Drug combinations
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!
Contact and Comments
If you want to give us some feedback/recommendation/comment on the chart, you can contact us:
Email: [email protected], or email GrimReaper directly at [email protected]
Chart versions
General information
Substance class description
Psychedelics
- 2C-T-x is a moderate MAO-A inhibitor, can cause Serotonin Syndrome when combined with monoamine releasers, SSRIs or other MAO inhibitors.
- αMT is a reversible MAOI in higher doses (the danger rises exponentially as αMT doses approach 150 mg due to increased monoamine release and increased MAO inhibition), can cause Serotonin Syndrome when combined with monoamine releasers, SSRIs or other MAO inhibitors.
- 5-MeO substituted tryptamines are SNRIs or SNDRIs and therefore should not be combined with other reuptake inhibitors or MAOIs.
Opioids
- Tramadol acts as a μ-opioid receptor agonist, serotonin releasing agent (SRA), serotonin and norepinephrine reuptake inhibitor (SNRI), NMDA receptor antagonist, 5-HT2C receptor antagonist, 5 nicotinic acetylcholine receptor antagonist, TRPV1 receptor agonist, and M1 and M3 muscarinic acetylcholine receptor antagonist. It can cause seizures, serotonin syndrome and even death when combined with certain stimulants and other reuptake inhibitors.
- https://www.ncbi.nlm.nih.gov/pubmed/2849950
- https://www.ncbi.nlm.nih.gov/pubmed/8955860
- https://www.ncbi.nlm.nih.gov/pubmed/9671098
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1908625/
- https://www.ncbi.nlm.nih.gov/pubmed/9389855
- https://www.ncbi.nlm.nih.gov/pubmed/8955860
- https://www.ncbi.nlm.nih.gov/pubmed/15845694
- https://www.ncbi.nlm.nih.gov/pubmed/15105221
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1573343/
- http://jpet.aspetjournals.org/content/299/1/255.long
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1572317/
Specific combinations with references (work in progress)
LSD & DMT
"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 & 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 & 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
DMT & Opioids
http://www.ncbi.nlm.nih.gov/pubmed/3006089
DMT & Tramadol
http://www.ncbi.nlm.nih.gov/pubmed/3006089
DOx & Amphetamines
http://www.ncbi.nlm.nih.gov/pubmed/1208759
Ketamine & Caffeine
http://onlinelibrary.wiley.com/doi/10.1111/j.1742-7843.2009.00382.x/full
Ketamine & Alcohol
http://onlinelibrary.wiley.com/doi/10.1002/jemt.22045/abstract
Ketamine & GHB/GBL
http://www.ncbi.nlm.nih.gov/pubmed/16483730
Ketamine & Opioids
http://www.ncbi.nlm.nih.gov/pubmed/21224020
MXE & DXM
http://www.sciencedirect.com/science/article/pii/S0014488607002543
MXE & Amphetamines
http://www.ncbi.nlm.nih.gov/pubmed/25060403
DXM & PCP
http://www.sciencedirect.com/science/article/pii/S0014488607002543
PCP & SSRIs
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1224745/
Amphetamines & Benzodiazepines
http://www.ncbi.nlm.nih.gov/pubmed/17320309
MDMA & Caffeine
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
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
Cocaine & SSRIs
http://www.ncbi.nlm.nih.gov/pubmed/23761390
http://www.ncbi.nlm.nih.gov/pubmed/20195220
Caffeine & Alcohol
http://www.ncbi.nlm.nih.gov/pubmed/20001110
Caffeine & Tramadol
http://www.ncbi.nlm.nih.gov/pubmed/20837047
Caffeine & SSRIs
Alcohol & GHB/GBL
http://www.ncbi.nlm.nih.gov/pubmed/15274975
Alcohol & SSRIs
http://www.ncbi.nlm.nih.gov/pubmed/15739105
GHB/GBL & Opioids
http://www.ncbi.nlm.nih.gov/pubmed/7782758
GHB/GBL & Tramadol
http://www.ncbi.nlm.nih.gov/pubmed/7782758
GHB/GBL & Benzodiazepines
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.
Opioids & Benzodiazepines
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/
Opioids & MAOIs
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
http://www.ncbi.nlm.nih.gov/pubmed/12842359
Tramadol & MAOIs
http://www.ncbi.nlm.nih.gov/pubmed/16051647
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/
Tramadol & SSRIs
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2714818/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2750095/
Benzodiazepines & SSRIs
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/
http://www.ncbi.nlm.nih.gov/pubmed/9435993