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!

File:TripSitDrugComboChart.gif

Overview

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Specific Combinations

Amphetamine & Mescaline

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

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

aMT 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

No unexpected interactions. Likely to increase blood pressure but not an issue with sensible doses

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

Amphetamines increase the neurotoxic effects of MDMA

Cocaine & Amphetamine

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 & Amphetamine

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 & Amphetamine

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 & Amphetamine

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 & Amphetamine

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 & Amphetamine

Tramadol and stimulants both increase the risk of seizures.

Cocaine & MDMA

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

Caffeine & MDMA

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

Alcohol & MDMA

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

Tramadol & MDMA

Tramadol and stimulants both increase the risk of seizures.

Caffeine & Cocaine

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

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.

Ghb/gbl & Cocaine

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

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

Tramadol and stimulants both increase the risk of seizures.

Ssris & Cocaine

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

Ghb/gbl & Alcohol

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

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

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

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

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

Ssris & Alcohol

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

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

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

Benzodiazepines & Ghb/gbl

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

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

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 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

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

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

Tramadol & SSRIs

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

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

MXE & DXM

http://i.imgur.com/zmqaw.jpg

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

MXE & Amphetamines

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

DXM & PCP

http://i.imgur.com/zmqaw.jpg

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

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

http://journals.lww.com/jpharmacogenetics/abstract/1996/06000/a_fluvoxamine_caffeine_interaction_study.3.aspx

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/

Benzodiazepines & SSRIs

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

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

MAOIs & SSRIs

http://www.ncbi.nlm.nih.gov/pubmed/24577320

Methoxetamine

N-methyl-D-aspartate receptor. NMDA antagonists are often dissociatives.

A substance that interferes with or inhibits the physiological action of another.

N-Benzyl-Ortho-Methoxy derivatives of psychedelic phenethylamines.

A monoamine neurotransmitter, biochemically derived from tryptophan, that is primarily found in the gastrointestinal (GI) tract, platelets, and central nervous system (CNS) of humans and animals. It is a well-known contributor to feelings of well-being.

Loss of motor coordination

Selective Serotonin Reuptake Inhibitor

A monoamine neurotransmitter, biochemically derived from tryptophan, that is primarily found in the gastrointestinal (GI) tract, platelets, and central nervous system (CNS) of humans and animals. It is a well-known contributor to feelings of well-being.

Central Nervous System

A neurotransmitter associated with movement, attention, learning, and the brain’s pleasure and reward system.

Monoamine Oxidase, an enzyme that catalyses the metabolism of many drugs (e.g., DMT, dopamine and serotonin).