Is it safe to use MDMA while taking an SSRI?
November 1, 2016 11:58 AM   Subscribe

Is it safe to use MDMA (ecstasy) while taking an SSRI such as Lexapro (escitalopram) or Zoloft (sertraline)? I am particularly interested in scientific research (that is accessible to lay people) on the subject, though anecdotal information is also welcome. Thank you.
posted by Conrad Cornelius o'Donald o'Dell to Health & Fitness (10 answers total) 1 user marked this as a favorite
Here's the MDMA and SSRI page on, with linked references. Everything I've heard anecdotally is yes, as safe as taking MDMA, but it makes MDMA significantly less effective.
posted by infinitewindow at 12:07 PM on November 1, 2016 [4 favorites]

According to one source, SSRIs will reduce the effects of MDMA. See here. Naturally there is not a whole lot of research given the illegal nature of MDMA.

Anecdotally, when I ran in those circles, it was common to recommend taking SSRIs in anticipation of rolling MDMA in order to attenuate the post-Ecstasy depression that is common, but I don't know if that was anything more than drug culture lore.

Combining SSRIs with any kind of other psychoactive like MDMA could run the risk of serotonin syndrome, I suppose, so you might want to be careful. Sadly it's not the kind of thing you can get solid medical advice about.
posted by dis_integration at 12:07 PM on November 1, 2016

Anecdotally, it won't work and will make you bonkers depressed the day after.
posted by tatiana wishbone at 12:30 PM on November 1, 2016 [4 favorites]

If I had a neurotransmitter imbalance, there is no way in hell I'd take a drug that floods your brain of neurotransmitters and leaves you depleted the next day(s).
posted by radioamy at 12:37 PM on November 1, 2016 [4 favorites]

Anecdotally, taking MDMA when you have existing chemical imbalances in your brain can result in some very bad experiences.
posted by gnutron at 2:41 PM on November 1, 2016 [2 favorites]

No. Serotonin syndrome is no good.
posted by chiquitita at 2:58 PM on November 1, 2016 [2 favorites]

Not recommended. The risks far outweigh the slim chance that it might be fun for a few hours.

As a side note, even when not on anti-depressants, many non-neurotypical people do not have the same experience with MDMA as other people do. Either in a boring, 'this isn't working' way, or in an unpleasant, 'this is not fun at all' way.

I have heard of people taking Prozac or other anti-depressants to hopefully increase the effectiveness of the roll and ease the post-MDMA comedown, but from my observations it was mostly a poor grasp of neuroscience and wishful thinking that spurred this line of experimentation.
posted by ananci at 3:19 PM on November 1, 2016

I've known quite a few people who have tried it, and although it doesn't seem to have done them any harm, it was a waste of perfectly good MDMA. The SSRI interferes with the MDMA's effectiveness (but not, it turns out, the less pleasant side effects) to the point where everyone that I've known who's combined them has regretted it.
posted by Parasite Unseen at 3:45 PM on November 1, 2016 [1 favorite]

No, because of the risk of serotonin syndrome as noted above. Not everyone who does this will end up getting serotonin syndrome, but if you do get it, it's a very serious health problem that could cause life-threatening illness. (few refs in the links)
posted by treehorn+bunny at 10:40 PM on November 1, 2016

If I had a neurotransmitter imbalance
taking MDMA when you have existing chemical imbalances in your brain

FYI, the "chemical imbalance" theory of depression is not very well supported, and relies, ironically, on reasoning related to taking drugs like MDMA. No one suggests that because one's affect and feelings are changed by MDMA one's neurotransmitters are out of balance. We instead recognize that drugs have effects that do not necessarily describe an etiology in re our baseline.

The bigger concern is that it may cause serotonin syndrome.
posted by OmieWise at 5:22 AM on November 2, 2016

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