Citation: Calmer. "When SSRI's Need a Vacation: An Experience with Citalopram, Syrian Rue & Cannabis (exp39568)". Erowid.org. Jul 22, 2005. erowid.org/exp/39568
Combining MAOIs with other psychoactive drugs carries serious medical risks and can result in extremely unpleasant side effects, overheating, nausea, confusion, heart problems, and even death. Please see Erowid's MAOI Vault]
For the last 6 years, Iíve been on and off (mostly on) several different SSRIís for depression/anxiety, which makes sense considering the fat list of mental and emotional disorders in my family history. Now, Iíve only been able to successfully treat my depression with two medicines: Effexor (aka venlafaxine) and Celexa (aka citalopram), and since Effexor caused me constipation and actually increased my anxiety, I opted for the libido-bashing Celexa.
I hate taking medicines. I hate the pill-popping routine. I hate the side effects. But I REALLY hate wasting my time in therapy crying on about nothing with nothing in my head and nothing bothering me but the annoyance of being miserable and decisively mean to people I care about, even when I know how wonderful my life really is.
Thatís why I take 60mg of Celexa every morning. I would take less, but I canít even manage on 55mg. Shit, all the more reason not to have a kid. Iím not about to further spread my genetic diseases!
Recently I asked my girlfriend to roll a joint I had prepared with some junk weed and approximately 30mg of 5-MeO-DMT sprinkled evenly on top. I would roll it myself, but I canít. Maybe if I had some kind of doobie training wheelsÖ
Being the good sitter she is, my girl walked out with me to the deck where I smoked half of the spliff while lying back in a lawn chair. Unlike the usual gym sock stink of burning 5-MeO-DMT, this time the smoke reminded me of corn tortillas. Weird.
Under winter moonlight, I stared up at the leafless trees. The more I smoked the heavier my body felt. Even in the dark, subtle lines and colors began to poke out with beautiful clarity. The closed-eye visuals were nil like the 2C-Tís.
I imagine I would have experienced more visual effects if I had been off of my SSRI for the appropriate 3-day minimum (Celexaís half-life). Iíve found that SSRIís will largely squash the effects of most hallucinogens, except for Salvia, DXM and maybe other disassociatives. Itís a bitch to do, but I find that 6 to 8 days is the ideal vacation time from my anti-depressants in order to get a proper trip off of the usual doses of LSD, MDMA, psilocybin, and other like drugs.
Since the trip was weak and over in about 20 minutes, on the following Saturday afternoon, I decided on that I would extend the life of the remaining half joint with the aid of an MAOI.
THE POLY-DRUG PROBLEM
Now, combining an SSRI with an MAOI is generally a stupid idea, since the increase of serotonin in the brain can result in a hypertensive state called Serotonin Syndrome.
ďSerotonin Syndrome is a potentially fatal condition, with symptoms and complications of euphoria, drowsiness, sustained rapid eye movement, overreaction of the reflexes, rapid muscle contraction and relaxation in the ankle causing abnormal movements of the foot, clumsiness, restlessness, feeling drunk and dizzy, muscle contraction and relaxation in the jaw, sweating, intoxication, muscle twitching, rigidity, high body temperature, frequent mental status changes (including confusion and hypomania - a Ďhappy drunkí state), shivering, diarrhea, loss of consciousness and death. ď
(The Serotonin Syndrome, AM J PSYCHIATRY, June 1991)
That all said, Serotonin Syndrome is a fairly rare disease that can occur from any number of drug combinations that affect the serotonergic systems of the brain, from Ecstasy to even St. Johnís Wort. I have gradually tested my body to see how much Syrian Rue (Harmala MAOI) I can safely take without reaching the mildest symptoms of Serotonin Syndrome, most commonly temporary (1-2 weeks) acute depression.
Surely itís smarter to simply get off the SSRI or tricyclic antidepressants for a few days before taking an MAOI, but making smart decisions frequently isnít my strong point. So, for the sake of education, Iíll share my missteps.
Iíve found that I can safely take a tablespoon or 9g of fresh Syrian Rue (approximately 200-600 mg Harmala, assuming a 4% MAOI alkaloid content of dry weight seeds). Itís my safety threshold, and I have never exceeded it while on Celexa.
Okay, itís a gorgeous Saturday afternoon. I have an empty stomach and about 5 hours to burn. I measure out a tablespoon of Rue and chop it to a powder in a clean coffee grinder, carefully trying my best not to inhale that funky, nauseous, toffee smell. I empty out several 1000mg Vitamin C gel tabs and fill them with the brown powder. After two glasses of water, the tabs are gone. Now I would have done a proper ascorbic acid extract, but the mere thought of breathing in the bitter stank of boiling RueÖ Ack! Ack!
I sit down on the couch, play a little Grand Theft Auto: San Andreas, and in about an hour or so, I begin to feel the lethargic drawl of the Harmala. I save the game, grab the joint, put my kitten in her harness and leash and venture into the backyard for some exploration time. I lie down in the grass as my kitty smells around and begins to stalk some bugs. I light up and start some more tree staring.
Now this is definitely differentÖ Branches begin to shimmer and wiggle as I focus and defocus my eyes. Fallen leaves drift back and forth on the lawn as if the blades of grass were gently moving tides. My weight feels heavier than before, like Iím anchored to the soil. I begin to notice various insects, bugs crawling everywhere, diligently hauling compost. Creatures everywhere moving with a purpose. I had no idea how truly alive my backyard was.
Time passes quickly, an MAOI phenomenon common for me. Iím guessing 40 minutes had passed after the half-joint had been burned down to an empty roach. I wrangled the kitten and carried her back into the house. During the following hour and a half, the trip peaked and began to subside as I encoded some of my recently bought CDís and categorized MP3ís on my computer. For some reason, the played-out sounds of 50-Cent fit my mood perfectly. I resolved to buy the debut G-Unit album. Though, unlike my typical self-admittance of bad taste, I felt no shame here. Was this ego inflation due to the trip, or was I just being honest with myself? Hell, Hi-Tek and Dr. Dre produced plenty of those beats. I still donít feel ashamedÖmostly.
Anyway, the trip tapered off after a total of about 3 hours, and physical and mental fatigue ensued for the rest of the evening.
Among other minor revelations, these last couple of trips have taught me that patience and respect must be given in ample amounts to hallucinogens. And, for the love of god, be careful with MAOIís. They can alter and intensify other drugs in disturbingly unpredictable ways. BE CAREFUL.
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