Are there relevant venlafaxine and MDMA interactions?

Hi Doc
I take 150mg Venlafaxine daily. Now, when I take MDMA it doesn’t do anything. So it takes about 600mg to feel a mild effect is this down to the venlafaxine. In fact, Im not a regular MDMA user as now a standard dose of 200mg does nothing.

Originally posted in Evolution 3/11/14 . Reviewed 4/3/23

Venlafaxine belongs to a family of drugs (selective serotonin and norepinephrine reuptake inhibitors (SNRIs)) that decrease some psychological effects of MDMA.

There are no clinical trials that have studied the pharmacological effects of the combination MDMA + venlafaxine.

But, based on the mechanism of action and studies with similar drugs, this effect is likely to be present: that of decreasing the pleasant properties of MDMA.

Consequently, some people try to compensate for this problem by increasing the dose of MDMA. But that is not a good idea.Because this decrease in the psychological effects of MDMA does not necessarily imply that the effects on the heart and the rest of the body also decrease.

So, 600 mg is a very high dose that can be dangerous. On the other hand, the negative psychological effects of MDMA and the after effects can be potentiated, not only by the pharmacological combination, but also by the problem that motivated the use of venlafaxine (a depressive or anxiety disorder, in many cases).

To enjoy the effects of MDMA, it is advisable to be in a good state of health, both physically and mentally. It would be more reasonable to wait until your treatment is over and use safer doses.

Finally, a recent study linked the combination MDMA + venlafaxine to an increase in mortality. The impact in real conditions is probably low, but it is a fact to consider.