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== Specific Combinations ==
== Specific Combinations ==


=== Amphetamine & Mescaline ===
=== LSD & Mushrooms ===
 
=== LSD & DMT ===
The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.
* http://www.ncbi.nlm.nih.gov/pubmed/3006089
 
=== Cocaine & Mescaline ===
 
The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.
 
=== Caffeine & Mescaline ===
 
High doses of caffeine are uncomfortable and this will be magnified by psychedelics.
 
=== 5-MeO-xxT & Mescaline ===
 
The 5-MeO class of tryptamines can be unpredictable in their interactions.
 
=== Tramadol & Mescaline ===
 
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 ===
 
The 5-MeO class of tryptamines can be unpredictable in their interactions, particularly increasing the risk of unpleasant physical side effects.
 
=== Ketamine & DOx ===
 
Ketamine and psychedelics tend to potentiate each other - go slowly.
 
=== MXE & DOx ===
 
As an NMDA antagonist MXE potentiates DOx which can be unpleasantly intense.
 
=== DXM & DOx ===
 
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 ===
Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
 
=== Amphetamine & DOx ===
 
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 ===
 
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 ===
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 ===
 
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 ===
 
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 ===
 
No unexpected interactions.
 
=== Tramadol & DOx ===
 
Tramadol is well known to lower seizure threshold and psychedelics also cause occasional seizures.
 
=== 5-MeO-xxT & NBOMes ===
 
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.
 
=== Amphetamine & NBOMes ===
 
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 ===
 
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 ===
 
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 ===
 
Tramadol is well known to lower seizure threshold and NBOMes have also shown a tendency to cause severe seizures.
 
=== 5-MeO-xxT & 2c-x ===
 
The 5-MeO psychedelics can interact unpredictably to potentiate other psychedelics.
 
=== Amphetamine & 2c-x ===
 
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 ===
 
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 ===
 
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 ===
 
Tramadol is well known to lower seizure threshold and psychedelics raise the risk of seizures.
 
=== Caffeine & 2C-T-x ===
 
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 ===
 
Both these classes of compound can interact unpredictably. Caution should be exercised.
 
=== Opioids & 2C-T-x ===
 
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.
 
=== Caffeine & αMT ===
 
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 & αMT ===
 
αMT has a broad mechanism of action in the brain and so does alcohol so the combination can be unpredictable.
 
=== Opioids & αMT ===
 
No unexpected interactions
 
=== Amphetamine & 5-MeO-xxT ===
 
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 ===
 
Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.
 
=== Cocaine & 5-MeO-xxT ===
 
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.
 
=== Amphetamine & Ketamine ===
 
Amphetamine worsens Ketamines ataxia.
 
=== Caffeine & Ketamine ===
 
No unexpected interactions.
 
=== Alcohol & Ketamine ===
 
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 ===
 
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 ===
 
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.
 
=== Tramadol & Ketamine ===
 
No unexpected interactions.
 
=== Benzodiazepines & Ketamine ===
 
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.
 
=== Amphetamine & MXE ===
 
Risk of tachycardia, hypertension, and manic states.
 
=== MDMA & MXE ===
 
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 ===
 
Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.
 
=== Caffeine & MXE ===
 
No likely interactions.
 
=== Alcohol & MXE ===
 
There is a high risk of memory loss, vomiting and severe ataxia from this combination.
 
=== GHB/GBL & MXE ===
 
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 ===
 
This combination can potentiate the effects of the opioid.
 
=== Benzodiazepines & MXE ===
 
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.
 
=== SSRIs & MXE ===
 
Depending on the SSRI this combination can be unpredictable.
 
=== Amphetamine & DXM ===
 
Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
 
=== MAOIs & DXM ===
 
High risk of serotonin syndrome.
 
=== Cocaine & DXM ===
 
Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
 
=== SSRIs & DXM ===
 
High risk of serotonin syndrome.
 
=== Caffeine & DXM ===
 
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 ===
 
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 ===
 
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 ===
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.
 
=== Benzodiazepines & DXM ===
 
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.
 
=== Amphetamine & PCP ===
 
This combination can easily lead to hypermanic states.
 
=== MDMA & PCP ===
 
This combination can easily lead to hypermanic states.
 
=== Cocaine & PCP ===
 
This combination can easily lead to hypermanic states.
 
=== Caffeine & PCP ===
 
Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
 
=== Alcohol & PCP ===
 
Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
 
=== GHB/GBL & PCP ===
 
Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
 
=== Opioids & PCP ===
 
PCP can reduce opioid tolerance, increasing the risk of overdose.
 
=== Benzodiazepines & PCP ===
 
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.
 
=== SSRIs & PCP ===
 
Details of this combination are not well understood but PCP generally interacts in an unpredictable manner.
 
=== Alcohol & N2O ===
 
This combination can lead to vomiting.


=== MDMA & Amphetamine ===
* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf


Amphetamines increase the neurotoxic effects of MDMA.
=== 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


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


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


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


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


=== Alcohol & Amphetamine ===
* http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf


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


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


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


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


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


=== Tramadol & Amphetamine ===
* http://www.ncbi.nlm.nih.gov/pubmed/8726753


Tramadol and stimulants both increase the risk of seizures.
=== 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


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


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


=== Caffeine & MDMA ===
=== 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.


Caffiene is not really necessary with MDMA and increases any neurotoxic effects from MDMA.
=== Mescaline & MDMA ===
=== Mescaline & Cocaine ===
* The focus and anxiety caused by stimulants is magnified by psychedelics and results in an increased risk of thought loops.


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


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


=== Tramadol & MDMA ===
=== 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.


Tramadol and stimulants both increase the risk of seizures.
=== DOx & Cannabis ===
=== DOx & Ketamine ===
* Ketamine and psychedelics tend to potentiate each other - go slowly.


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


Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.
=== 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.
=== Alcohol & Cocaine ===


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.
=== 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.


=== GHB/GBL & Cocaine ===
* http://www.ncbi.nlm.nih.gov/pubmed/1208759


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.
=== 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.


=== Opioids & Cocaine ===
=== 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.


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.
=== 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.


=== Tramadol & Cocaine ===
=== 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.


Tramadol and stimulants both increase the risk of seizures.
=== DOx & GHB\GBL ===
=== DOx & Opioids ===
* No unexpected interactions.


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


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.
=== 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.


=== GHB/GBL & Alcohol ===
=== 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.


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.
=== 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.


=== Opioids & Alcohol ===
=== 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.


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.
=== 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.


=== Tramadol & Alcohol ===
=== 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.


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.
=== 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.


=== Benzodiazepines & Alcohol ===
=== 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.


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.
=== 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.


=== MAOIs & Alcohol ===
=== 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.


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


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


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.
=== 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.


=== Opioids & GHB/GBL ===
=== 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.


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


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


The sedative effects of this combination can lead to dangerous respiratory depression.
=== αMT & Tramadol ===
 
=== αMT & Benzodiazepines ===
=== Benzodiazepines & GHB/GBL ===
=== αMT & MAOIs ===
 
=== αMT & SSRIs ===
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.
=== 5-MeO-xxT & Cannabis ===
 
=== 5-MeO-xxT & Ketamine ===
=== Tramadol & Opioids ===
=== 5-MeO-xxT & MXE ===
 
=== 5-MeO-xxT & DXM ===
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.
=== 5-MeO-xxT & Nitrous ===
 
=== 5-MeO-xxT & Amphetamines ===
=== Benzodiazepines & Opioids ===
* 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.
 
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 ===
 
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.
 
=== Benzodiazepines & Tramadol ===
 
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.
 
== References ==
 
=== LSD & DMT ===


http://www.ncbi.nlm.nih.gov/pubmed/3006089
=== 5-MeO-xxT & MDMA ===
http://deepblue.lib.umich.edu/bitstream/handle/2027.42/26285/0000370.pdf
* Some of the 5-MeO tryptamines are a bit unpredictable and should be mixed with MDMA with care.


===LSD & GHB/GBL===
=== 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.


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


===LSD & Opioids===
* http://www.ncbi.nlm.nih.gov/pubmed/23660488


http://www.ncbi.nlm.nih.gov/pubmed/547279
=== Ketamine & MDMA ===
=== Ketamine & Cocaine ===
=== Ketamine & Caffeine ===
* No unexpected interactions.


http://www.ncbi.nlm.nih.gov/pubmed/3006089
* http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full


"Low doses antagonized the effects of both hallucinogens, whereas larger doses enhanced their effects."
=== 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://www.ncbi.nlm.nih.gov/pubmed/3006089
* http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract


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


===LSD & Tramadol===
* http://www.ncbi.nlm.nih.gov/pubmed/16483730


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


===LSD & MAOIs===
* http://www.ncbi.nlm.nih.gov/pubmed/21224020


http://www.ncbi.nlm.nih.gov/pubmed/8788508
=== Ketamine & Tramadol ===
* No unexpected interactions.


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


https://www.erowid.org/references/refs_view.php?A=ShowDocPartFrame&ID=2439&DocPartID=2199
=== Ketamine & MAOIs ===
=== Ketamine & SSRIs ===
=== MXE & DXM ===
* http://i.imgur.com/zmqaw.jpg


===LSD & SSRIs===
* http://www.sciencedirect.com/science/article/pii/S0014488607002543


http://www.nature.com/npp/journal/v14/n6/full/1380431a.html
=== MXE & Nitrous ===
=== MXE & Amphetamines ===
* Risk of tachycardia, hypertension, and manic states.


http://www.ncbi.nlm.nih.gov/pubmed/8726753
* http://www.ncbi.nlm.nih.gov/pubmed/25060403


===DMT & Opioids===
=== 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.


http://www.ncbi.nlm.nih.gov/pubmed/3006089
=== MXE & Cocaine ===
* Stimulants taken with MXE can lead to hypermanic states much more easily, especially if sleep is avoided.


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


http://www.ncbi.nlm.nih.gov/pubmed/3006089
=== MXE & Alcohol ===
* There is a high risk of memory loss, vomiting and severe ataxia from this combination.


===MDMA & GHB/GBL===
=== 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.


http://www.ncbi.nlm.nih.gov/pubmed/16234132
=== MXE & Opioids ===
* This combination can potentiate the effects of the opioid.


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


http://www.ncbi.nlm.nih.gov/pubmed/20730418
=== MXE & MAOIs ===
=== MXE & SSRIs ===
* Depending on the SSRI this combination can be unpredictable.


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


===DOx & Amphetamines===
=== 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.


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


===Ketamine & Caffeine===
=== 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.


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


===Ketamine & Amphetamine===
=== 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.


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


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


http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract
=== DXM & SSRIs ===
* High risk of serotonin syndrome.


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


http://www.ncbi.nlm.nih.gov/pubmed/16483730
=== Nitrous & GHB\GBL ===
=== Nitrous & Opioids ===
=== Nitrous & Tramadol ===
=== Nitrous & Benzodiazepines ===
=== Nitrous & MAOIs ===
=== Nitrous & SSRIs ===
=== Amphetamines & MDMA ===
* Amphetamines increase the neurotoxic effects of MDMA.


===Ketamine & Opioids===
=== 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.


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


===Tramadol & SSRIs===
=== 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.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/
=== 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.


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


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


http://i.imgur.com/zmqaw.jpg
=== Amphetamines & Benzodiazepines ===
* http://www.ncbi.nlm.nih.gov/pubmed/17320309


http://www.sciencedirect.com/science/article/pii/S0014488607002543
=== Amphetamines & MAOIs ===
=== Amphetamines & SSRIs ===
=== MDMA & Cocaine ===
* Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.


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


http://www.ncbi.nlm.nih.gov/pubmed/25060403
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/


===DXM & PCP===
* http://link.springer.com/article/10.1007/s00213-010-1864-1


http://i.imgur.com/zmqaw.jpg
* http://www.sciencedirect.com/science/article/pii/S0028390805003114


http://www.sciencedirect.com/science/article/pii/S0014488607002543
* http://www.ncbi.nlm.nih.gov/pubmed/24211539


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


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224745/
* http://www.ncbi.nlm.nih.gov/pubmed/21040238


===Amphetamines & Benzodiazepines===
* http://www.ncbi.nlm.nih.gov/pubmed/21756931


http://www.ncbi.nlm.nih.gov/pubmed/17320309
=== MDMA & GHB\GBL ===
* http://www.ncbi.nlm.nih.gov/pubmed/16234132


===MDMA & Caffeine===
* http://www.ncbi.nlm.nih.gov/pubmed/22554869


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492978/
* http://www.ncbi.nlm.nih.gov/pubmed/20730418


http://link.springer.com/article/10.1007/s00213-010-1864-1
* http://www.ncbi.nlm.nih.gov/pubmed/16483730


http://www.sciencedirect.com/science/article/pii/S0028390805003114
=== MDMA & Opioids ===
=== MDMA & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.


http://www.ncbi.nlm.nih.gov/pubmed/24211539
=== MDMA & Benzodiazepines ===
=== MDMA & MAOIs ===
=== MDMA & SSRIs ===
=== Cocaine & Caffeine ===
* Both stimulants, risk of tachycardia, hypertension, and in extreme cases heart failure.  


===MDMA & Alcohol===
=== 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.


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


http://www.ncbi.nlm.nih.gov/pubmed/21756931
=== 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 & SSRIs===
=== Cocaine & Tramadol ===
* Tramadol and stimulants both increase the risk of seizures.


http://www.ncbi.nlm.nih.gov/pubmed/23761390
=== 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/20195220
* http://www.ncbi.nlm.nih.gov/pubmed/23761390


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381
* http://www.ncbi.nlm.nih.gov/pubmed/20195220


===Caffeine & Alcohol===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3377381


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


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


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


===Caffeine & SSRIs===
=== 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://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx
* http://www.ncbi.nlm.nih.gov/pubmed/15274975


===Alcohol & GHB/GBL===
=== 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.


http://www.ncbi.nlm.nih.gov/pubmed/15274975
=== 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 & SSRIs===
=== 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.


http://www.ncbi.nlm.nih.gov/pubmed/15739105
=== Alcohol & MAOIs ===
* The chemical tyramine in alcoholic beverages can have dangerous reactions with MAOIs, causing an increase in blood pressure.


===GHB/GBL & Opioids===
=== 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/7782758
* http://www.ncbi.nlm.nih.gov/pubmed/15739105


===GHB/GBL & Tramadol===
=== 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
* http://www.ncbi.nlm.nih.gov/pubmed/7782758


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


http://www.ncbi.nlm.nih.gov/pubmed/16483730
* http://www.ncbi.nlm.nih.gov/pubmed/7782758


===GHB/GBL & MAOIs===
=== 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.


No study, but MAO B inhibitors should enhance the effects, no interaction with MAO A.
* http://www.ncbi.nlm.nih.gov/pubmed/16483730


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


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/
=== 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 & MAOIs===
=== 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/pubmed/17157368 (?)
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/


http://www.ncbi.nlm.nih.gov/pubmed/2891392
=== 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.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf
* http://www.ncbi.nlm.nih.gov/pubmed/17157368 (?)


===Opioids & SSRIs===
* http://www.ncbi.nlm.nih.gov/pubmed/2891392


http://www.ncbi.nlm.nih.gov/pubmed/23391344
* http://www.if-pan.krakow.pl/pjp/pdf/2013/3_593.pdf


http://www.ncbi.nlm.nih.gov/pubmed/20513454
=== Opioids & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pubmed/23391344


http://www.ncbi.nlm.nih.gov/pubmed/16005413
* http://www.ncbi.nlm.nih.gov/pubmed/20513454


http://www.ncbi.nlm.nih.gov/pubmed/18676387
* http://www.ncbi.nlm.nih.gov/pubmed/16005413


http://www.ncbi.nlm.nih.gov/pubmed/17381671
* http://www.ncbi.nlm.nih.gov/pubmed/18676387


===Tramadol & Benzodiazepines===
* http://www.ncbi.nlm.nih.gov/pubmed/17381671


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


===Tramadol & MAOIs===
* http://www.ncbi.nlm.nih.gov/pubmed/12842359


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


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


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


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/


http://www.ncbi.nlm.nih.gov/pubmed/9435993
=== Benzodiazepines & MAOIs ===
=== Benzodiazepines & SSRIs ===
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/


===MAOIs & SSRIs===
* http://www.ncbi.nlm.nih.gov/pubmed/9435993


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


[[Category:Guides]]
[[Category:Guides]]

Revision as of 06:38, 18 January 2016

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!

Overview

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

Join #content channel on IRC

Email: [email protected], or email GrimReaper directly at [email protected]

Chart versions

English

Portuguese

German

Polish

Specific Combinations

LSD & Mushrooms

LSD & DMT

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

LSD & Opioids

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

LSD & Tramadol

LSD & Benzodiazepines

LSD & MAOIs

LSD & SSRIs

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

DMT & Tramadol

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.

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.

Ketamine & MDMA

Ketamine & Cocaine

Ketamine & Caffeine

  • No unexpected interactions.

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.

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.

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.

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

MXE & Nitrous

MXE & Amphetamines

  • Risk of tachycardia, hypertension, and manic states.

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

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.

MDMA & Alcohol

  • Both MDMA and alcohol cause severe dehydration. Approach this combination with caution, moderation and sufficient hydration.

MDMA & GHB\GBL

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.

Caffeine & Alcohol

Caffeine & GHB\GBL

Caffeine & Opioids

Caffeine & Tramadol

Caffeine & Benzodiazepines

Caffeine & MAOIs

Caffeine & SSRIs

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.

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.

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.

GHB\GBL & Tramadol

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

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.

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.

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.

Opioids & SSRIs

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.

Tramadol & MAOIs

Tramadol & SSRIs

Benzodiazepines & MAOIs

Benzodiazepines & SSRIs

MAOIs & SSRIs

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