TripSit Wiki - User contributions [en]

Drug combinations

2017-11-30T09:42:25Z

Robustrepresent: /* mdma & cannabis */

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! See below the graphic for important information regarding specific combinations.'''

[[File:Combo_2.png|1000px|center]]

== Overview ==
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== Categorisations ==

''Low Risk & Synergy'' - These drugs work together to cause an effect greater than the sum of its parts, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before combining drugs.

''Low Risk & No Synergy'' - Effects are just additive. The combination is unlikely to cause any adverse or undesirable reaction beyond those that might ordinarily be expected from these drugs.

''Caution'' - These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.

''Unsafe'' - There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.

''Dangerous'' - These combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.

== Chart versions ==

'''[https://wiki.tripsit.me/images/3/3f/TripSitDrugComboChart-Spanish.png Spanish]'''

'''[https://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/images/0/0c/Drug-combinations-fr.png French]'''

'''[https://wiki.tripsit.me/images/9/9e/TripSitDrugComboChart-Esperanto.png Esperanto]'''

'''Portuguese''' (Needs Translation)

'''Polish''' (Needs Translation)

== Specific Combinations ==
===cannabis & lsd===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & lsd===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & mushrooms===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & mushrooms===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & dmt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & dmt===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===5-meo-xxt & mescaline===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions

===cannabis & mescaline===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===cocaine & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===caffeine & mescaline===

Status: Low Risk & No Synergy

Note: High doses of caffeine are uncomfortable and this will be magnified by psychedelics

===tramadol & mescaline===

Status: Unsafe

Note: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

===5-meo-xxt & dox===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

===cannabis & dox===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===ketamine & dox===

Status: Low Risk & Synergy

Note: Ketamine and psychedelics tend to potentiate each other - go slowly.

===mxe & dox===

Status: Caution

Note: As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

===dxm & dox===

Status: Unsafe

Note: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

===pcp & dox===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===amphetamines & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

===mdma & dox===

Status: Caution

Note: The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

===cocaine & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

===caffeine & dox===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

===alcohol & dox===

Status: Low Risk & Decrease

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

===opioids & dox===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===tramadol & dox===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===maois & dox===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & nbomes===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

===cannabis & nbomes===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===mxe & nbomes===

Status: Caution

Note: As an NMDA antagonist MXE potentiates NBOMes which can be unpleasantly intense

===amphetamines & nbomes===

Status: Unsafe

Note: Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

===cocaine & nbomes===

Status: Unsafe

Note: Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & nbomes===

Status: Caution

Note: Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

===tramadol & nbomes===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

===maois & nbomes===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-x===

Status: Caution

Note: The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

===cannabis & 2c-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===cocaine & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===caffeine & 2c-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===tramadol & 2c-x===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

===maois & 2c-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-t-x===

Status: Caution

Note: Both classes of compounds can be unpredictable alone

===cannabis & 2c-t-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-t-x===

Status: Unsafe

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===cocaine & 2c-t-x===

Status: Unsafe

Note: Cocaine and 2c-t-x both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & 2c-t-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & 2c-t-x===

Status: Low Risk & Decrease

Note: Both these classes of compound can interact unpredictably. Caution should be exercised.

===opioids & 2c-t-x===

Status: Low Risk & No Synergy

Note: No expected interactions, some opioids have serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

===maois & 2c-t-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably, which could be dangerous given the unpredictability of the 2C-T-x series

===cannabis & amt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics. Small amounts can reduce nausea with aMT but take care.

===caffeine & amt===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & amt===

Status: Caution

Note: aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

===opioids & amt===

Status: Low Risk & No Synergy

Note: No unexpected interactions

===maois & amt===

Status: Dangerous

Note: aMT is an MAOI on its own. Using enzyme inhibitors can greatly reduce predictability of effects.

===mxe & 5-meo-xxt===

Status: Low Risk & Synergy

Note: Little information exists about this combination.

===dxm & 5-meo-xxt===

Status: Unsafe

Note: Little information exists about this combination.

===cannabis & 5-meo-xxt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===mdma & 5-meo-xxt===

Status: Caution

Note: Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

===cocaine & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===caffeine & 5-meo-xxt===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===amphetamines & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===mdma & cannabis===

Status: Low Risk & Synergy

Note: Large amounts of either or both may cause strong and somewhat unpredictable experiences, which can be as intense as psychedelics. Consider rather Set and Setting are good, before you combine these. Cannabis should be saved for towards the end of the MDMA experience if possible, where the psychedelic alike effect won't come to play.

===cocaine & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===alcohol & cannabis===

Status: Low Risk & Synergy

Note: In excess, this combination can cause nausea.

===amphetamines & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===mdma & ketamine===

Status: Low Risk & Synergy

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===cocaine & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===caffeine & ketamine===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===alcohol & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===ghb/gbl & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & ketamine===

Status: Dangerous

Note: Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===benzodiazepines & ketamine===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & ketamine===

Status: Caution

Note: MAO-B inhibitors appear to increase the potency of Ketamine. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===pcp & mxe===

Status: Caution

Note: There are no reports available about this combination

===amphetamines & mxe===

Status: Caution

Note: Risk of tachycardia, hypertension, and manic states

===mdma & mxe===

Status: Caution

Note: There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

===cocaine & mxe===

Status: Caution

Note: Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

===caffeine & mxe===

Status: Low Risk & No Synergy

Note: No likely interactions

===alcohol & mxe===

Status: Dangerous

Note: There is a high risk of memory loss, vomiting and severe ataxia from this combination.

===ghb/gbl & mxe===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & mxe===

Status: Dangerous

Note: This combination can potentiate the effects of the opioid

===benzodiazepines & mxe===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

===maois & mxe===

Status: Unsafe

Note: MAO-B inhibitors appear to increase the potency of MXE. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===ssris & mxe===

Status: Caution

Note: Depending on the SSRI this combination can be unpredictable

===amphetamines & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

===cocaine & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

===caffeine & dxm===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & dxm===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

===ghb/gbl & dxm===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

===opioids & dxm===

Status: Dangerous

Note: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

===benzodiazepines & dxm===

Status: Caution

Note: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome

===ssris & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome.

===amphetamines & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===mdma & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===cocaine & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===caffeine & pcp===

Status: Caution

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===ghb/gbl & pcp===

Status: Dangerous

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===opioids & pcp===

Status: Caution

Note: PCP can reduce opioid tolerance, increasing the risk of overdose

===benzodiazepines & pcp===

Status: Unsafe

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

===maois & pcp===

Status: Dangerous

Note: This combination is very poorly explored

===ssris & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===ghb/gbl & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===opioids & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===tramadol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===mdma & amphetamines===

Status: Low Risk & Synergy

Note: Amphetamines increase the neurotoxic effects of MDMA

===cocaine & amphetamines===

Status: Caution

Note: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

===caffeine & amphetamines===

Status: Caution

Note: This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

===alcohol & amphetamines===

Status: Caution

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

===ghb/gbl & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===opioids & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & amphetamines===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===benzodiazepines & amphetamines===

Status: Low Risk & Decrease

Note: Both can dull each other's effects, so if one wears off before the other it's possible to overdose due to the lack of counteraction

===maois & amphetamines===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.

===cocaine & mdma===

Status: Caution

Note: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

===caffeine & mdma===

Status: Caution

Note: Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

===alcohol & mdma===

Status: Caution

Note: Both MDMA and alcohol cause dehydration. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA

===ghb/gbl & mdma===

Status: Caution

Note: Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.

===tramadol & mdma===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & mdma===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.

===caffeine & cocaine===

Status: Caution

Note: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

===alcohol & cocaine===

Status: Unsafe

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

===ghb/gbl & cocaine===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

===opioids & cocaine===

Status: Dangerous

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & cocaine===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & cocaine===

Status: Dangerous

Note: This combination is poorly explored

===ssris & cocaine===

Status: Low Risk & No Synergy

Note: May reduce each others' effectiveness. Cocaine can reduce mental stability and therefore exacerbate conditions which SSRIs are used to treat.

===ghb/gbl & alcohol===

Status: Dangerous

Note: Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

===opioids & alcohol===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

===tramadol & alcohol===

Status: Dangerous

Note: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

===benzodiazepines & alcohol===

Status: Dangerous

Note: Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

===maois & alcohol===

Status: Unsafe

Note: Tyramine found in many alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

===ssris & alcohol===

Status: Caution

Note: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

===opioids & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

===tramadol & ghb/gbl===

Status: Dangerous

Note: The sedative effects of this combination can lead to dangerous respiratory depression.

===benzodiazepines & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===tramadol & opioids===

Status: Dangerous

Note: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

===benzodiazepines & opioids===

Status: Dangerous

Note: Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

===maois & opioids===

Status: Caution

Note: Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

===ssris & opioids===

Status: Low Risk & No Synergy

Note: There have been very infrequent reports of a risk of serotonin syndrome with this combination, though this should not be a practical concern.

===benzodiazepines & tramadol===

Status: Dangerous

Note: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

--

=== LSD & Mushrooms ===
=== LSD & DMT ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Mescaline ===
=== LSD & DOx ===
=== LSD & NBOMes ===
=== LSD & 2C-x ===
=== LSD & 2C-T-x ===
=== LSD & αMT ===
=== LSD & 5-MeO-xxT ===
=== LSD & Cannabis ===
=== LSD & Ketamine ===
=== LSD & MXE ===
=== LSD & DXM ===
=== LSD & Nitrous ===
=== LSD & Amphetamines ===
=== LSD & MDMA ===
=== LSD & Cocaine ===
=== LSD & Caffeine ===
=== LSD & Alcohol ===
=== LSD & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== LSD & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/547279

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* "Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== LSD & Benzodiazepines ===
=== LSD & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/8788508

* http://www.ncbi.nlm.nih.gov/pubmed/108709

* https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

=== LSD & SSRIs ===
* http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

* http://www.ncbi.nlm.nih.gov/pubmed/8726753

=== Mushrooms & DMT ===
=== Mushrooms & Mescaline ===
=== Mushrooms & DOx ===
=== Mushrooms & NBOMes ===
=== Mushrooms & 2C-x ===
=== Mushrooms & 2C-T-x ===
=== Mushrooms & αMT ===
=== Mushrooms & 5-MeO-xxT ===
=== Mushrooms & Cannabis ===
=== Mushrooms & Ketamine ===
=== Mushrooms & MXE ===
=== Mushrooms & DXM ===
=== Mushrooms & Nitrous ===
=== Mushrooms & Amphetamines ===
=== Mushrooms & MDMA ===
=== Mushrooms & Cocaine ===
=== Mushrooms & Caffeine ===
=== Mushrooms & Alcohol ===
=== Mushrooms & GHB\GBL ===
=== Mushrooms & Opioids ===
=== Mushrooms & Tramadol ===
=== Mushrooms & Benzodiazepines ===
=== Mushrooms & MAOIs ===
=== Mushrooms & SSRIs ===
=== DMT & Mescaline ===
=== DMT & DOx ===
=== DMT & NBOMes ===
=== DMT & 2C-x ===
=== DMT & 2C-T-x ===
=== DMT & αMT ===
=== DMT & 5-MeO-xxT ===
=== DMT & Cannabis ===
=== DMT & Ketamine ===
=== DMT & MXE ===
=== DMT & DXM ===
=== DMT & Nitrous ===
=== DMT & Amphetamines ===
=== DMT & MDMA ===
=== DMT & Cocaine ===
=== DMT & Caffeine ===
=== DMT & Alcohol ===
=== DMT & GHB\GBL ===
=== DMT & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Benzodiazepines ===
=== DMT & MAOIs ===
=== DMT & SSRIs ===
=== Mescaline & DOx ===
=== Mescaline & NBOMes ===
=== Mescaline & 2C-x ===
=== Mescaline & 2C-T-x ===
=== Mescaline & αMT ===
=== Mescaline & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions.

=== Mescaline & Cannabis ===
=== Mescaline & Ketamine ===
=== Mescaline & MXE ===
=== Mescaline & DXM ===
=== Mescaline & Nitrous ===
=== Mescaline & Amphetamines ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & MDMA ===
=== Mescaline & Cocaine ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & Caffeine ===
* High doses of caffeine are uncomfortable and this will be magnified by psychedelics.

=== Mescaline & Alcohol ===
=== Mescaline & GHB\GBL ===
=== Mescaline & Opioids ===
=== Mescaline & Tramadol ===
* This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== Mescaline & Benzodiazepines ===
=== Mescaline & MAOIs ===
=== Mescaline & SSRIs ===
=== DOx & NBOMes ===
=== DOx & 2C-x ===
=== DOx & 2C-T-x ===
=== DOx & αMT ===
=== DOx & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== DOx & Cannabis ===
=== DOx & Ketamine ===
* Ketamine and psychedelics tend to potentiate each other - go slowly.

=== DOx & MXE ===
* As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.

=== DOx & DXM ===
* The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== DOx & Nitrous ===
=== DOx & Amphetamines ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

* http://www.ncbi.nlm.nih.gov/pubmed/1208759

=== DOx & MDMA ===
* The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== DOx & Cocaine ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.

=== DOx & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== DOx & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== DOx & GHB\GBL ===
=== DOx & Opioids ===
* No unexpected interactions.

=== DOx & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== DOx & Benzodiazepines ===
=== DOx & MAOIs ===
=== DOx & SSRIs ===
=== NBOMes & 2C-x ===
=== NBOMes & 2C-T-x ===
=== NBOMes & αMT ===
=== NBOMes & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided.

=== NBOMes & Cannabis ===
=== NBOMes & Ketamine ===
=== NBOMes & MXE ===
=== NBOMes & DXM ===
=== NBOMes & Nitrous ===
=== NBOMes & Amphetamines ===
* Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== NBOMes & MDMA ===
=== NBOMes & Cocaine ===
* Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== NBOMes & Caffeine ===
* Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping.

=== NBOMes & Alcohol ===
=== NBOMes & GHB\GBL ===
=== NBOMes & Opioids ===
=== NBOMes & Tramadol ===
* Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.

=== NBOMes & Benzodiazepines ===
=== NBOMes & MAOIs ===
=== NBOMes & SSRIs ===
=== 2C-x & 2C-T-x ===
=== 2C-x & αMT ===
=== 2C-x & 5-MeO-xxT ===
* The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.

=== 2C-x & Cannabis ===
=== 2C-x & Ketamine ===
=== 2C-x & MXE ===
=== 2C-x & DXM ===
=== 2C-x & Nitrous ===
=== 2C-x & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & MDMA ===
=== 2C-x & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-x & Alcohol ===
=== 2C-x & GHB\GBL ===
=== 2C-x & Opioids ===
=== 2C-x & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== 2C-x & Benzodiazepines ===
=== 2C-x & MAOIs ===
=== 2C-x & SSRIs ===
=== 2C-T-x & αMT ===
=== 2C-T-x & 5-MeO-xxT ===
=== 2C-T-x & Cannabis ===
=== 2C-T-x & Ketamine ===
=== 2C-T-x & MXE ===
=== 2C-T-x & DXM ===
=== 2C-T-x & Nitrous ===
=== 2C-T-x & Amphetamines ===
=== 2C-T-x & MDMA ===
=== 2C-T-x & Cocaine ===
=== 2C-T-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-T-x & Alcohol ===
* Both these classes of compound can interact unpredictably. Caution should be exercised.

=== 2C-T-x & GHB\GBL ===
=== 2C-T-x & Opioids ===
* No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== 2C-T-x & Tramadol ===
=== 2C-T-x & Benzodiazepines ===
=== 2C-T-x & MAOIs ===
=== 2C-T-x & SSRIs ===
=== αMT & 5-MeO-xxT ===
=== αMT & Cannabis ===
=== αMT & Ketamine ===
=== αMT & MXE ===
=== αMT & DXM ===
=== αMT & Nitrous ===
=== αMT & Amphetamines ===
=== αMT & MDMA ===
=== αMT & Cocaine ===
=== αMT & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== αMT & Alcohol ===
* αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.

=== αMT & GHB\GBL ===
=== αMT & Opioids ===
* No unexpected interactions

=== αMT & Tramadol ===
=== αMT & Benzodiazepines ===
=== αMT & MAOIs ===
=== αMT & SSRIs ===
=== 5-MeO-xxT & Cannabis ===
=== 5-MeO-xxT & Ketamine ===
=== 5-MeO-xxT & MXE ===
=== 5-MeO-xxT & DXM ===
=== 5-MeO-xxT & Nitrous ===
=== 5-MeO-xxT & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & MDMA ===
* Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.

=== 5-MeO-xxT & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & Caffeine ===
=== 5-MeO-xxT & Alcohol ===
=== 5-MeO-xxT & GHB\GBL ===
=== 5-MeO-xxT & Opioids ===
=== 5-MeO-xxT & Tramadol ===
=== 5-MeO-xxT & Benzodiazepines ===
=== 5-MeO-xxT & MAOIs ===
=== 5-MeO-xxT & SSRIs ===
=== Cannabis & Ketamine ===
=== Cannabis & MXE ===
=== Cannabis & DXM ===
=== Cannabis & Nitrous ===
=== Cannabis & Amphetamines ===
=== Cannabis & MDMA ===
=== Cannabis & Cocaine ===
=== Cannabis & Caffeine ===
=== Cannabis & Alcohol ===
=== Cannabis & GHB\GBL ===
=== Cannabis & Opioids ===
=== Cannabis & Tramadol ===
=== Cannabis & Benzodiazepines ===
=== Cannabis & MAOIs ===
=== Cannabis & SSRIs ===
=== Ketamine & MXE ===
=== Ketamine & DXM ===
=== Ketamine & Nitrous ===
=== Ketamine & Amphetamines ===
* Amphetamine worsens Ketamines ataxia.

* http://www.ncbi.nlm.nih.gov/pubmed/23660488

=== Ketamine & MDMA ===
=== Ketamine & Cocaine ===
=== Ketamine & Caffeine ===
* No unexpected interactions.

* http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

=== Ketamine & Alcohol ===
* Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

=== Ketamine & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== Ketamine & Opioids ===
* Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/21224020

=== Ketamine & Tramadol ===
* No unexpected interactions.

=== Ketamine & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Ketamine & MAOIs ===
=== Ketamine & SSRIs ===
=== MXE & DXM ===
* http://i.imgur.com/zmqaw.jpg

* http://www.sciencedirect.com/science/article/pii/S0014488607002543

=== MXE & Nitrous ===
=== MXE & Amphetamines ===
* Risk of tachycardia, hypertension, and manic states.

* http://www.ncbi.nlm.nih.gov/pubmed/25060403

=== MXE & MDMA ===
* There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== MXE & Cocaine ===
* Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== MXE & Caffeine ===
* No likely interactions.

=== MXE & Alcohol ===
* There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== MXE & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== MXE & Opioids ===
* This combination can potentiate the effects of the opioid.

=== MXE & Tramadol ===
=== MXE & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== MXE & MAOIs ===
=== MXE & SSRIs ===
* Depending on the SSRI this combination can be unpredictable.

=== DXM & Nitrous ===
=== DXM & Amphetamines ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & MDMA ===
=== DXM & Cocaine ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== DXM & Alcohol ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== DXM & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict.

=== DXM & Opioids ===
* CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== DXM & Tramadol ===
=== DXM & Benzodiazepines ===
* Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== DXM & MAOIs ===
* High risk of serotonin syndrome.

=== DXM & SSRIs ===
* High risk of serotonin syndrome.

=== Nitrous & Amphetamines ===
=== Nitrous & MDMA ===
=== Nitrous & Cocaine ===
=== Nitrous & Caffeine ===
=== Nitrous & Alcohol ===
* This combination can lead to vomiting.

=== Nitrous & GHB\GBL ===
=== Nitrous & Opioids ===
=== Nitrous & Tramadol ===
=== Nitrous & Benzodiazepines ===
=== Nitrous & MAOIs ===
=== Nitrous & SSRIs ===
=== Amphetamines & MDMA ===
* Amphetamines increase the neurotoxic effects of MDMA.

=== Amphetamines & Cocaine ===
* This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.

=== Amphetamines & Caffeine ===
* This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Amphetamines & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Amphetamines & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Amphetamines & Benzodiazepines ===
* http://www.ncbi.nlm.nih.gov/pubmed/17320309

=== Amphetamines & MAOIs ===
=== Amphetamines & SSRIs ===
=== MDMA & Cocaine ===
* Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== MDMA & Caffeine ===
* Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

* http://link.springer.com/article/10.1007/s00213-010-1864-1

* http://www.sciencedirect.com/science/article/pii/S0028390805003114

* http://www.ncbi.nlm.nih.gov/pubmed/24211539

=== MDMA & Alcohol ===
* Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

* http://www.ncbi.nlm.nih.gov/pubmed/21040238

* http://www.ncbi.nlm.nih.gov/pubmed/21756931

=== MDMA & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16234132

* http://www.ncbi.nlm.nih.gov/pubmed/22554869

* http://www.ncbi.nlm.nih.gov/pubmed/20730418

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== MDMA & Opioids ===
=== MDMA & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== MDMA & Benzodiazepines ===
=== MDMA & MAOIs ===
=== MDMA & SSRIs ===
=== Cocaine & Caffeine ===
* Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

=== Cocaine & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Cocaine & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

=== Cocaine & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Cocaine & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & Benzodiazepines ===
=== Cocaine & MAOIs ===
=== Cocaine & SSRIs ===
* Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together.

* http://www.ncbi.nlm.nih.gov/pubmed/23761390

* http://www.ncbi.nlm.nih.gov/pubmed/20195220

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381

=== Caffeine & Alcohol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20001110

=== Caffeine & GHB\GBL ===
=== Caffeine & Opioids ===
=== Caffeine & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20837047

=== Caffeine & Benzodiazepines ===
=== Caffeine & MAOIs ===
=== Caffeine & SSRIs ===
* http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

=== Alcohol & GHB\GBL ===
* Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

* http://www.ncbi.nlm.nih.gov/pubmed/15274975

=== Alcohol & Opioids ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Tramadol ===
* Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Benzodiazepines ===
* Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== Alcohol & MAOIs ===
* The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Alcohol & SSRIs ===
* Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

* http://www.ncbi.nlm.nih.gov/pubmed/15739105

=== GHB\GBL & Opioids ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Tramadol ===
* The sedative effects of this combination can lead to dangerous respiratory depression.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Benzodiazepines ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== GHB\GBL & MAOIs ===
* No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

=== GHB\GBL & SSRIs ===
=== Opioids & Tramadol ===
* Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.

=== Opioids & Benzodiazepines ===
* Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

=== Opioids & MAOIs ===
* Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

* http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

* http://www.ncbi.nlm.nih.gov/pubmed/2891392

* http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

=== Opioids & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/23391344

* http://www.ncbi.nlm.nih.gov/pubmed/20513454

* http://www.ncbi.nlm.nih.gov/pubmed/16005413

* http://www.ncbi.nlm.nih.gov/pubmed/18676387

* http://www.ncbi.nlm.nih.gov/pubmed/17381671

=== Tramadol & Benzodiazepines ===
* Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

* http://www.ncbi.nlm.nih.gov/pubmed/12842359

=== Tramadol & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/16051647

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Tramadol & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Benzodiazepines & MAOIs ===
=== Benzodiazepines & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

* http://www.ncbi.nlm.nih.gov/pubmed/9435993

=== MAOIs & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

Drug combinations

2017-11-30T09:39:48Z

Robustrepresent: /* mdma & cannabis */

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! See below the graphic for important information regarding specific combinations.'''

[[File:Combo_2.png|1000px|center]]

== Overview ==
This chart is meant as a quick reference guide and additional research MUST always be done. If you use this chart or information on your site you must link to the full summaries and display this message.

If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me'''.

== Categorisations ==

''Low Risk & Synergy'' - These drugs work together to cause an effect greater than the sum of its parts, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before combining drugs.

''Low Risk & No Synergy'' - Effects are just additive. The combination is unlikely to cause any adverse or undesirable reaction beyond those that might ordinarily be expected from these drugs.

''Caution'' - These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.

''Unsafe'' - There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.

''Dangerous'' - These combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.

== Chart versions ==

'''[https://wiki.tripsit.me/images/3/3f/TripSitDrugComboChart-Spanish.png Spanish]'''

'''[https://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/images/0/0c/Drug-combinations-fr.png French]'''

'''[https://wiki.tripsit.me/images/9/9e/TripSitDrugComboChart-Esperanto.png Esperanto]'''

'''Portuguese''' (Needs Translation)

'''Polish''' (Needs Translation)

== Specific Combinations ==
===cannabis & lsd===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & lsd===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & mushrooms===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & mushrooms===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & dmt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & dmt===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===5-meo-xxt & mescaline===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions

===cannabis & mescaline===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===cocaine & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===caffeine & mescaline===

Status: Low Risk & No Synergy

Note: High doses of caffeine are uncomfortable and this will be magnified by psychedelics

===tramadol & mescaline===

Status: Unsafe

Note: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

===5-meo-xxt & dox===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

===cannabis & dox===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===ketamine & dox===

Status: Low Risk & Synergy

Note: Ketamine and psychedelics tend to potentiate each other - go slowly.

===mxe & dox===

Status: Caution

Note: As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

===dxm & dox===

Status: Unsafe

Note: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

===pcp & dox===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===amphetamines & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

===mdma & dox===

Status: Caution

Note: The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

===cocaine & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

===caffeine & dox===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

===alcohol & dox===

Status: Low Risk & Decrease

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

===opioids & dox===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===tramadol & dox===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===maois & dox===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & nbomes===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

===cannabis & nbomes===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===mxe & nbomes===

Status: Caution

Note: As an NMDA antagonist MXE potentiates NBOMes which can be unpleasantly intense

===amphetamines & nbomes===

Status: Unsafe

Note: Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

===cocaine & nbomes===

Status: Unsafe

Note: Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & nbomes===

Status: Caution

Note: Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

===tramadol & nbomes===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

===maois & nbomes===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-x===

Status: Caution

Note: The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

===cannabis & 2c-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===cocaine & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===caffeine & 2c-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===tramadol & 2c-x===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

===maois & 2c-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-t-x===

Status: Caution

Note: Both classes of compounds can be unpredictable alone

===cannabis & 2c-t-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-t-x===

Status: Unsafe

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===cocaine & 2c-t-x===

Status: Unsafe

Note: Cocaine and 2c-t-x both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & 2c-t-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & 2c-t-x===

Status: Low Risk & Decrease

Note: Both these classes of compound can interact unpredictably. Caution should be exercised.

===opioids & 2c-t-x===

Status: Low Risk & No Synergy

Note: No expected interactions, some opioids have serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

===maois & 2c-t-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably, which could be dangerous given the unpredictability of the 2C-T-x series

===cannabis & amt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics. Small amounts can reduce nausea with aMT but take care.

===caffeine & amt===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & amt===

Status: Caution

Note: aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

===opioids & amt===

Status: Low Risk & No Synergy

Note: No unexpected interactions

===maois & amt===

Status: Dangerous

Note: aMT is an MAOI on its own. Using enzyme inhibitors can greatly reduce predictability of effects.

===mxe & 5-meo-xxt===

Status: Low Risk & Synergy

Note: Little information exists about this combination.

===dxm & 5-meo-xxt===

Status: Unsafe

Note: Little information exists about this combination.

===cannabis & 5-meo-xxt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===mdma & 5-meo-xxt===

Status: Caution

Note: Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

===cocaine & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===caffeine & 5-meo-xxt===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===amphetamines & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===mdma & cannabis===

Status: Low Risk & Synergy

Note: Large amounts of either or both may cause strong and somewhat unpredictable experiences in combination with MDMA which can be compared to psychedelics. Consider rather Set and Setting are good, before you combine these. Cannabis should be saved for towards the end of the experience if possible.

===cocaine & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===alcohol & cannabis===

Status: Low Risk & Synergy

Note: In excess, this combination can cause nausea.

===amphetamines & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===mdma & ketamine===

Status: Low Risk & Synergy

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===cocaine & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===caffeine & ketamine===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===alcohol & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===ghb/gbl & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & ketamine===

Status: Dangerous

Note: Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===benzodiazepines & ketamine===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & ketamine===

Status: Caution

Note: MAO-B inhibitors appear to increase the potency of Ketamine. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===pcp & mxe===

Status: Caution

Note: There are no reports available about this combination

===amphetamines & mxe===

Status: Caution

Note: Risk of tachycardia, hypertension, and manic states

===mdma & mxe===

Status: Caution

Note: There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

===cocaine & mxe===

Status: Caution

Note: Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

===caffeine & mxe===

Status: Low Risk & No Synergy

Note: No likely interactions

===alcohol & mxe===

Status: Dangerous

Note: There is a high risk of memory loss, vomiting and severe ataxia from this combination.

===ghb/gbl & mxe===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & mxe===

Status: Dangerous

Note: This combination can potentiate the effects of the opioid

===benzodiazepines & mxe===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

===maois & mxe===

Status: Unsafe

Note: MAO-B inhibitors appear to increase the potency of MXE. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===ssris & mxe===

Status: Caution

Note: Depending on the SSRI this combination can be unpredictable

===amphetamines & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

===cocaine & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

===caffeine & dxm===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & dxm===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

===ghb/gbl & dxm===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

===opioids & dxm===

Status: Dangerous

Note: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

===benzodiazepines & dxm===

Status: Caution

Note: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome

===ssris & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome.

===amphetamines & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===mdma & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===cocaine & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===caffeine & pcp===

Status: Caution

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===ghb/gbl & pcp===

Status: Dangerous

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===opioids & pcp===

Status: Caution

Note: PCP can reduce opioid tolerance, increasing the risk of overdose

===benzodiazepines & pcp===

Status: Unsafe

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

===maois & pcp===

Status: Dangerous

Note: This combination is very poorly explored

===ssris & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===ghb/gbl & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===opioids & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===tramadol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===mdma & amphetamines===

Status: Low Risk & Synergy

Note: Amphetamines increase the neurotoxic effects of MDMA

===cocaine & amphetamines===

Status: Caution

Note: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

===caffeine & amphetamines===

Status: Caution

Note: This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

===alcohol & amphetamines===

Status: Caution

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

===ghb/gbl & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===opioids & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & amphetamines===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===benzodiazepines & amphetamines===

Status: Low Risk & Decrease

Note: Both can dull each other's effects, so if one wears off before the other it's possible to overdose due to the lack of counteraction

===maois & amphetamines===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.

===cocaine & mdma===

Status: Caution

Note: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

===caffeine & mdma===

Status: Caution

Note: Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

===alcohol & mdma===

Status: Caution

Note: Both MDMA and alcohol cause dehydration. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA

===ghb/gbl & mdma===

Status: Caution

Note: Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.

===tramadol & mdma===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & mdma===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.

===caffeine & cocaine===

Status: Caution

Note: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

===alcohol & cocaine===

Status: Unsafe

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

===ghb/gbl & cocaine===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

===opioids & cocaine===

Status: Dangerous

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & cocaine===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & cocaine===

Status: Dangerous

Note: This combination is poorly explored

===ssris & cocaine===

Status: Low Risk & No Synergy

Note: May reduce each others' effectiveness. Cocaine can reduce mental stability and therefore exacerbate conditions which SSRIs are used to treat.

===ghb/gbl & alcohol===

Status: Dangerous

Note: Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

===opioids & alcohol===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

===tramadol & alcohol===

Status: Dangerous

Note: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

===benzodiazepines & alcohol===

Status: Dangerous

Note: Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

===maois & alcohol===

Status: Unsafe

Note: Tyramine found in many alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

===ssris & alcohol===

Status: Caution

Note: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

===opioids & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

===tramadol & ghb/gbl===

Status: Dangerous

Note: The sedative effects of this combination can lead to dangerous respiratory depression.

===benzodiazepines & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===tramadol & opioids===

Status: Dangerous

Note: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

===benzodiazepines & opioids===

Status: Dangerous

Note: Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

===maois & opioids===

Status: Caution

Note: Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

===ssris & opioids===

Status: Low Risk & No Synergy

Note: There have been very infrequent reports of a risk of serotonin syndrome with this combination, though this should not be a practical concern.

===benzodiazepines & tramadol===

Status: Dangerous

Note: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

--

=== LSD & Mushrooms ===
=== LSD & DMT ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Mescaline ===
=== LSD & DOx ===
=== LSD & NBOMes ===
=== LSD & 2C-x ===
=== LSD & 2C-T-x ===
=== LSD & αMT ===
=== LSD & 5-MeO-xxT ===
=== LSD & Cannabis ===
=== LSD & Ketamine ===
=== LSD & MXE ===
=== LSD & DXM ===
=== LSD & Nitrous ===
=== LSD & Amphetamines ===
=== LSD & MDMA ===
=== LSD & Cocaine ===
=== LSD & Caffeine ===
=== LSD & Alcohol ===
=== LSD & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== LSD & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/547279

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* "Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== LSD & Benzodiazepines ===
=== LSD & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/8788508

* http://www.ncbi.nlm.nih.gov/pubmed/108709

* https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

=== LSD & SSRIs ===
* http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

* http://www.ncbi.nlm.nih.gov/pubmed/8726753

=== Mushrooms & DMT ===
=== Mushrooms & Mescaline ===
=== Mushrooms & DOx ===
=== Mushrooms & NBOMes ===
=== Mushrooms & 2C-x ===
=== Mushrooms & 2C-T-x ===
=== Mushrooms & αMT ===
=== Mushrooms & 5-MeO-xxT ===
=== Mushrooms & Cannabis ===
=== Mushrooms & Ketamine ===
=== Mushrooms & MXE ===
=== Mushrooms & DXM ===
=== Mushrooms & Nitrous ===
=== Mushrooms & Amphetamines ===
=== Mushrooms & MDMA ===
=== Mushrooms & Cocaine ===
=== Mushrooms & Caffeine ===
=== Mushrooms & Alcohol ===
=== Mushrooms & GHB\GBL ===
=== Mushrooms & Opioids ===
=== Mushrooms & Tramadol ===
=== Mushrooms & Benzodiazepines ===
=== Mushrooms & MAOIs ===
=== Mushrooms & SSRIs ===
=== DMT & Mescaline ===
=== DMT & DOx ===
=== DMT & NBOMes ===
=== DMT & 2C-x ===
=== DMT & 2C-T-x ===
=== DMT & αMT ===
=== DMT & 5-MeO-xxT ===
=== DMT & Cannabis ===
=== DMT & Ketamine ===
=== DMT & MXE ===
=== DMT & DXM ===
=== DMT & Nitrous ===
=== DMT & Amphetamines ===
=== DMT & MDMA ===
=== DMT & Cocaine ===
=== DMT & Caffeine ===
=== DMT & Alcohol ===
=== DMT & GHB\GBL ===
=== DMT & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Benzodiazepines ===
=== DMT & MAOIs ===
=== DMT & SSRIs ===
=== Mescaline & DOx ===
=== Mescaline & NBOMes ===
=== Mescaline & 2C-x ===
=== Mescaline & 2C-T-x ===
=== Mescaline & αMT ===
=== Mescaline & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions.

=== Mescaline & Cannabis ===
=== Mescaline & Ketamine ===
=== Mescaline & MXE ===
=== Mescaline & DXM ===
=== Mescaline & Nitrous ===
=== Mescaline & Amphetamines ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & MDMA ===
=== Mescaline & Cocaine ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & Caffeine ===
* High doses of caffeine are uncomfortable and this will be magnified by psychedelics.

=== Mescaline & Alcohol ===
=== Mescaline & GHB\GBL ===
=== Mescaline & Opioids ===
=== Mescaline & Tramadol ===
* This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== Mescaline & Benzodiazepines ===
=== Mescaline & MAOIs ===
=== Mescaline & SSRIs ===
=== DOx & NBOMes ===
=== DOx & 2C-x ===
=== DOx & 2C-T-x ===
=== DOx & αMT ===
=== DOx & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== DOx & Cannabis ===
=== DOx & Ketamine ===
* Ketamine and psychedelics tend to potentiate each other - go slowly.

=== DOx & MXE ===
* As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.

=== DOx & DXM ===
* The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== DOx & Nitrous ===
=== DOx & Amphetamines ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

* http://www.ncbi.nlm.nih.gov/pubmed/1208759

=== DOx & MDMA ===
* The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== DOx & Cocaine ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.

=== DOx & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== DOx & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== DOx & GHB\GBL ===
=== DOx & Opioids ===
* No unexpected interactions.

=== DOx & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== DOx & Benzodiazepines ===
=== DOx & MAOIs ===
=== DOx & SSRIs ===
=== NBOMes & 2C-x ===
=== NBOMes & 2C-T-x ===
=== NBOMes & αMT ===
=== NBOMes & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided.

=== NBOMes & Cannabis ===
=== NBOMes & Ketamine ===
=== NBOMes & MXE ===
=== NBOMes & DXM ===
=== NBOMes & Nitrous ===
=== NBOMes & Amphetamines ===
* Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== NBOMes & MDMA ===
=== NBOMes & Cocaine ===
* Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== NBOMes & Caffeine ===
* Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping.

=== NBOMes & Alcohol ===
=== NBOMes & GHB\GBL ===
=== NBOMes & Opioids ===
=== NBOMes & Tramadol ===
* Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.

=== NBOMes & Benzodiazepines ===
=== NBOMes & MAOIs ===
=== NBOMes & SSRIs ===
=== 2C-x & 2C-T-x ===
=== 2C-x & αMT ===
=== 2C-x & 5-MeO-xxT ===
* The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.

=== 2C-x & Cannabis ===
=== 2C-x & Ketamine ===
=== 2C-x & MXE ===
=== 2C-x & DXM ===
=== 2C-x & Nitrous ===
=== 2C-x & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & MDMA ===
=== 2C-x & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-x & Alcohol ===
=== 2C-x & GHB\GBL ===
=== 2C-x & Opioids ===
=== 2C-x & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== 2C-x & Benzodiazepines ===
=== 2C-x & MAOIs ===
=== 2C-x & SSRIs ===
=== 2C-T-x & αMT ===
=== 2C-T-x & 5-MeO-xxT ===
=== 2C-T-x & Cannabis ===
=== 2C-T-x & Ketamine ===
=== 2C-T-x & MXE ===
=== 2C-T-x & DXM ===
=== 2C-T-x & Nitrous ===
=== 2C-T-x & Amphetamines ===
=== 2C-T-x & MDMA ===
=== 2C-T-x & Cocaine ===
=== 2C-T-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-T-x & Alcohol ===
* Both these classes of compound can interact unpredictably. Caution should be exercised.

=== 2C-T-x & GHB\GBL ===
=== 2C-T-x & Opioids ===
* No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== 2C-T-x & Tramadol ===
=== 2C-T-x & Benzodiazepines ===
=== 2C-T-x & MAOIs ===
=== 2C-T-x & SSRIs ===
=== αMT & 5-MeO-xxT ===
=== αMT & Cannabis ===
=== αMT & Ketamine ===
=== αMT & MXE ===
=== αMT & DXM ===
=== αMT & Nitrous ===
=== αMT & Amphetamines ===
=== αMT & MDMA ===
=== αMT & Cocaine ===
=== αMT & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== αMT & Alcohol ===
* αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.

=== αMT & GHB\GBL ===
=== αMT & Opioids ===
* No unexpected interactions

=== αMT & Tramadol ===
=== αMT & Benzodiazepines ===
=== αMT & MAOIs ===
=== αMT & SSRIs ===
=== 5-MeO-xxT & Cannabis ===
=== 5-MeO-xxT & Ketamine ===
=== 5-MeO-xxT & MXE ===
=== 5-MeO-xxT & DXM ===
=== 5-MeO-xxT & Nitrous ===
=== 5-MeO-xxT & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & MDMA ===
* Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.

=== 5-MeO-xxT & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & Caffeine ===
=== 5-MeO-xxT & Alcohol ===
=== 5-MeO-xxT & GHB\GBL ===
=== 5-MeO-xxT & Opioids ===
=== 5-MeO-xxT & Tramadol ===
=== 5-MeO-xxT & Benzodiazepines ===
=== 5-MeO-xxT & MAOIs ===
=== 5-MeO-xxT & SSRIs ===
=== Cannabis & Ketamine ===
=== Cannabis & MXE ===
=== Cannabis & DXM ===
=== Cannabis & Nitrous ===
=== Cannabis & Amphetamines ===
=== Cannabis & MDMA ===
=== Cannabis & Cocaine ===
=== Cannabis & Caffeine ===
=== Cannabis & Alcohol ===
=== Cannabis & GHB\GBL ===
=== Cannabis & Opioids ===
=== Cannabis & Tramadol ===
=== Cannabis & Benzodiazepines ===
=== Cannabis & MAOIs ===
=== Cannabis & SSRIs ===
=== Ketamine & MXE ===
=== Ketamine & DXM ===
=== Ketamine & Nitrous ===
=== Ketamine & Amphetamines ===
* Amphetamine worsens Ketamines ataxia.

* http://www.ncbi.nlm.nih.gov/pubmed/23660488

=== Ketamine & MDMA ===
=== Ketamine & Cocaine ===
=== Ketamine & Caffeine ===
* No unexpected interactions.

* http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

=== Ketamine & Alcohol ===
* Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

=== Ketamine & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== Ketamine & Opioids ===
* Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/21224020

=== Ketamine & Tramadol ===
* No unexpected interactions.

=== Ketamine & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Ketamine & MAOIs ===
=== Ketamine & SSRIs ===
=== MXE & DXM ===
* http://i.imgur.com/zmqaw.jpg

* http://www.sciencedirect.com/science/article/pii/S0014488607002543

=== MXE & Nitrous ===
=== MXE & Amphetamines ===
* Risk of tachycardia, hypertension, and manic states.

* http://www.ncbi.nlm.nih.gov/pubmed/25060403

=== MXE & MDMA ===
* There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== MXE & Cocaine ===
* Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== MXE & Caffeine ===
* No likely interactions.

=== MXE & Alcohol ===
* There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== MXE & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== MXE & Opioids ===
* This combination can potentiate the effects of the opioid.

=== MXE & Tramadol ===
=== MXE & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== MXE & MAOIs ===
=== MXE & SSRIs ===
* Depending on the SSRI this combination can be unpredictable.

=== DXM & Nitrous ===
=== DXM & Amphetamines ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & MDMA ===
=== DXM & Cocaine ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== DXM & Alcohol ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== DXM & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict.

=== DXM & Opioids ===
* CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== DXM & Tramadol ===
=== DXM & Benzodiazepines ===
* Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== DXM & MAOIs ===
* High risk of serotonin syndrome.

=== DXM & SSRIs ===
* High risk of serotonin syndrome.

=== Nitrous & Amphetamines ===
=== Nitrous & MDMA ===
=== Nitrous & Cocaine ===
=== Nitrous & Caffeine ===
=== Nitrous & Alcohol ===
* This combination can lead to vomiting.

=== Nitrous & GHB\GBL ===
=== Nitrous & Opioids ===
=== Nitrous & Tramadol ===
=== Nitrous & Benzodiazepines ===
=== Nitrous & MAOIs ===
=== Nitrous & SSRIs ===
=== Amphetamines & MDMA ===
* Amphetamines increase the neurotoxic effects of MDMA.

=== Amphetamines & Cocaine ===
* This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.

=== Amphetamines & Caffeine ===
* This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Amphetamines & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Amphetamines & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Amphetamines & Benzodiazepines ===
* http://www.ncbi.nlm.nih.gov/pubmed/17320309

=== Amphetamines & MAOIs ===
=== Amphetamines & SSRIs ===
=== MDMA & Cocaine ===
* Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== MDMA & Caffeine ===
* Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

* http://link.springer.com/article/10.1007/s00213-010-1864-1

* http://www.sciencedirect.com/science/article/pii/S0028390805003114

* http://www.ncbi.nlm.nih.gov/pubmed/24211539

=== MDMA & Alcohol ===
* Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

* http://www.ncbi.nlm.nih.gov/pubmed/21040238

* http://www.ncbi.nlm.nih.gov/pubmed/21756931

=== MDMA & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16234132

* http://www.ncbi.nlm.nih.gov/pubmed/22554869

* http://www.ncbi.nlm.nih.gov/pubmed/20730418

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== MDMA & Opioids ===
=== MDMA & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== MDMA & Benzodiazepines ===
=== MDMA & MAOIs ===
=== MDMA & SSRIs ===
=== Cocaine & Caffeine ===
* Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

=== Cocaine & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Cocaine & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

=== Cocaine & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Cocaine & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & Benzodiazepines ===
=== Cocaine & MAOIs ===
=== Cocaine & SSRIs ===
* Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together.

* http://www.ncbi.nlm.nih.gov/pubmed/23761390

* http://www.ncbi.nlm.nih.gov/pubmed/20195220

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381

=== Caffeine & Alcohol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20001110

=== Caffeine & GHB\GBL ===
=== Caffeine & Opioids ===
=== Caffeine & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20837047

=== Caffeine & Benzodiazepines ===
=== Caffeine & MAOIs ===
=== Caffeine & SSRIs ===
* http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

=== Alcohol & GHB\GBL ===
* Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

* http://www.ncbi.nlm.nih.gov/pubmed/15274975

=== Alcohol & Opioids ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Tramadol ===
* Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Benzodiazepines ===
* Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== Alcohol & MAOIs ===
* The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Alcohol & SSRIs ===
* Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

* http://www.ncbi.nlm.nih.gov/pubmed/15739105

=== GHB\GBL & Opioids ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Tramadol ===
* The sedative effects of this combination can lead to dangerous respiratory depression.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Benzodiazepines ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== GHB\GBL & MAOIs ===
* No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

=== GHB\GBL & SSRIs ===
=== Opioids & Tramadol ===
* Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.

=== Opioids & Benzodiazepines ===
* Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

=== Opioids & MAOIs ===
* Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

* http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

* http://www.ncbi.nlm.nih.gov/pubmed/2891392

* http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

=== Opioids & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/23391344

* http://www.ncbi.nlm.nih.gov/pubmed/20513454

* http://www.ncbi.nlm.nih.gov/pubmed/16005413

* http://www.ncbi.nlm.nih.gov/pubmed/18676387

* http://www.ncbi.nlm.nih.gov/pubmed/17381671

=== Tramadol & Benzodiazepines ===
* Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

* http://www.ncbi.nlm.nih.gov/pubmed/12842359

=== Tramadol & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/16051647

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Tramadol & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Benzodiazepines & MAOIs ===
=== Benzodiazepines & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

* http://www.ncbi.nlm.nih.gov/pubmed/9435993

=== MAOIs & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]

Drug combinations

2017-11-30T09:33:30Z

Robustrepresent: /* mdma & cannabis */ Higher amounts of both substances may lead to intense trips with the full range of beautiful and horrific experiences.

'''WARNING! For educational purposes: We do not endorse any of these combinations. This page will always be 'work in progress'. It is extremely important to be safe at all times! See below the graphic for important information regarding specific combinations.'''

[[File:Combo_2.png|1000px|center]]

== Overview ==
This chart is meant as a quick reference guide and additional research MUST always be done. If you use this chart or information on your site you must link to the full summaries and display this message.

If you want to give us some feedback/recommendation/comment on the chart, you can contact us:

[http://chat.tripsit.me/?nick=AskContent?#content Join #content channel on IRC]

Email: '''content@tripsit.me'''.

== Categorisations ==

''Low Risk & Synergy'' - These drugs work together to cause an effect greater than the sum of its parts, and they aren't likely to cause an adverse or undesirable reaction when used carefully. Additional research should always be done before combining drugs.

''Low Risk & No Synergy'' - Effects are just additive. The combination is unlikely to cause any adverse or undesirable reaction beyond those that might ordinarily be expected from these drugs.

''Caution'' - These combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.

''Unsafe'' - There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.

''Dangerous'' - These combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.

== Chart versions ==

'''[https://wiki.tripsit.me/images/3/3f/TripSitDrugComboChart-Spanish.png Spanish]'''

'''[https://wiki.tripsit.me/images/d/d4/TripSitDrugComboChart-German.png German]'''

'''[http://wiki.tripsit.me/images/0/0c/Drug-combinations-fr.png French]'''

'''[https://wiki.tripsit.me/images/9/9e/TripSitDrugComboChart-Esperanto.png Esperanto]'''

'''Portuguese''' (Needs Translation)

'''Polish''' (Needs Translation)

== Specific Combinations ==
===cannabis & lsd===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & lsd===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & lsd===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & mushrooms===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & mushrooms===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & mushrooms===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===cannabis & dmt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===cocaine & dmt===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===tramadol & dmt===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===5-meo-xxt & mescaline===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions

===cannabis & mescaline===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===cocaine & mescaline===

Status: Caution

Note: The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops

===caffeine & mescaline===

Status: Low Risk & No Synergy

Note: High doses of caffeine are uncomfortable and this will be magnified by psychedelics

===tramadol & mescaline===

Status: Unsafe

Note: This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

===5-meo-xxt & dox===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

===cannabis & dox===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===ketamine & dox===

Status: Low Risk & Synergy

Note: Ketamine and psychedelics tend to potentiate each other - go slowly.

===mxe & dox===

Status: Caution

Note: As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense

===dxm & dox===

Status: Unsafe

Note: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

===pcp & dox===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===amphetamines & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

===mdma & dox===

Status: Caution

Note: The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

===cocaine & dox===

Status: Unsafe

Note: The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic

===caffeine & dox===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

===alcohol & dox===

Status: Low Risk & Decrease

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

===opioids & dox===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===tramadol & dox===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

===maois & dox===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & nbomes===

Status: Caution

Note: The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided

===cannabis & nbomes===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===mxe & nbomes===

Status: Caution

Note: As an NMDA antagonist MXE potentiates NBOMes which can be unpleasantly intense

===amphetamines & nbomes===

Status: Unsafe

Note: Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

===cocaine & nbomes===

Status: Unsafe

Note: Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & nbomes===

Status: Caution

Note: Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping

===tramadol & nbomes===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures

===maois & nbomes===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-x===

Status: Caution

Note: The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics

===cannabis & 2c-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===cocaine & 2c-x===

Status: Caution

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

===caffeine & 2c-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===tramadol & 2c-x===

Status: Unsafe

Note: Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

===maois & 2c-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably

===5-meo-xxt & 2c-t-x===

Status: Caution

Note: Both classes of compounds can be unpredictable alone

===cannabis & 2c-t-x===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 2c-t-x===

Status: Unsafe

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===cocaine & 2c-t-x===

Status: Unsafe

Note: Cocaine and 2c-t-x both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

===caffeine & 2c-t-x===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & 2c-t-x===

Status: Low Risk & Decrease

Note: Both these classes of compound can interact unpredictably. Caution should be exercised.

===opioids & 2c-t-x===

Status: Low Risk & No Synergy

Note: No expected interactions, some opioids have serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

===maois & 2c-t-x===

Status: Caution

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably, which could be dangerous given the unpredictability of the 2C-T-x series

===cannabis & amt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics. Small amounts can reduce nausea with aMT but take care.

===caffeine & amt===

Status: Caution

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & amt===

Status: Caution

Note: aMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable

===opioids & amt===

Status: Low Risk & No Synergy

Note: No unexpected interactions

===maois & amt===

Status: Dangerous

Note: aMT is an MAOI on its own. Using enzyme inhibitors can greatly reduce predictability of effects.

===mxe & 5-meo-xxt===

Status: Low Risk & Synergy

Note: Little information exists about this combination.

===dxm & 5-meo-xxt===

Status: Unsafe

Note: Little information exists about this combination.

===cannabis & 5-meo-xxt===

Status: Caution

Note: Cannabis has an unexpectedly strong and somewhat unpredictable synergy with psychedelics.

===amphetamines & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===mdma & 5-meo-xxt===

Status: Caution

Note: Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care

===cocaine & 5-meo-xxt===

Status: Unsafe

Note: The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

===caffeine & 5-meo-xxt===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===amphetamines & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===mdma & cannabis===

Status: Low Risk & Synergy

Note: Large amounts of cannabis may cause strong and somewhat unpredictable experiences in combination with MDMA. Overlapping peaks of both substances in higher doses may result in psychedelic experiences. Set and Setting should taken into consideration before combining these. Cannabis should be saved for towards the end of the experience if possible.

===cocaine & cannabis===

Status: Caution

Note: Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences

===alcohol & cannabis===

Status: Low Risk & Synergy

Note: In excess, this combination can cause nausea.

===amphetamines & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===mdma & ketamine===

Status: Low Risk & Synergy

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===cocaine & ketamine===

Status: Caution

Note: No unexpected interactions, though likely to increase blood pressure but not an issue with sensible doses. Moving around on high doses of this combination may be ill advised due to risk of physical injury.

===caffeine & ketamine===

Status: Low Risk & No Synergy

Note: No unexpected interactions.

===alcohol & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===ghb/gbl & ketamine===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & ketamine===

Status: Dangerous

Note: Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===benzodiazepines & ketamine===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & ketamine===

Status: Caution

Note: MAO-B inhibitors appear to increase the potency of Ketamine. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===pcp & mxe===

Status: Caution

Note: There are no reports available about this combination

===amphetamines & mxe===

Status: Caution

Note: Risk of tachycardia, hypertension, and manic states

===mdma & mxe===

Status: Caution

Note: There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

===cocaine & mxe===

Status: Caution

Note: Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

===caffeine & mxe===

Status: Low Risk & No Synergy

Note: No likely interactions

===alcohol & mxe===

Status: Dangerous

Note: There is a high risk of memory loss, vomiting and severe ataxia from this combination.

===ghb/gbl & mxe===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

===opioids & mxe===

Status: Dangerous

Note: This combination can potentiate the effects of the opioid

===benzodiazepines & mxe===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

===maois & mxe===

Status: Unsafe

Note: MAO-B inhibitors appear to increase the potency of MXE. MAO-A inhbitors have some negative reports associated with the combination but there isn't much information available

===ssris & mxe===

Status: Caution

Note: Depending on the SSRI this combination can be unpredictable

===amphetamines & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

===cocaine & dxm===

Status: Unsafe

Note: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues

===caffeine & dxm===

Status: Low Risk & No Synergy

Note: High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

===alcohol & dxm===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

===ghb/gbl & dxm===

Status: Dangerous

Note: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict

===opioids & dxm===

Status: Dangerous

Note: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

===benzodiazepines & dxm===

Status: Caution

Note: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===maois & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome

===ssris & dxm===

Status: Dangerous

Note: High risk of serotonin syndrome.

===amphetamines & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===mdma & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===cocaine & pcp===

Status: Unsafe

Note: This combination can easily lead to hypermanic states

===caffeine & pcp===

Status: Caution

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===ghb/gbl & pcp===

Status: Dangerous

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===opioids & pcp===

Status: Caution

Note: PCP can reduce opioid tolerance, increasing the risk of overdose

===benzodiazepines & pcp===

Status: Unsafe

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely

===maois & pcp===

Status: Dangerous

Note: This combination is very poorly explored

===ssris & pcp===

Status: Unsafe

Note: Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.

===alcohol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===ghb/gbl & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===opioids & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===tramadol & nitrous===

Status: Caution

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely.

===mdma & amphetamines===

Status: Low Risk & Synergy

Note: Amphetamines increase the neurotoxic effects of MDMA

===cocaine & amphetamines===

Status: Caution

Note: This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine

===caffeine & amphetamines===

Status: Caution

Note: This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

===alcohol & amphetamines===

Status: Caution

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

===ghb/gbl & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===opioids & amphetamines===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & amphetamines===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===benzodiazepines & amphetamines===

Status: Low Risk & Decrease

Note: Both can dull each other's effects, so if one wears off before the other it's possible to overdose due to the lack of counteraction

===maois & amphetamines===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises.

===cocaine & mdma===

Status: Caution

Note: Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

===caffeine & mdma===

Status: Caution

Note: Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA

===alcohol & mdma===

Status: Caution

Note: Both MDMA and alcohol cause dehydration. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA

===ghb/gbl & mdma===

Status: Caution

Note: Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown.

===tramadol & mdma===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & mdma===

Status: Dangerous

Note: MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with MDMA will lead to hypertensive crises.

===caffeine & cocaine===

Status: Caution

Note: Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

===alcohol & cocaine===

Status: Unsafe

Note: Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

===ghb/gbl & cocaine===

Status: Caution

Note: Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind

===opioids & cocaine===

Status: Dangerous

Note: Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

===tramadol & cocaine===

Status: Dangerous

Note: Tramadol and stimulants both increase the risk of seizures.

===maois & cocaine===

Status: Dangerous

Note: This combination is poorly explored

===ssris & cocaine===

Status: Low Risk & No Synergy

Note: May reduce each others' effectiveness. Cocaine can reduce mental stability and therefore exacerbate conditions which SSRIs are used to treat.

===ghb/gbl & alcohol===

Status: Dangerous

Note: Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

===opioids & alcohol===

Status: Dangerous

Note: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely

===tramadol & alcohol===

Status: Dangerous

Note: Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

===benzodiazepines & alcohol===

Status: Dangerous

Note: Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

===maois & alcohol===

Status: Unsafe

Note: Tyramine found in many alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

===ssris & alcohol===

Status: Caution

Note: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

===opioids & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position

===tramadol & ghb/gbl===

Status: Dangerous

Note: The sedative effects of this combination can lead to dangerous respiratory depression.

===benzodiazepines & ghb/gbl===

Status: Dangerous

Note: The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

===tramadol & opioids===

Status: Dangerous

Note: Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present

===benzodiazepines & opioids===

Status: Dangerous

Note: Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely

===maois & opioids===

Status: Caution

Note: Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

===ssris & opioids===

Status: Low Risk & No Synergy

Note: There have been very infrequent reports of a risk of serotonin syndrome with this combination, though this should not be a practical concern.

===benzodiazepines & tramadol===

Status: Dangerous

Note: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

--

=== LSD & Mushrooms ===
=== LSD & DMT ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Mescaline ===
=== LSD & DOx ===
=== LSD & NBOMes ===
=== LSD & 2C-x ===
=== LSD & 2C-T-x ===
=== LSD & αMT ===
=== LSD & 5-MeO-xxT ===
=== LSD & Cannabis ===
=== LSD & Ketamine ===
=== LSD & MXE ===
=== LSD & DXM ===
=== LSD & Nitrous ===
=== LSD & Amphetamines ===
=== LSD & MDMA ===
=== LSD & Cocaine ===
=== LSD & Caffeine ===
=== LSD & Alcohol ===
=== LSD & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== LSD & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/547279

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* "Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."

* http://www.ncbi.nlm.nih.gov/pubmed/3006089

* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf

=== LSD & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== LSD & Benzodiazepines ===
=== LSD & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/8788508

* http://www.ncbi.nlm.nih.gov/pubmed/108709

* https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199

=== LSD & SSRIs ===
* http://www.nature.com/npp/journal/v14/n6/full/1380431a.html

* http://www.ncbi.nlm.nih.gov/pubmed/8726753

=== Mushrooms & DMT ===
=== Mushrooms & Mescaline ===
=== Mushrooms & DOx ===
=== Mushrooms & NBOMes ===
=== Mushrooms & 2C-x ===
=== Mushrooms & 2C-T-x ===
=== Mushrooms & αMT ===
=== Mushrooms & 5-MeO-xxT ===
=== Mushrooms & Cannabis ===
=== Mushrooms & Ketamine ===
=== Mushrooms & MXE ===
=== Mushrooms & DXM ===
=== Mushrooms & Nitrous ===
=== Mushrooms & Amphetamines ===
=== Mushrooms & MDMA ===
=== Mushrooms & Cocaine ===
=== Mushrooms & Caffeine ===
=== Mushrooms & Alcohol ===
=== Mushrooms & GHB\GBL ===
=== Mushrooms & Opioids ===
=== Mushrooms & Tramadol ===
=== Mushrooms & Benzodiazepines ===
=== Mushrooms & MAOIs ===
=== Mushrooms & SSRIs ===
=== DMT & Mescaline ===
=== DMT & DOx ===
=== DMT & NBOMes ===
=== DMT & 2C-x ===
=== DMT & 2C-T-x ===
=== DMT & αMT ===
=== DMT & 5-MeO-xxT ===
=== DMT & Cannabis ===
=== DMT & Ketamine ===
=== DMT & MXE ===
=== DMT & DXM ===
=== DMT & Nitrous ===
=== DMT & Amphetamines ===
=== DMT & MDMA ===
=== DMT & Cocaine ===
=== DMT & Caffeine ===
=== DMT & Alcohol ===
=== DMT & GHB\GBL ===
=== DMT & Opioids ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/3006089

=== DMT & Benzodiazepines ===
=== DMT & MAOIs ===
=== DMT & SSRIs ===
=== Mescaline & DOx ===
=== Mescaline & NBOMes ===
=== Mescaline & 2C-x ===
=== Mescaline & 2C-T-x ===
=== Mescaline & αMT ===
=== Mescaline & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions.

=== Mescaline & Cannabis ===
=== Mescaline & Ketamine ===
=== Mescaline & MXE ===
=== Mescaline & DXM ===
=== Mescaline & Nitrous ===
=== Mescaline & Amphetamines ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & MDMA ===
=== Mescaline & Cocaine ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.

=== Mescaline & Caffeine ===
* High doses of caffeine are uncomfortable and this will be magnified by psychedelics.

=== Mescaline & Alcohol ===
=== Mescaline & GHB\GBL ===
=== Mescaline & Opioids ===
=== Mescaline & Tramadol ===
* This combination can cause seizures due to the lowering of the threshold by tramadol and the potential of mescaline to cause seziures.

=== Mescaline & Benzodiazepines ===
=== Mescaline & MAOIs ===
=== Mescaline & SSRIs ===
=== DOx & NBOMes ===
=== DOx & 2C-x ===
=== DOx & 2C-T-x ===
=== DOx & αMT ===
=== DOx & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.

=== DOx & Cannabis ===
=== DOx & Ketamine ===
* Ketamine and psychedelics tend to potentiate each other - go slowly.

=== DOx & MXE ===
* As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.

=== DOx & DXM ===
* The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.

=== DOx & Nitrous ===
=== DOx & Amphetamines ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.

* http://www.ncbi.nlm.nih.gov/pubmed/1208759

=== DOx & MDMA ===
* The combined stimulating effects of the two can be uncomfortable. Coming down on the MDMA while the DOx is still active can be quite anxiogenic.

=== DOx & Cocaine ===
* The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of cocaine can easily lead to thought loops. Coming down from cocaine while the DOx is still active can be quite anxiogenic.

=== DOx & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating it may cause some physical discomfort.

=== DOx & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk.

=== DOx & GHB\GBL ===
=== DOx & Opioids ===
* No unexpected interactions.

=== DOx & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.

=== DOx & Benzodiazepines ===
=== DOx & MAOIs ===
=== DOx & SSRIs ===
=== NBOMes & 2C-x ===
=== NBOMes & 2C-T-x ===
=== NBOMes & αMT ===
=== NBOMes & 5-MeO-xxT ===
* The 5-MeO class of tryptamines can be unpredictable in their interactions and the NBOMes are known to be unpredictable even alone. This combination is best avoided.

=== NBOMes & Cannabis ===
=== NBOMes & Ketamine ===
=== NBOMes & MXE ===
=== NBOMes & DXM ===
=== NBOMes & Nitrous ===
=== NBOMes & Amphetamines ===
* Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.

=== NBOMes & MDMA ===
=== NBOMes & Cocaine ===
* Cocaine and NBOMes both provide considerable stimulation. When combined they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.

=== NBOMes & Caffeine ===
* Caffiene can bring out the natural stimulation from psychedelic drugs to make it uncomfortable. High doses can cause anxiety which is hard to handle while tripping.

=== NBOMes & Alcohol ===
=== NBOMes & GHB\GBL ===
=== NBOMes & Opioids ===
=== NBOMes & Tramadol ===
* Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.

=== NBOMes & Benzodiazepines ===
=== NBOMes & MAOIs ===
=== NBOMes & SSRIs ===
=== 2C-x & 2C-T-x ===
=== 2C-x & αMT ===
=== 2C-x & 5-MeO-xxT ===
* The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.

=== 2C-x & Cannabis ===
=== 2C-x & Ketamine ===
=== 2C-x & MXE ===
=== 2C-x & DXM ===
=== 2C-x & Nitrous ===
=== 2C-x & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally uneccessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & MDMA ===
=== 2C-x & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics. Combination of the stimulating effects may be uncomfortable.

=== 2C-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-x & Alcohol ===
=== 2C-x & GHB\GBL ===
=== 2C-x & Opioids ===
=== 2C-x & Tramadol ===
* Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.

=== 2C-x & Benzodiazepines ===
=== 2C-x & MAOIs ===
=== 2C-x & SSRIs ===
=== 2C-T-x & αMT ===
=== 2C-T-x & 5-MeO-xxT ===
=== 2C-T-x & Cannabis ===
=== 2C-T-x & Ketamine ===
=== 2C-T-x & MXE ===
=== 2C-T-x & DXM ===
=== 2C-T-x & Nitrous ===
=== 2C-T-x & Amphetamines ===
=== 2C-T-x & MDMA ===
=== 2C-T-x & Cocaine ===
=== 2C-T-x & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== 2C-T-x & Alcohol ===
* Both these classes of compound can interact unpredictably. Caution should be exercised.

=== 2C-T-x & GHB\GBL ===
=== 2C-T-x & Opioids ===
* No expected interactions, some Opioids have Serotonin action, and could lead to Serotonin Syndrome or a seizure. These are pretty much only to Pentazocine, Methadone, Tramadol, Tapenatdol.

=== 2C-T-x & Tramadol ===
=== 2C-T-x & Benzodiazepines ===
=== 2C-T-x & MAOIs ===
=== 2C-T-x & SSRIs ===
=== αMT & 5-MeO-xxT ===
=== αMT & Cannabis ===
=== αMT & Ketamine ===
=== αMT & MXE ===
=== αMT & DXM ===
=== αMT & Nitrous ===
=== αMT & Amphetamines ===
=== αMT & MDMA ===
=== αMT & Cocaine ===
=== αMT & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== αMT & Alcohol ===
* αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.

=== αMT & GHB\GBL ===
=== αMT & Opioids ===
* No unexpected interactions

=== αMT & Tramadol ===
=== αMT & Benzodiazepines ===
=== αMT & MAOIs ===
=== αMT & SSRIs ===
=== 5-MeO-xxT & Cannabis ===
=== 5-MeO-xxT & Ketamine ===
=== 5-MeO-xxT & MXE ===
=== 5-MeO-xxT & DXM ===
=== 5-MeO-xxT & Nitrous ===
=== 5-MeO-xxT & Amphetamines ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & MDMA ===
* Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.

=== 5-MeO-xxT & Cocaine ===
* The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.

=== 5-MeO-xxT & Caffeine ===
=== 5-MeO-xxT & Alcohol ===
=== 5-MeO-xxT & GHB\GBL ===
=== 5-MeO-xxT & Opioids ===
=== 5-MeO-xxT & Tramadol ===
=== 5-MeO-xxT & Benzodiazepines ===
=== 5-MeO-xxT & MAOIs ===
=== 5-MeO-xxT & SSRIs ===
=== Cannabis & Ketamine ===
=== Cannabis & MXE ===
=== Cannabis & DXM ===
=== Cannabis & Nitrous ===
=== Cannabis & Amphetamines ===
=== Cannabis & MDMA ===
=== Cannabis & Cocaine ===
=== Cannabis & Caffeine ===
=== Cannabis & Alcohol ===
=== Cannabis & GHB\GBL ===
=== Cannabis & Opioids ===
=== Cannabis & Tramadol ===
=== Cannabis & Benzodiazepines ===
=== Cannabis & MAOIs ===
=== Cannabis & SSRIs ===
=== Ketamine & MXE ===
=== Ketamine & DXM ===
=== Ketamine & Nitrous ===
=== Ketamine & Amphetamines ===
* Amphetamine worsens Ketamines ataxia.

* http://www.ncbi.nlm.nih.gov/pubmed/23660488

=== Ketamine & MDMA ===
=== Ketamine & Cocaine ===
=== Ketamine & Caffeine ===
* No unexpected interactions.

* http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full

=== Ketamine & Alcohol ===
* Both substances cause ataxia and bring a very high risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract

=== Ketamine & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== Ketamine & Opioids ===
* Both substances bring a risk of vomiting and unconsciousness. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/21224020

=== Ketamine & Tramadol ===
* No unexpected interactions.

=== Ketamine & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== Ketamine & MAOIs ===
=== Ketamine & SSRIs ===
=== MXE & DXM ===
* http://i.imgur.com/zmqaw.jpg

* http://www.sciencedirect.com/science/article/pii/S0014488607002543

=== MXE & Nitrous ===
=== MXE & Amphetamines ===
* Risk of tachycardia, hypertension, and manic states.

* http://www.ncbi.nlm.nih.gov/pubmed/25060403

=== MXE & MDMA ===
* There have been reports of risky serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.

=== MXE & Cocaine ===
* Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.

=== MXE & Caffeine ===
* No likely interactions.

=== MXE & Alcohol ===
* There is a high risk of memory loss, vomiting and severe ataxia from this combination.

=== MXE & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.

=== MXE & Opioids ===
* This combination can potentiate the effects of the opioid.

=== MXE & Tramadol ===
=== MXE & Benzodiazepines ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess.

=== MXE & MAOIs ===
=== MXE & SSRIs ===
* Depending on the SSRI this combination can be unpredictable.

=== DXM & Nitrous ===
=== DXM & Amphetamines ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & MDMA ===
=== DXM & Cocaine ===
* Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.

=== DXM & Caffeine ===
* High doses of caffeine may cause anxiety which is less manageable when tripping, and since both are stimulating the combination may cause some physical discomfort.

=== DXM & Alcohol ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Additionally CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.

=== DXM & GHB\GBL ===
* Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the patient falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict.

=== DXM & Opioids ===
* CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally, there is a reverse cross tolerance between opiates/dxm. I.E. if one takes dxm, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.

=== DXM & Tramadol ===
=== DXM & Benzodiazepines ===
* Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

=== DXM & MAOIs ===
* High risk of serotonin syndrome.

=== DXM & SSRIs ===
* High risk of serotonin syndrome.

=== Nitrous & Amphetamines ===
=== Nitrous & MDMA ===
=== Nitrous & Cocaine ===
=== Nitrous & Caffeine ===
=== Nitrous & Alcohol ===
* This combination can lead to vomiting.

=== Nitrous & GHB\GBL ===
=== Nitrous & Opioids ===
=== Nitrous & Tramadol ===
=== Nitrous & Benzodiazepines ===
=== Nitrous & MAOIs ===
=== Nitrous & SSRIs ===
=== Amphetamines & MDMA ===
* Amphetamines increase the neurotoxic effects of MDMA.

=== Amphetamines & Cocaine ===
* This combination of stimulants will increase strain on the heart. It is not generally worth it as cocaine has a mild blocking effect on dopamine releasers like amphetamine.

=== Amphetamines & Caffeine ===
* This combination of stimulants is not generally necessary and may increase strain on the heart, as well as potentially causing anxiety and greater physical discomfort.

=== Amphetamines & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel the alcohol and the stimulant less. Extended release formulations may severely impede sleep, further worsening the hangover.

=== Amphetamines & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Amphetamines & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Amphetamines & Benzodiazepines ===
* http://www.ncbi.nlm.nih.gov/pubmed/17320309

=== Amphetamines & MAOIs ===
=== Amphetamines & SSRIs ===
=== MDMA & Cocaine ===
* Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.

=== MDMA & Caffeine ===
* Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/

* http://link.springer.com/article/10.1007/s00213-010-1864-1

* http://www.sciencedirect.com/science/article/pii/S0028390805003114

* http://www.ncbi.nlm.nih.gov/pubmed/24211539

=== MDMA & Alcohol ===
* Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

* http://www.ncbi.nlm.nih.gov/pubmed/21040238

* http://www.ncbi.nlm.nih.gov/pubmed/21756931

=== MDMA & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16234132

* http://www.ncbi.nlm.nih.gov/pubmed/22554869

* http://www.ncbi.nlm.nih.gov/pubmed/20730418

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== MDMA & Opioids ===
=== MDMA & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== MDMA & Benzodiazepines ===
=== MDMA & MAOIs ===
=== MDMA & SSRIs ===
=== Cocaine & Caffeine ===
* Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.

=== Cocaine & Alcohol ===
* Drinking on stimulants is risky because the sedative effects of the alcohol are reduced, and these are what the body uses to gauge drunkenness. This typically leads to excessive drinking with greatly reduced inhibitions, high risk of liver damage and increased dehydration. They will also allow you to drink past a point where you might normally pass out, increasing the risk. If you do decide to do this then you should set a limit of how much you will drink each hour and stick to it, bearing in mind that you will feel he alcohol less. Cocaine is potentiated somewhat by alcohol because of the formation of cocaethylene.

=== Cocaine & GHB\GBL ===
* Stimulants increase respiration rate allowing a higher dose of sedatives. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest. Likewise the G can wear off and leave a dangerous concentration of cocaine behind.

=== Cocaine & Opioids ===
* Stimulants increase respiration rate allowing a higher dose of opiates. If the stimulant wears off first then the opiate may overcome the patient and cause respiratory arrest.

=== Cocaine & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.

=== Cocaine & Benzodiazepines ===
=== Cocaine & MAOIs ===
=== Cocaine & SSRIs ===
* Risk of serotonin syndrome, Likely to make the SSRI's innefective with regular cocaine use. The SSRIs may also make the cocaine less effective. Mental stability and cocaine don't go together.

* http://www.ncbi.nlm.nih.gov/pubmed/23761390

* http://www.ncbi.nlm.nih.gov/pubmed/20195220

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381

=== Caffeine & Alcohol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20001110

=== Caffeine & GHB\GBL ===
=== Caffeine & Opioids ===
=== Caffeine & Tramadol ===
* http://www.ncbi.nlm.nih.gov/pubmed/20837047

=== Caffeine & Benzodiazepines ===
=== Caffeine & MAOIs ===
=== Caffeine & SSRIs ===
* http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

=== Alcohol & GHB\GBL ===
* Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.

* http://www.ncbi.nlm.nih.gov/pubmed/15274975

=== Alcohol & Opioids ===
* Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Tramadol ===
* Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place affected patients in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.

=== Alcohol & Benzodiazepines ===
* Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.

=== Alcohol & MAOIs ===
* The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.

=== Alcohol & SSRIs ===
* Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

* http://www.ncbi.nlm.nih.gov/pubmed/15739105

=== GHB\GBL & Opioids ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Tramadol ===
* The sedative effects of this combination can lead to dangerous respiratory depression.

* http://www.ncbi.nlm.nih.gov/pubmed/7782758

=== GHB\GBL & Benzodiazepines ===
* The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.

* http://www.ncbi.nlm.nih.gov/pubmed/16483730

=== GHB\GBL & MAOIs ===
* No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.

=== GHB\GBL & SSRIs ===
=== Opioids & Tramadol ===
* Concomitant use of tramadol increases the seizure risk in patients taking other opioids. These agents are often individually epileptogenic and may have additive effects on seizure threshold during coadministration. Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present.

=== Opioids & Benzodiazepines ===
* Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely.

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/

=== Opioids & MAOIs ===
* Coadministration of monoamine oxidase inhibitors (MAOIs) with certain opioids has been associated with rare reports of severe and fatal adverse reactions. There appear to be two types of interaction, an excitatory and a depressive one. Symptoms of the excitatory reaction may include agitation, headache, diaphoresis, hyperpyrexia, flushing, shivering, myoclonus, rigidity, tremor, diarrhea, hypertension, tachycardia, seizures, and coma. Death has occurred in some cases.

* http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)

* http://www.ncbi.nlm.nih.gov/pubmed/2891392

* http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf

=== Opioids & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/23391344

* http://www.ncbi.nlm.nih.gov/pubmed/20513454

* http://www.ncbi.nlm.nih.gov/pubmed/16005413

* http://www.ncbi.nlm.nih.gov/pubmed/18676387

* http://www.ncbi.nlm.nih.gov/pubmed/17381671

=== Tramadol & Benzodiazepines ===
* Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration a risk when passed out, lay down in recovery position if ingested.

* http://www.ncbi.nlm.nih.gov/pubmed/12842359

=== Tramadol & MAOIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/16051647

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Tramadol & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/

* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/

=== Benzodiazepines & MAOIs ===
=== Benzodiazepines & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

* http://www.ncbi.nlm.nih.gov/pubmed/9435993

=== MAOIs & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/24577320

[[Category:Guides]]