MDMA and Paroxetine (Paxil)
Blunts MDMA, and because it also slows MDMA's breakdown, effects can be unpredictable - do not redose.
Why this happens
Paroxetine is an SSRI that blunts MDMA by blocking its transporter, and it also inhibits CYP2D6, the enzyme that clears MDMA, which can make the overall effect less predictable.
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
- Acute psychological effects of MDMA are attenuated by the serotonin uptake inhibitor citalopram - Neuropsychopharmacology (2000)
- Qualitative review of serotonin syndrome, ecstasy (MDMA) and the use of other serotonergic substances: hierarchy of risk - Australian & New Zealand Journal of Psychiatry (2007)