Methylene Blue as an MAOI

[Kenota]

So, in my considerations for creating a finely tuned preparation for personal use, I have been looking at readily available, cheap MAO-A inhibitors. I have come across reference to methylene blue as a potent selective MAO-A inhibitor, with varying advice on the kinds of dose which might precipitate inhibition without serotonin syndrome.
Has anyone else stumbled upon this possibility, and if they have:
a) Did it work?
b) What dosage did you use?
c) How does it compare to harmala or passiflora alkaloids?
Of course, if no one has tried this, this thread will become a record of my experiments to try to determine the dose needed, starting at sub-inhibition threshold levels and working my way up.

 

[jamie]

This should not be referred to here as "pharmahuasca". There is no beta carbolines in it. It could confuse some people. In general ayahuasca, ayahuasca analogues and pharmahuasca are known to be extremely safe. We dont know anything here about methylene blue in combination with DMT. Calling it pharmahuasca serves to confuse new people etc who might think that is safe also.

Rue is a cheap source of RIMA's..is there some other reason you would rather use this stuff?

 

[Kenota]

My mistake, I wrote this down quickly and the details completely slipped my mind. If it is possible for this to be moved to others to eliminate confusion, I would be much obliged.
Essentially, the use of a chemically pure substance which is readily available at high purity is the main attraction. It serves to be easy to use and allows for a higher degree of precision in preparation. Eliminating uncertainty in the form of impurities, which otherwise would require extensive work up.
Again I apologise for any confusion the original post may have caused.

 

[jamie]

It's fine here where it is..it's just good that we make it clear that these combinations of non beta carboline MAOI's and oral DMT are not the same thing as the "pharmahuasca" that is talked about here and elsewhere that is usually extracted but sometimes synthetic beta carbolines and DMT/5meoDMT. People just need to be aware that one has been tested by thousands if not millions of people while the other has not.

 

[pinkoyd]

Intriguing notion Kenota. Can you post a link to the reference? Having an alternate MAOI would be a good thing for the community, but there wouldn't be any advantage as far as taste is concerned over rue or caapi extracts.

 

[Ilex]

Methylene blue might be available in pure form, but that doesn't make it safer than syrian rue or caapi. From the sounds of it, probably it is more dangerous. You can easily extract high purity harmala alkaloids, so why would you bother using a chemical that's untested for this purpose and probably more dangerous? Just curious.

This info taken from:

http://ntp.niehs.nih.gov/ntp/htdocs/Chem_Background/ExecSumm/MethyleneBlue/MethBlue_exp_toxeffects.html

(and there is a lot more in the link, if you want to browse it)

Acute

Human Data

Gosselin et al. have given methylene blue a toxicity rating of 4 [Gosselin, et al., 1984]. Acute exposure to methylene blue by intravenous injection has been found to cause hypertension, sweating, chest pain, confusion, nausea, vomiting, dizziness, and cyanosis, as well as urine and stool discoloration [Arena, 1986; Gennaro, 1985].

Large, oral doses of methylene blue may cause fever [McEvoy, 1989]. Methylene blue has also been reported to cause quadriplegia after intrathecal injection [Driesbach, 1980]. Subcutaneous injection of methylene blue may cause necrotic abscesses [Reynolds and Prasad, 1989].

Methylene blue induces hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G-6-PD) enzyme deficiency. Dark-skinned races have a higher incidence of methylene blue-induced hemolytic anemia than lighter skinned races, but the disease has not been noted in North American Indians or Eskimos [Thienes and Haley, 1972].

Methylene blue is a severe eye irritant [Lenga, 1988]. High concentrations of methylene blue have been found to induce corneal and conjunctival injury [Grant, 1986].

 

[Kenota]

People just need to be aware that one has been tested by thousands if not millions of people while the other has not.

I couldn't agree more, I stress this is entirely speculative and to my knowledge, completely untried.

Can you post a link to the reference?

Azure B, a metabolite of methylene blue, is a high-potency, reversible inhibitor of monoamine oxidase - PubMed

Methylene blue and serotonin toxicity: inhibition of monoamine oxidase A (MAO A) confirms a theoretical prediction

Monoamine oxidase inhibitors (MAOI) are known to cause serotonin toxicity (ST) when administered with selective serotonin reuptake inhibitors (SSRI). Methylene blue (methylthionium chloride, MB), a redox dye in clinical use, has been reported to precipitate ...

www.ncbi.nlm.nih.gov

The first paper actually suggests that MB is also a prodrug to Azure B, which too is an MAO-A inhibitor. I would be certainly curious to see if this would have any effect on duration by providing prolonged inhibition. Given that the duration of an ayahuasca trip is on a comparable time scale to the 1-2 half life range of harmala alkaloids.
Also, try not to be too peturbed by the title of the second article, it does related to drug interaction induced serotonin syndrome, but in combination with SSRI.

Methylene blue might be available in pure form, but that doesn't make it safer than syrian rue or caapi. From the sounds of it, probably it is more dangerous. You can easily extract high purity harmala alkaloids, so why would you bother using a chemical that's untested for this purpose and probably more dangerous?

I agree it is likely less safe, though I don't believe it is necessarily unsafe. Most of the risks I have seen are associated with the more common usage of IV methylene blue. Though large oral doses causing fever would make sense, I cannot find the relevant article, or more correctly cannot access it from the AHFS.

 

[corpus callosum]

Max-Planck-Institute und Experten

Die Max-Planck-Institute forschen im Bereich der Lebens-, Natur- und Geisteswissenschaften, vielfach auch interdisziplinär. Ein einzelnes Institut lässt sich daher kaum einem einzigen Forschungsgebiet zuordnen, umgekehrt arbeiten verschiedene Max-Planck-Institute durchaus auch auf demselben...

www.mpasmb-hamburg.mpg.de

Interesting stuff is methylene blue!

The important things to note are that it and its metabolite Azure B have widespread effects beyond MAOI-A effects, including some phenothiazine (and hence potentially anti-psychotic) effects. These may conceivably reduce a psychedelic esperience if used to activate oral DMT.

Ive seen it used once as an antidote to methemoglobinemia- the patient was blue and looked cyanosed but with no breathlessness/cardiac signs; it turned out he had eaten alot of sausages which had been preserved with a nitrite containing compound. It worked brilliantly in restoring his hemoglobin to normality and is a case I will never forget.

Its multiple actions make me wary of regarding it as a good choice of MAOI-A; if I wanted a non-rue or caapi version I'd opt for moclobemide.

 

[Kenota]

That was a fascinating article. I thank you for it.
Interesting to not the possibility that the oral potency might be reduced by anti-psychotic effects. I wonder if these effects would be in the same dosage range as more MAOI inhibition.

 

[wearepeople]

I thought this was interesting:

Methylene blue was identified by Paul Ehrlich about 1891 as a successful treatment for malaria. It disappeared as an anti-malarial during the Pacific War in the tropics, since American and Allied soldiers disliked its two prominent, but reversible side effects: turning the urine green, and the sclera (the whites of the eyes) blue.

Methylene blue - Wikipedia

en.m.wikipedia.org

 

[Kenota]

Using the Spice turning the sclera blue...where have I heard that before...? :lol:

 

[pinkoyd]

Incidentally, oral MB is also used on occasion after various GI surgeries, especially bariatric (stomach reductions and such) to rule out leaks. The patient is given some to drink and a careful eye is kept on drains and dressings for blue staining. Usually this is done when there have been complications and the patient is critically ill, so MB can't be that toxic.

Never saw anyone's sclera turn blue from it though...

 

[Kenota]

It's a symptom of chronic use, if I am correct. The kind of acute dose you'd need to do it would be dangerous, to say the least, I would imagine.

 

[twitchy]

Clinical Toxicology Sep 2010

Methylene Blue: A Strong, but Poorly-Appreciated,
MAOI
Collins C,1 Hurley W.2
1University of Washington School of Pharmacy, Seattle,
WA, USA; 2Harborview Medical Center, Seattle, WA, USA

...Conclusions: This patient demonstrated
severe Serotonin Syndrome likely due to the concomitant
use of Escitalopram and Methylene Blue. Methylene
Blue is gaining increased use in cardiac and
parathyroid surgery, but the risk of concomitant use of
serotonergic agents and Methylene Blue is not well
appreciated. Methylene Blue should be considered a
strong MAO inhibitor and patients should be screened
for the use of serotonergic agents prior to undergoing
administration of Methylene Blue.
295.

Clinical Toxicology Sep 2010

Serotonin Syndrome Precipitated by Methylene
Blue
Smith C, Marshall SW, Crouch B, Caravati EM.
Utah Poison Control Center, College of Pharmacy,
University of Utah, Salt Lake City, UT, USA

...Conclusion: Administration of high dose
methylene blue for parathyroidectomy was associated
with serotonin syndrome in patients taking serotonergic
drugs before surgery. Whether this interaction can
be expected to occur at methylene blue doses which
are used to treat methemoglobinemia (1 mg/kg)
remains to be seen but should be considered.

Figured I'd add these to the thread for posterity. :thumb_up:


Edit:
Found this on the dosage...

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2009.06029.x

Small doses of methylene blue, previously considered safe, can precipitate serotonin toxicity

C. Schwiebert, C. Irving, P. K. Gillman

... We would like to add to the record a case from our practice, where definite serotonin toxicity was precipitated by only 1 mg.kg−1 of methylene blue. This case involved a young female with malignant disease of the pelvis, whose regular medication included the selective serotonin re‐uptake inhibitor paroxetine. She received 1 mg.kg−1 of methylene blue intraoperatively to aid cystoscopic identification of the ureteric ostia. Following emergence from anaesthesia she exhibited confusion, agitation, aphasia, ocular clonus, mydriasis, hyperreflexia and arterial hypertension. In the presence of an selective serotonin re‐uptake inhibitor, these signs allow the clear and unambiguous diagnosis of serotonin toxicity.

This case is the first to demonstrate a clear link between definitive serotonin toxicity and an methylene blue dose of < 5 mg.kg−1. It also provides evidence that the small dose of 1 mg.kg−1 provides MAO inhibition in vivo, and risks serotonin toxicity. We suggest that drug safety advice as well as clinical use of methylene blue should be modified accordingly.