Serotonin Syndrome From Harmalas + DMT?

[Apoc]

HI!

I was wondering how big the risk is for getting serotonin syndrome when using harmalas with maoi. I have read that harmine and harmaline alone have been known to cause SS, so I assume combined with dmt, the risk is greater. However, harmalas are a certain type of maoi, (temporary), and I'm wondering if anyone who knows the science behind harmalas and dmt could explain why or why not serotonin syndrome is a concern for aya/pharmahuasca users. Some pages out there are claiming that lsd can cause serotonin syndrome, but then people on this site claim it can't, and provide the reasons why not. So I'm wondering if it is the same for ayahuasca.

It seems like many report most of the symtoms of serotonin syndrome while on pharmahuasca (with harmalas). From here, Serotonin syndrome - Wikipedia

confusion, hallucinations, shivering (myoclonus), delayed breathing, hyperreflexia, acidosis, dialated pupils.

Most noteable of those symptoms indicating serotonin syndrome are myoclonus and confusion. Some people have reported major confusion which goes along with odd shivering for no apparent reason.

 

[jamie]

Seratonin syndrom is not an issue with DMT and harmalas from either rue or caapi. The only time thats an issue is if you take something like MDMA along with harmalas..or possibly take a ton of 5htp etc before hand..so dont do that..

the idea that you might eat some cheese or something before taking ayahuasca and get seratonin syndrom is a myth..that doesnt happen with RIMA's

Be careful with other types of MAOI's though..i know nothing about non harmala MAOI's.

 

[prottel]

Most of the effects of serotonin syndrome can happen on ayahuasca, especially on higher doses. But I have not heard that it is dangerous with ayahuasca. I wonder if what happens on ayahuasca could possibly be serotonin syndrome, although not strong enough to cause death?

Symptoms of serotonin syndrome --- Experienced with ayahuasca:

Increased heart rate --- CHECK
Shivering --- CHECK
Sweating --- CHECK
Dilated pupils --- CHECK
Myoclonus --- CHECK
Agitation or restlessness --- CHECK
Confusion --- CHECK
Diarrhea --- CHECK
Headache --- CHECK
Vomiting --- CHECK
Ataxia --- CHECK
Hallucinations --- CHECK
Hyperreflexia --- Not sure
Goose bumps --- Not sure

 

[L_Star]

SS is bad bad news. Mental confusion is twisted, analysing situations just goes out hte window paranoia sets in from past exp

 

[SnozzleBerry]

Most of the effects of serotonin syndrome can happen on ayahuasca, especially on higher doses. But I have not heard that it is dangerous with ayahuasca. I wonder if what happens on ayahuasca could possibly be serotonin syndrome, although not strong enough to cause death?

Symptoms of serotonin syndrome --- Experienced with ayahuasca:

Increased heart rate --- CHECK
Shivering --- CHECK
Sweating --- CHECK
Dilated pupils --- CHECK
Myoclonus --- CHECK
Agitation or restlessness --- CHECK
Confusion --- CHECK
Diarrhea --- CHECK
Headache --- CHECK
Vomiting --- CHECK
Ataxia --- CHECK
Hallucinations --- CHECK
Hyperreflexia --- Not sure
Goose bumps --- Not sure

But hang on now...just because these symptoms are experienced doesn't mean anything as far as serotonin syndrome. All any disease or syndrome is is a bundled up group of symptoms and the only reason they are bundled up is because it indicates a problem that we have a treatment for. The vast majority of these symptoms can be experienced as the result of taking almost any psychedelic. According to the logic presented thus far by the OP, this would mean that every time you take a psychedelic you are experiencing ss, and that's patently untrue. This seems to be...if not a category error (I don't think it is, just can't remember which one this would be)..then some fallacious reasoning along similar lines. The psychedelics listed on that same wikipedia page as having the potential to cause/contribute to serotonin syndrome are; MDMA, MDA, 5-MeO-DiPT, and LSD. Out of curiosity Apoc...where did you read "harmine and harmaline have been known to cause serotonin syndrome"? And what additional risk do you think adding dmt to those two creates? I'm a little confused and trying to follow your logic.

 

[corpus callosum]

According to the British National Formulary ( a book listing all the medications we use in the UK, along with their side-effects and important interactions) all the symptoms listed by dagger are side-effects of MAOIs in isolation.Having these symptoms doesn't mean one is experiencing serotonin syndrome.

 

[prottel]

I am not saying they are the same, just that the symptoms seem very similar. May it not be some connection here?

Harmine and harmaline are reversible monoamine oxidase inhibitors. They can stimulate CNS by inhibiting the metabolism of serotonin and other monoamines.

Couldn't this mean that MAOIS in high doses can increase serotonin and reach a low level Serotonin syndrome, although you may need a SSRI to reach dangerous levels?

 

[corpus callosum]

Yes dagger, there is a link.The symptoms you list can relate to serotoninergic effects but then again MAOIs also have effects on noradrenaline and dopamine which can also produce some the effects you list by altering the functional status of the autonomic nervous system.The term Serotonin Syndrome refers to a pathological and potentially very nasty state whereas the production of similar symptoms as side-effects is more of a nuisance rather than a significant illness.Stopping the MAOI/other contributing substance is usually all thats required to ease side effects;serotonin syndrome, depending on its severity will require more than just abstinence.

 

[acolon_5]

I am not saying they are the same, just that the symptoms seem very similar. May it not be some connection here?

quote]


Yes, taking MAOI's and DMT both affect the serotonin receptors, I believe that is the connection.

The list of deaths from Aya/pharma (limited to harmala's and DMT) is so small, and allways in conjuction w/ taking some other contraindicated chemical (massive doses of tobacco enemas, 100g syrian rue, 5-meo-dmt, MDMA, amphetamines, cocaine, etc...) or the person had a pre-existing severe condition.

I highly doubt that we can say that, while in a powerful trance/other world, that symptoms perceived (body hallucinations possibly) indicate serotonin syndrome.

DMT by itself will make me feel very cold for a few minutes...and I come back slightly confused.

 

[Apoc]

ok, so the the original concern was that serotonin syndrome is most likely to be caused when you have a substance such as an MAOI (harmala), which inhibits the breakdown of serotonin. That combined with an increase of serotonin can cause what is defined as Serotonin Syndrome.

According to Wikipedia's dmt site, "DMT acts as a non-selective agonist at most or all of the serotonin receptors" . N,N-Dimethyltryptamine - Wikipedia
Furthermore, according to wikipedia's site on serotonin syndrome, "The combination of MAOIs and other serotonin agonists or precursors pose a particularly severe risk of a life-threatening serotonin syndrome." Serotonin syndrome - Wikipedia

So, according to wikipedia at least, the combination of maoi's (harmals), with a serotonin agonist (DMT) "poses a particularly severe risk of a life-threatening serotonin syndrome".

Now, I know this to be not entirely accurate, since from many accounts here at the nexus, I know of many who have taken large doses of both harmalas with large doses of dmt and never experienced acute life threatening, or permanent dysfunction. In fact, most felt quite good after their session. However, many of the official symptoms of serotonin syndrome are present with aya or pharma use. The only symtoms I haven't experienced on pharma were over heating, diareheah, or loud bowel sounds, but pretty much all the rest.

I was just curious if there is some scientific reason why ayahuasca combo in particular does not seem to be life threatening, although the literature suggests that it should be. Lots of people out there are taking harmalas with dmt and not dying...... so....... I was just wondering what's going on here. I have also read that taking prescription MAOI with dmt significantly increases the risk of serotonin syndrome.

You know, it may simply be a case of no one has ever really delved deep enough in to this issue to truly answer the question, and I suppose doctors probably don't care about this one question in particular.... the question being if ayahuasca intoxication counts as serotonin syndrome. They are aware of this thing called serotonin syndrome, and it is well established that it can be a problem with MDMA and maoi's. It may be a case of serotonin syndrome being defined as potentially fatal, yet there are so many levels of it, a level which ayahuasca is unlikely to reach. It may be a case of defining a sub drunk alcohol buzz as alcohol poisoning (because the literature suggests that serotonin syndrome is defined as poisoning).

According to the logic presented thus far by the OP, this would mean that every time you take a psychedelic you are experiencing ss

Well, yes, that was my concern. It was the logic of what is presented as serotonin syndrome. I thought I should investigate further to see if anyone has a better answer. It seemed according to what is defined as serotonin syndrome, almost anyone who is on ayahuasca is experiencing "a potentially fatal poisoning". That is what the literature on SS suggests, and yet the reality of ayahuasca use does not seem to support that logic. I wondered why.