26 November 2024 18:56
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Can 5HTP together with MDMA cause serotonin syndrome?
26 November 2024 19:38
Can 5HTP together with MDMA cause serotonin syndrome?
Yes, if you combine 5HTP and MDMA, you increase the risk of serotonin syndrome. For this reason, it is advisable to stop taking 5HTP, tryptophan, and other supplements that affect the amount of available serotonin one day before using MDMA. You can only restart these supplements once the MDMA has completely worn off, which means you may not be able to take supplements like 5HTP again until the second day after using MDMA.
Serotonin syndrome and its causes
Serotonin syndrome can, in rare cases, occur due to excessive intake of XTC or MDMA alone. Only when MDMA is combined with other serotonergic medication or supplements can the risk increase significantly. This concerns psychoactive medication, serotonin boosters, and MAO inhibitors.
An MAO inhibitor (Monoamine Oxidase inhibitor) inhibits the action of the enzyme monoamine oxidase, which is involved in the breakdown of neurotransmitters such as serotonin, dopamine, and norepinephrine. Combining XTC/MDMA with an MAO inhibitor is very risky and is strongly advised against.
Examples of combinations that increase the risk are:
- XTC + antidepressants, such as SSRI, SNRI or MAOi
- XTC + supplements that affect serotonin, such as tryptophan, 5-HTP, St. John's wort, Banisteriopsis caapi, Shambala, and MAO inhibitors.
- XTC + opiates such as tramadol, morphine and buprenorphine
More about serotonin syndrome
Serotonin syndrome is rare, but it is a potentially life-threatening condition caused by excessively high serotonin levels in the brain. This can lead to symptoms such as:
- Epileptic seizures
- Confusion
- Overheating
- Death
Symptoms of serotonin syndrome vary in severity and may include:
- Mild symptoms: sweating, shivering, hyperactivity, dilated pupils, nystagmus (rapid back-and-forth movement of the eyes), increased muscle tension in the jaws and accelerated heart rate.
- Severe symptoms: severe hyperactivity, overheating, confusion, diarrhea, muscle stiffness, muscle spasms and hyperactive reflexes.
Some of these symptoms can also occur with normal use of MDMA. However, the higher the dose of MDMA or when other substances have been ingested, the more severe the symptoms can be. This can ultimately lead to a life-threatening situation. In particular, overheating and the risk of organ failure can increase the chance of death.
Diagnosis of serotonin syndrome and action:
If you think that you or someone else is developing serotonin syndrome, then call 1-1-2 as soon as possible. Medical professionals will then take action and, in the case of serotonin syndrome, often opt for symptomatic treatment such as thrombosis prophylaxis (to prevent blood clots), intravenous fluids, and possible hyperthermia treatment (for abnormally high body temperature). The administration of benzodiazepines also occurs.
In people with prolonged serotonin syndrome, treatment is often started with cyproheptadine (8 mg three times daily) until symptoms disappear or when thrombocytopenia (a shortage of platelets) threatens to become a problem.
More about serotonin or MDMA:
2 Answers
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11 July 2025 11:47
Yes, Using 5-HTP and MDMA together can cause serotonin syndrome. — and that risk is significant. Both substances increase serotonin levels in the brain via different mechanisms, and in combination, they can lead to a dangerous excess of serotonin.
It is best if you at least 24 hours before a MDMA or MDMA analogue session stops taking supplements such as 5-HTP, tryptophan, and St. John's wort. These substances stimulate serotonin production and, together with MDMA which releases serotonin and blocks reuptake, can disrupt the balance.
Taking 5-HTP before or immediately after an MDMA session increases the risk of serotonin syndrome. You may only 5-HTP two days after the session use again — only when you are certain that MDMA or the analogue has completely worn off.
In short: The combination is dangerous. If you want to support serotonin around a session, seek personal advice via the intake of Triptherapie. This way, you avoid risks and safely optimize your recovery.
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20 October 2025 13:28
To be on the safe side, it is best to avoid 5HTP on the day of MDMA use and for up to 48 hours after use.