2012


I agree with this 1000%. MDMA is not magic, it is an amphetamine.

I don't agree with it at all. I didn't experience the downside of at all until I had done it weekly for an extended period of time. "What goes up, must come down" is pseudo-scientific nonsense, frankly. The first time I did it, I had an afterglow for weeks--I literally felt like a new person. If I had just done it once, it would have just been a tremendously positive experience with no negative side effects at all. You're in no way guaranteed to feel equally as bad on the downside as you felt good on the upside.

That said, the people I know who used it who did suffer from depression seemed to have way wilder mood swings from it afterwards than I ever did, even after just one use, and it does seem to be unpredictable.

Also, the subjective effect of MDMA is almost nothing like the effect of other amphetamines, and the (from my limited understanding), the mechanism of action is also much different.
posted by empath at 8:28 PM on February 28, 2012 [1 favorite]


I did this, but NOT while on any other medications...and I'll tell ya...changed my life for the better. It was the first time I really knew what people were talking about when they talked about loving oneself and, although I knew the feeling of self-esteem and love I had while on ecstasy was an unsustainable extreme, it made me realize just how far I was from feeling that way in my day-to-day life and gave me a goal to strive for. Inspired, I went into therapy soon after and began the hard work of becoming the person I want to be.

As far as the come-down goes, I did not find it bad at all. There was some degree of mourning that I couldn't feel like that all the time, but it also left me with a residual memory of feeling good about myself that I could access for some time after.
posted by The Dutchman at 8:07 AM on February 29, 2012 [2 favorites]


Dutchman, maybe you had another drug entirely.
posted by Lesser Shrew at 12:53 PM on March 2, 2012


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