Comment · Fri, October 30, 2015
MDMA + psychedelic combinations: An underrated risk?
Original post in this thread
tasty_cupcakes · 120 points
I was recently researching the potential health risks of MDMA + psychedelic combinations (also known as candyflipping, hippyflipping, etc.). While awareness of MDMA's potential neurotoxicity is very present in forums that promote harm reduction such as Erowid, /r/drugs, /r/mdma, Bluelight, DanceSafe, RollSafe, etc., there was not much discussion about the potential dangers of MDMA + psychedelic combinations. For example, on RollSafe, a site exclusively dedicated to MDMA harm reduction, cites MDMA+LSD, MDMA+Mushrooms and MDMA+2C-B as generally positive combinations without any kind of warning about the possible health consequences of those. Erowid recognizes that there has been no research on this front but doesn't especially warn about it.
While the scientific literature about MDMA + psychedelic combinations is very small, and centered on animal studies, this is some information I could find:
**Potentiation of (DL)-3,4-methylenedioxymethamphetamine (MDMA)-induced toxicity by the serotonin 2A receptior partial agonist d-lysergic acid diethylamide (LSD), and the protection of same by the serotonin 2A/2C recep…
What they were answering
Borax · 3 points
Considering that ketanserin blocks the depletion of glutathione it looks like 5-HT*_2a_* is modulating the known neurotoxicity mechanism whereby an MDA-glutathione conjugate is responsible for the damage.
Therefore it seems reasonable that the supplementation recommended by many here or the substitution I and others recommend will offer some protection as it does for regular MDMA consumption.
/u/misteryouaresodumb I would be interested on your thoughts.
u/MisterYouAreSoDumb
My theory on that is that LSD can exacerbate MDMA induced 5-HT system toxicity by agonizing the 5-HT2c receptors, consequently leading to increased body temperature, which makes the damage from MDMA worse. Curiously enough, ketanserin also markedly inhibits 5-HT2C activity. So the fact that the above study showed ketanserin blocked the depletion of glutathione could be related it its 5-HT2C effects, rather than the 5-HT2A affinities.