(Pictures: Getty)Taking MDMA isn’t recommended regardless of your mental health status, but when you’re taking antidepressants it can cause a number of extra problems.
Normally, when taking MDMA, you’ll experience a high that makes you feel happy and with a heightened sensory perception. You might also feel way more awake, to the point where you’re restless.
That’s along with the more negative effects like gurning your jaw off, feeling dizzy and faint, and high blood pressure.
Then we get to the fact it can be fatal, potentially causing heatstroke (particularly in warm environments like clubs) that leads to respiratory failure, heart failure, or death by overhydration if the person’s liver fails and they drink too much water.
Harry Sumnall, Professor in Substance Use at the Public Health Institute, tells Metro.co.uk: ‘The risk of harm is related to the dose taken, but there are currently tablets and powders in circulation with harmfully high doses of MDMA, or contain completely different, but more toxic chemicals.
‘However, deaths and hospitalisation commonly occur at ‘normal’ doses of MDMA, suggesting that underlying factors, or drug-related behaviours are also important determinants of harm. This makes predicting who might experience harms from MDMA use difficult.’
These cases are certainly in the minority, but we still need to think about what we do to mitigate risk due to the unpredictability mentioned by Sumnall. Most initiatives such as Drugwise advise a harm reduction strategy that helps mitigate risk because – let’s face it – people are still going to do drugs despite the dangers.
Harm reduction techniques include going low and going slow (taking a small dose and waiting 1 to 2 hours to see the effect) and taking breaks from warm areas with small sips of water (less than a pint per hour).
For people on antidepressants, that harm reduction steps up a notch to the point most professionals would avoid taking it altogether, even in a controlled and ‘safe’ way.
Sumnall tells us: ‘MDMA partly produces it effects by entering neurons and increasing the release of a neurochemical in the brain called serotonin (5-HT), and then also preventing recycling of 5-HT back into neurons.’
Most common antidepressants are called SSRIs (Selective Serotonin Reuptake Inhibitors) and do a similar thing; what Sumnall calls the ‘chemical recycling process’. However, due to the fact MDMA has all sorts of other effects on the brain, you don’t get a similar high from taking an SSRI.
He continues: ‘SSRIs, particularly at high doses, have their own negative effects, including tremors and nausea, and in more serious cases seizures and a loss of consciousness.
‘But mixing SSRIs with MDMA will actually decrease the desired effects of MDMA as the SSRIs compete with MDMA for access to the neuron, meaning that MDMA cannot exert its full effects.’
Someone taking a standard dose of MDMA while on an SSRI would find, according to research, that the ‘combination reduces the psychological and some, but not all, of the physical effects of MDMA, although both are prolonged in duration. The combination prevents the increase in heart rate and blood pressure, but not the increase in body temperature usually experienced after MDMA.’
So, because you can’t feel the effects as much, you may take more, which increases your chances of overdosing. Plus, because your body temperature is still going up (regardless of whether you’re getting a high) the risk of hyperthermia is greater.
If you’re taking any of the now rarely prescribed Monoamine Oxidase Inhibitors (MAOI) type of antidepressant, you could also find yourself with serotonin syndrome, which can make your body overheat quickly. According to Sumnall, a number of deaths have been reported due to this.
If you’re taking an MAOI drug, in no circumstances should you ever use MDMA.
You should also avoid them if you’re on SSRIs, obviously because MDMA and your antidepressant could cause your body to overheat, but also because the high just won’t be that great.
Taking drugs or drinking excessively while you’re getting through mental health issues is not advisable. Comedowns and hangovers, which are unbearable for many anyway, can become the bleakest days of your whole life.
Although the research is patchy on whether conditions like depression and anxiety are caused by chemical imbalances in the brain, screwing with your mind using outside substances is extremely counterproductive.
If you’re worried about your drug usage in general, you can find support near you via Frank. You can also call their 24 hours helpline on 0300 123 6600 for more information.