Posted by scott-d-o on April 5, 2004, at 16:22:54
In reply to Re: effexor and ectasy -LINK » scott-d-o, posted by PsychoSage on April 5, 2004, at 13:04:30
> >
> > no need to worry about serotonin syndrome from this combination. ecstasy (3,4-methylenedioxyamphetamine) releases serotonin via reversing the action of the serotonin transporter (SERT), causing it to release serotonin into the synapse instead of taking it up into the cell like it normally does. effexor would almost entirely block any serotonin release induced by mdma, via it's occupation of the SERT. however, the supposed neurotoxicity of mdma is believed to be caused by excess dopamine at serotonin terminals. this seems to be a bunch of b/s thou and doesn't occur when the compound is used at common "recreational" doses.
>
> Wait a second. Is this hypothetical or official information from NIDA?
>It's based primarily on personal knowledge of pharmacology/biochemistry and testimonials from people who have had experiences with such combinations.
> It doesn't make sense whatsoever. We often through around our imperfect interpretations of studies and medical information, but I think when it comes to this particular issue where no doctor is accountable then we have to raise the bar here and not confuse neurotoxic rhetoric from the government with serotonin syndrome which is not a principal argument from anyone who wants to scare American youth away from ecstacy.
>I wasn't trying to equate serotonin syndrome with mdma neurotoxicity. the poster was seeking information regarding the risks involved in consuming such compounds, and I provided that. I don't claim to have a ph.d so you can take my information for whatever it's worth to you.
> If you think the warnings about serotonin syndrome here are influenced by flawed neurotoxicity research then you are entirely wrong.
>this is a misinterpretation, the neurotoxicity matter was just additional information I was providing the poster about the risks involved.
> I am not keen on neuroscience specifics, but an agonist and a reuptake inhibitor do not cancel each other out.
>obviously not, because mdma is not a direct agonist. as explained in my previous post, it works by reversing the reuptake carrier and causing it to release 5-HT/DA/NE instead of transporting it back into the cell. thus the receptors are agonised by the endogenous monoamine, not the compound itself. hopefully this will clear things up:
lets take a look at the function of the serotonin transporter:
normal conditions: serotonin transporter takes up released serotonin from the synapse and stores it back inside the cell (sort of like recycling.)
ssri: serotonin transporter is blocked (doesn't do anything). released serotonin is allowed to hang around outside the cell and find a receptor or get broken down/metabolized by MAO-A.
mdma: binds onto serotonin transporter and *reverses* it's normal function. instead of taking serotonin up from the synapse, 5-HT is taken up from within the cell and released out into the extracellular space, kinda like taking reuptake inhibition one step further, by not just blocking reuptake but also pointing it in the opposite direction.
mdma + ssri: ssri is blocking serotonin transporter, mdma cannot "knock" ssri off to bind to it and reverse its function. result: nothing, not a very fun trip.
by the way, amphetamine and methamphetamine work the same way except they function mostly at the dopamine and norepinephrine transporters. methamphetamine is slightly serotonergic as well.
> Specific Drug interactions and Serontonin syndrome:
> http://www.currentpsychiatry.com/2003_05/0503_serotonin.aspnotice, the drug interaction cited is taking mdma with a maoi, NOT a ssri. This is a whole different matter and I can definitely see how such a combination could cause serotonin syndrome.
scott
poster:scott-d-o
thread:332813
URL: http://www.dr-bob.org/babble/20040402/msgs/332979.html