MDMA and Duloxetine (Cymbalta)
Shown to inhibit MDMA's effects; the danger is redosing and stacking other serotonergic drugs.
Why this happens
Duloxetine is an SNRI shown in a controlled human study to inhibit MDMA's rise in noradrenaline, blood pressure, heart rate and subjective effects by blocking the transporters MDMA uses.
What this means in practice
Do not try to push through by taking more MDMA - that is where the real risk is. Whether to pause an antidepressant for MDMA is a medical decision, never a DIY one; ask the prescriber.
Warning signs - get help
Call your local emergency number straight away if you notice any of these:
- A high fever or skin that is hot to the touch
- Agitation, confusion or hallucinations
- Rigid, twitching or cramping muscles
- A racing heartbeat
- Heavy sweating or shivering
Information, not medical advice. Threshold does not promote or encourage MDMA use. This exists so that people who make their own choices can make safer, better-informed ones. It is not a substitute for professional care.
Sources
- Duloxetine inhibits effects of MDMA in vitro and in humans (randomized placebo-controlled study) - PLoS ONE (2012)
- Qualitative review of serotonin syndrome, ecstasy (MDMA) and the use of other serotonergic substances: hierarchy of risk - Australian & New Zealand Journal of Psychiatry (2007)