MDMA and oxcarbazepine interaction

Is there a pharmacological interaction between MDMA and oxcarbazepine?

At 4I years old I was recently diagnosed as being bipolar. So my psychiatrist put me on Oxcarbazepine / Trileptal.My question is: How does Oxcarbazepine affect LSD, MDMA, psilocybin? is there any interaction?  And, does it make it unsafe for me to use them?

Originally posted in SR2.0 7/2/14, Reviewed 2/2/23

Oxcarbazepine is not known to have any interactions with recreational psychedelics. However, it is essential to keep in mind that people who have bipolar disorder may be more sensitive to the adverse effects of drugs like LSD, MDMA, or psilocybin. This increased sensitivity is not due to drug interactions, but rather due to the underlying condition of bipolar disorder.

Bipolar disorder can manifest itself in different ways, such as cyclical manic and depressive phases, but this may not always be the case.

During depressive phases, the use of psychedelics may worsen mood symptoms. However, it is important to note that some individuals may become more aware of their symptoms and avoid using these substances altogether.

On the other hand, during manic phases, some people may exhibit normal behavior or have hypomanic episodes, while others may display clear signs of inappropriate behavior. As a result, it is crucial to have a thorough understanding of one’s specific case of bipolar disorder before deciding to use these substances.

In the event that an individual decides to use these substances, it is essential to be in the presence of trustworthy individuals who are familiar with the individual and can provide support.

MDMA is generally considered to be more manageable for most people, as it allows for better control over thoughts, feelings, and actions. However, it is worth noting that a depressive episode 24-48 hours after use is more commonly observed with MDMA than with psychedelics.

MDMA and psychedelic phenethylamines

Comparatively, how bad would you say psychedelic phenethylamines are compared to MDMA? I’ve been reading a lot about phenethylamines lately and how they can boost the body’s metabolism, induce the feeling of love, and possibly improve cognitive function and mood. On a personal level, I can say that after consuming a variety of different 2C-x compounds at lower doses, I’ve never had adverse after-effects, which I cannot say for MDMA. 2C-I, 2C-E, and other 2C-x compounds seem to utilize a more of a pay-it-forward approach, where you feel like shit on the come-up (not unlike mescaline), but then just feel amazing through the trip and without any sort of ill-effects in the come-down. Can psychedelic phenethylamines potentially cause damage akin to what MDMA does to Nigral cells? Could you start burning holes in to your brain if you took psychedelic phenethylamines a few too many times, or are they fairly safe when compared to MDMA?

Originally posted in SR 2.0 4/2/14 . Reviewed 5/2/23

It is important to understand that drugs cannot be classified as solely good or bad; their effects depend on the manner in which they are used.

It is a myth that drugs can burn holes in the brain as substances such as hydrochloric acid are not considered drugs.

MDMA, on the other hand, has undergone four decades of intensive research in both humans and animals, making it much safer than the psychedelic phenylethylamines. MDMA has been tested on thousands of people in clinical trials, whereas the human pharmacology of 2C-B or 2C-E has only been documented in anecdotal studies.

The use of phenylethylamines from the 2C family is uncommon at the population level. However, while the use of some members such as 2C-I, 2C-B, and 2C-E has gone unnoticed for decades, cases of toxicity and serious adverse effects from newer ones such as 2C-B Fly and Bromodragonfly have been reported more frequently. In addition to the lack of human experience, many psychedelic phenylethylamines are highly potent, and small differences in dosage, sometimes measured in milligrams or even micrograms, can produce intense effects, including organ toxicity.

It is true that the aftermath or «comedown» related to MDMA use is harder for most people than with 2C-X. This is due to both the pharmacological properties of each substance and the dose, frequency, and patterns of use.

MDMA and psychedelic cross-tolerance

Is there MDMA and psychedelic cross-tolerance?

 I’m having a difficult time actually getting visuals when taking LSD or the 2c family (2c-e, 2c-p, 2c-b). Only connection I can come up with is the fact that I did DMT a few days prior, but again the 2nd time I did LSD I didn’t do DMT for about a week.

So, my question is do they work on the same receptors or does the DMT effect the trip of LSD/2c family? Some things I also noticed is when I did 2c-b/LSD, I would get a cramp on my upper trapezius muscle but when I did DMT during the LSD I it would just go away. Additionally I should mention that I have type 1 diabetes which is well controlled (A1C has been in the range of 6-6.5 for the past 10 years).

Also is there any other long term health concerns other than serotonin syndrome with psychedelics? 

Originally posted in SR2.0 Forum 2/2/14 Updated 2/2/23)

There is some degree of cross-tolerance among most «classical» psychedelics, which are phenethylamines or tryptamines that interact differently with 5-HT2A serotonin receptors. Tolerance to hallucinogenic effects developed with one substance often applies to similar substances. To reset tolerance, a minimum of several weeks or a month is needed.

LSD, DMT, and the 2C-x family are considered physically safe.

Anecdotical reports  suggest cross-tolerance between LSD and psilocybin lasts for at least 7-10 days.

For those with well-controlled diabetes who take normal precautions, there are no additional risks and the risks are similar to those of non-diabetic individuals

Diabetics should take specific precautions before using psychedelics, such as setting a watch alarm to remember to eat and take insulin. The altered perception of time and self-perception of the body can make it difficult to detect hypo- or hyperglycemic episodes. Although psychedelics do not affect blood glucose levels, it’s advisable to check blood glucose levels once or twice during the experience to ensure safety



St John’s Ward interactions

I got a quick question:

I’ve started taking St. John’s Wort extract with amazing results (treating a mild – moderate depression).Do you know how long before taking MDMA I have to discontinue St. John’s in order not to get into a dangerous situation like serotonin syndrome or spoil the roll?

What about Amphetamines? Are they dangerous whilst on St. John’s (I figured no because they are not acting on serotonin that much)? Are you aware of any other drugs that might be dangerous with St. John’s?

Do just the same rules apply to St. John’s as to any «regular» SSRI in regards to drug use? I have done an extensive research on the internet but couldn’t find an answer

Originally posted in SR 2.0 7/5/23 . Reviewed 4/2/23

St. John’s Wort is a popular herbal supplement often used to help with depression and anxiety. Some people think that because it comes from a plant, it’s a more natural and healthier option. But it can interact with other drugs and medicines.

St John´s Wort acts like a monoamine oxidase inhibitor. So, theoretically, it could induce severe adverse effects in combination with drugs whose mechanism of action is related to dopamine, norepinephrine and/or serotonin liberation.

This includes MDMA, LSD, amphetamines, cocaine, psilocybin.

The use of ketamine , GHB or cannabis is probably safe .No toxicity has been reported and according the pharmacological mechanisms an interaction does not seem likely. Anyway this combinations are no recommended, as they could worsen or trigger depressive symptoms.

To be safe, it’s a good idea to stop taking St. John’s Wort for a couple of weeks before starting any other new drugs

MDMA, amphetamines and breast-feeding

Should MDMA and amphetamines be avoided during lactation? Is it strictly forbidden or risks are acceptable?

Originally posted in SR 2.0 31/10/2013. Reviewed 20/2/22

The relation between MDMA and lactation is not clear. As far as I know, there are no published studies on this particular issue. Available data on amphetamine show that «In dosages prescribed for medical indications, some evidence indicates that amphetamine might not affect nursing infants adversely.». On the other hand, data from methamphetamine show that meth is secreted to breast milk and it should be avoided.

In my opinion, it is basic to avoid use that can be harmful to third persons. A person can asume risks for himself but not for others, even less a baby. So there would be three options:

1) Wait to finish lactation and then use MDMA or amphs

2) Interrupt natural lactation (use artificial milk) and use MDMA or amphs

3) Collect enough milk for 3-4 days (using a breast-pump), keep it in the fridge and use it during the following days to MDMA or amphetamines use.