MDMA and Sertraline (Zoloft)
Usually blunts MDMA and is rarely dangerous by itself, but redosing to 'break through' is the real risk.
Why this happens
Sertraline is an SSRI. It occupies the serotonin transporter that MDMA works through, so MDMA usually feels weaker or flat. Taking more to compensate raises the risk, and combining it with other serotonergic drugs can push toward serotonin syndrome.
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)