Reduction of Effects

SSRIs tend to cause reduced physiological and mental effects when taken before MDMA. A study for which there was a poster at the College on Problems of Drug Dependence in June of 2002, administered 20 mg Paroxetine (Paxil, a common dosage) orally to subjects for 3 days before administering MDMA. Subjects had reduced experiential and physiological responses to the MDMA. See Erowid.org/references/refs_view.php?ID=1388.

An important study by Liechti et al., concerning the effects of SSRI pretreatment on subjective MDMA effects in humans, administered Citalopram (an SSRI) at 40 mg by IV and found that the Citalopram reduced physiological and emotional responses:

"The main result of this study is that the psychoactive effects of 1.5 mg/kg MDMA were substantially attenuated by pretreatment with the SSRI citalopram (40 mg iv). Citalopram inhibited most of the psychological effects of MDMA. MDMA-induced increases in positive mood, derealization and depersonalization phenomena, thought disorder, and the loss of thought and body control were all attenuated by citalopram pretreatment. MDMA-evoked intensification of sensory perception, changes in the meaning of percepts, and subjectively facilitated imagination were also inhibited by citalopram as compared to MDMA alone. Citalopram alone also lowered scores on some scales compared to placebo. Most of these changes, however, were clearly due to side effects of citalopram such as fatigue, headache, and nausea, which influenced the mood rating. MDMA also produced marked increases in emotional excitability and sensitivity that, however, were not reduced by citalopram."
See Erowid.org/references/refs_view.php?ID=392.

"We investigated the effect of citalopram pretreatment (40 mg i.v.) on vegetative and cardiovascular effects of MDMA (1.5 mg/kg p.o.) in a double-blind placebo-controlled study in 16 healthy volunteers. MDMA moderately increased blood pressure and heart rate, slightly elevated body temperature and produced a broad range of acute and shortterm side-effects. Citalopram reduced all these MDMA-induced physiological changes except for body temperature."
See Erowid.org/references/refs_view.php?ID=1073.

Finally, chronic use of SSRIs, as is done in the treatment of depression, seems to reduce the effects of MDMA. That is, a higher dose of MDMA is required to achieve the entactogenic effect.

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