Drug combinations: Difference between revisions

Latest revision as of 10:36, 10 February 2021

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.

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.

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Use & Attribution

Use of the data the combination chart and app are built upon is free-of-charge for non-commercial purposes. Distribution and display of the combination chart is also free for non-commercial purposes. In both cases, we only require that you link back to either this page, or [1]. This should be accompanied with a note citing TripSit as the source for the information wherever it appears. The presentation should also include a note that the information is only intended for a quick overview and reference, and that it is necessary for users to perform more individual research before making a decision.

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

https://www.ncbi.nlm.nih.gov/pubmed/28677880 ; Just in case I forget.

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 by reduction of cocaine breakdown which results in increased risk to the heart.

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.