suspected serotonin syndrome from methoxetamine use

spamuel

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Quetiapine is a dopamine, serotonin and adrenergic antagonist, and one of its active metabolites, norquetiapine, is a norepinephrine reuptake inhibitor.
I'm no expert though, so I'm not sure how they'd react in theory.
All I know is what my body tells me, which is that when I take quetiapine and methoxetamine too close together, I feel strung out and jittery.
 

Albion

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This is interesting. Here are a couple of hairy experiences I've had on MXE. I was convinced the first time that I had SS, but was convinced otherwise by others. However, this has happened 3 times now and each time I was struggling to remain conscious. Whatever is going on with MXE, it is very, very dangerous.

(1)
I can go into plenty more detail with regards to what actually happened.

I took 100mg 5-APB. Waited for it to kick in and plugged 50mg MXE. This was absolutely awesome. It was a completely lucid journey through my bedroom roof into the universe beyond. Very nice indeed. Under the influence of the MXE I remember dosing another 100mg of 5-APB. I had about 4 hours of unadulterated fun.

However as I started to return to reality, the hallucinations simply got more and more intense (They were of the wobbly-eye, wiggly worm, floating translucent blob variety). These symptoms got gradually worse over the space of about 2 hours. I tried to keep time, but I couldn't read or understand the time on my phone.

My vision was a mess. The intensity of my bedside lamp completely overwhelmed my field of view. Everything turned to a red and purple infra-red camera-style vision.

My brain was making a 'swish-swish-swish-swish' sound, and felt as though it was about to burst.

I felt as though I was filling with air, unbearably 'inflating' far more than capacity allowed.

My heart beat was just a blur. Was beating so, so fast....Faster than it ever should.

Muscles were shaking uncontrollably, whole body tensed up.

I had to keep moving about because every time I laid down, consciousness seemed to slip away. If I stopped moving for even a few seconds, I lost all feeling in my body. As it was, my brain was aching, my face had gone numb, extremities were numb. My vision began to fade, began to look as though I was watching events through a flickering projector. Everything just turned to pot, faculties such as sight, sound, touch were all failing. Naturally I believed I was going to die.

So I continued the cycle of calm breathing, sitting up, sitting down, turning light on, turning light off, so that I wasn't overwhelmed by numbness and blindness. I ought to point out that I became seriously exhausted. I almost gave up. However after 3 hours or so, the effects began to subside. Whatever it was, it felt like it could have been lethal. I'm sure it's enough of an ordeal to put a body into shock, or trigger heart failure.

So dopamine syndrome? Serotonin syndrome? The level of hallucination I had would be on par with high dopamine levels, but I did not become psychotic or paranoid about anything other than my own health. By the 48 hour mark the effects had gone completely, but left me very shaken.

People who have previously combined MXE with 6-APB and 5-APB, you must have been very lucky to not have run into a situation like this. Also this is probably the last time I try out a combo because others recommended it. It is apparent that this is not safe at all.


Hopefully this provides enough information for someone in the know to recognise the symptoms and hazard a guess as to what happened, and how much danger I was really in.

(2)
I took 50mg of MXE yesterday evening. I had been on 5-APB the day before. Everything was normal, only I couldn't get to sleep after no matter what, even well after the effects of the MXE had worn off. I started to get hot flushes running up around my temples along with the occasional shiver. Upon trying to sleep, within seconds of me laying still my face would contort and my tongue would roll back inside of me and prevent me from breathing. I'd come over all pleasurable as this happened. Then one particular bout of this left me seriously struggling to remain conscious. I had to get up, move about, in order to fight this overwhelming feeling of sleepiness. I've been fighting this feeling for a couple of hours now. It's constantly trying to sedate me. If I shut my eyes for one moment the euphoria and drowsiness overwhelms me. My body goes rapidly numb, my tongue rolls back, my face contorts. It feels as though my body is trying to put me in a coma. I feel a lot of pressure around my temples, my brain is also squelching a little. This is very unnerving. The fact that my body is blasting out this euphoria, urging me to go along with it. But it feels so, so wrong. I'm not sure how long this is going to go on for, all I know is that as long as I don't give in, I'm still alive and breathing.

What the hell is happening to me??? It feels as though my own body is trying to lure me into something awful. It's so sinister, my own body has foregone pain and instead chosen to knock me out cold with an irresistible euphoria. Like it's saying 'there there, it'll all be over soon'. Is this something anyone has encountered before?

(3)
I'm feeling much better thankyou.

Unfortunately the exact same thing happened yesterday, a full 3 days after I took the 5-APB and more than a day since the last incident. I just dosed the MXE, and 7 hours later I was struggling to hold it together. 1 solid hour of moving about, massaging my head, trying not to let it build up, or let myself get too panicked. I don't know whether 5-APB has such a long half-life that it was still dangerous, or whether I've developed a dangerous reaction to MXE. I'm never touching either drug again, nor any other for a very, very long time.

There is a definite pattern to this experience though.

First 1-4 hours standard MXE experience. No troubles

Hours 5-6 I return to baseline mentally, but physically weak. Coordination is awful, fingers and extremities become numbed. Vision becomes very wobbly, my eyes slide about as though on ice, unable to keep them on any particular focal point.

Hours 7-10 consciousness slips, rhythmic squelching in head, brain feels as though it is inflating. Hallucinations (vision becomes reminiscent of rain running down a window), colour distortion, detachment from reality. Speech slurred.

Hours 10 + slowly fades away (very slowly).

Like I say, shall not let myself get into this sort of predicament again. It's a very lonely place, especially if you think you're going to die. I feel blessed for surviving this multiple times, but appalled that I've let it happen all over again. All I want to know now is (1) What was going on and (2) Why it was going on, and (3) Get the message out to people that this is NOT a safe combination. And I'm sure it's not the only one. MXE does NOT play nicely. MXE CAN kill. In fact it's already happened once before. I wonder if that death was a result of what has happened here (Death came from IV'ing 70mg MXE and 400mg MDAI).


I really really want some answers.
 

Solipsis

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Ketamine feels safer to me acutely while it can be nasty stuff indeed on the longer run. But methoxetamine felt more edgy acutely, like it has some dopamine activity which it does right? DARI?

Perhaps that is one of the more nasty sides when you overdose with methoxetamine while with ketamine the NMDA antagonism of S-ket shuts stuff like that down. On the other hand with R-ket, I have found manic schizo type behavior in excessive doses although it more mentally threatening still than physical.

People need to watch out more with methoxetamine. The history of use is just so much shorter. And the pharmacology apparently more complex in significant ways.
 

any major dude

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^agreed. seeing how many people are taking this somewhat habitually is a touch worrisome, especially since it is utterly new in the human experience & has had no formal toxicological studies.
 

yuseaname7

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Hey everyone. I have had a really scary experience that goes along with jspete's experience with the euphoria that felt completely wrong. I was coming down from a relatively (<20mg) dose of mxe cause it was all I had left, and decided to smoke some spice (mad hatter specifically). Bad idea. I had done this before, but fully under the influence of a high dose of mxe and was dropped into a state of existence where i felt such a sinister euphoria on top of the mxe mindfuck I wanted to jump out of my skin. However, this time was epically frightening. My ears were ringing. Not tinnitus, but standing in the church bell tower at noon ringing. It was so loud and the outlines of everything became distorted. I felt like i was burning up and electricity was coursing throughout my whole body. Negative thoughts flooded my conciousness that no amount of calming myself helped. I became so frightened I put 911 on my phone and waited to see how bad it got before I hit "dial". I was gonna write it off as a really bad reaction with the (possibly) jwh-250 in the mad hatter. Please note that with high grade cannabis, the combination did not produce any effects like this as it was a magical enlightening experience. MXE and spice threw me into an experience that almost had me call an ambulance cause something dark, sinister and nerve synapse degenerating was going on. I felt like I was going to swallow my tongue, and i felt like I was losing control of my body and possibly have a seizure.
 

sekio

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Sounds suspiciously like a JWH overdose to me.

I wish people would keep in mind that mixing ultrapotent cannabinoid agonists with other drugs (even using them on their own) is a bad bad plan. They are well known for bringing out The Fear even though there may be very little in the way of bodily damage.


I personally feel that MxE is just a version of ketamine that's a little heavier on the dopamine-reuptake side, and more potent. I imagine it would be a mediocre to okay anesthetic if the manic delusions wouldn'tbecome an issue.
 

yuseaname7

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Sekio, I totally agree with you. I apologize for derailing the thread since this issue was not related to serotonin syndrome and belongs elsewhere. I believe it was a JWH overdose plain and simple that I experienced but even though the bowl was extremely small, there was synergestic properties between the two and the two did not mix. Needless to say, this happened on the 22 of march and I have not touched synthetic cannabis again. At this point all of the synthetic cannabinoids have negatively impacted me in ways the real deal cannot. Lesson definitely learned, I just wanted to post in the interest of harm reduction. That, among other substances I have been able to cessate with mxe.
 

Mercc96

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I too have had a weird experience with mxe and cannabis , but i put it down to inexperience in combining it with cannabis although I am experienced with MXE alone, in low and high doses. After taking 35mg of mxe (bad idea as my tolerance had decreased from a 4 month abstinence) , I took to the bong and had 5 huge bowl rips on it, more then I would usually as my throat was numb and could take more. This was at about 10 pm, 15 minutes after doing so I was thrown into a extremely weird headspace. In which the concepts and images in my head would manifest into real world hallucinations, things such as purple and yellow rotating cogs and what not. At the same time my vision seemed to change as in when looking at my phone it was larger, in HD and bent, elongated around my hand. Then it got worse as I felt extremely anxious and laid down on my bed and started sweating loads and twitching, I could feel it interacting with my whole body. This went on for hours , with loads of mental / pseudo visual hallucinations and also some auditory hallucinations. But I did manage to grab a hold of myself and start to enjoy the trip in the end, except the twitching. I was fine in the morning, quite refreshed. It just worried me as it seemed to be an odd reaction to the combo.
 

RedBaron

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I've smoked pure JWH while on MXE many times now, and haven't had many problems. But my JWH tolerance is pretty high, I rarely get panicky, and I have my dose down well.
It's frightening to hear all of these experiences though. I was thinking of trying a balls-to-the-wall dose of MXE to try to hit a hole, but now I think I'll just stick to what I'm used to.
 

yuseaname7

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In the interest of the questions asked by the OP, besides serotonergic type drugs and research chems, what drugs can possibly trigger serotonin syndrome? I myself am looking into this and will try to post relevant information.

Even though this is technically a dopamine question, it does not take my organic chemistry background to figure out that opiate and opioid drugs, like the oxycodone that I will be perscribed for my wisdom teeth removal next week, can cause an interaction? Methoxetamine is a supposed dopamine reuptake inhibitor and oxycodone triggers the release of dopamine, and I could see an issue popping up here. Until I find some reports or information I will avoid this combo like a lepor colony. Methadone and and dextromethorphan (methadone was taken after he was trippin on dxm) killed my best friend, I want to make smart decisions and not wind up putting my family through that situation.

Redbarron, which jwh series are you using? Im sure that only a select few affect the brain the way mine was. The mad hatter blend I smoked, I'm sure, contains primarily JWH 250. It is the effects of this compound that resulted in my horror experience.
 
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Mercc96

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It's frightening to hear all of these experiences though. I was thinking of trying a balls-to-the-wall dose of MXE to try to hit a hole, but now I think I'll just stick to what I'm used to.

Tried that, wasn't really very much fun :\
 

romiir

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methoxetamine discontinuation syndrome responds well to cyproheptadine

I am posting this information here in this seemingly dead thread since it appears to be the most relevent place on the internet at this time to post the information.

If you find yourself in this situation without a supply of cyproheptadine on hand, I strongly urge you to get to the ER immediately and discuss/recommend cyproheptadine treatment (benzos seem to also help, atavan IME) with your physician. I believe my quick and informed thinking saved my friends life during a particularly troubling negative experience of recuring symptoms similar to those mentioned above.

I strongly suggest anyone considering experimenting (repeated/frequent or combo use ESPECIALLY) with methoxetamine who values their life have a supply of cyproheptadine on hand. It was discovered that a friend experienced something similar to the experiences described here by JSPete. A couple of times it resulted from methylone used in proximity to methoxetamine usage. I wholeheartedly believe it was indeed serotonin syndrome, the symptoms matched the description of the condition perfectly and in one particularly difficult experience triggered by eating eggs with cheese 3 days after prior MXE use in proximity to but not in combonation with Methylone. (no other substances consumed during that time) An ER doctor seemed to agree [another doctor later believed SS was misdiagnosed, but the symtoms sure the hell seemed to respond well to cyproheptadine (+ asprin added for cardiac benefit) with or without benzos.] I must caution the incidents seem to be directly triggered by serotonic drug interaction with MXE; but also triggered after binge or high dosage use of MXE alone. Sometimes days after usage but usually immediately a few hours after coming down from MXE (JSPete's timing of about 6 or so hours after last administration seems spot on IMO). The panic attack/serotonin syndrome like effects seem to slowly subside over a few hours but sometimes also may recur in similar duration and intensity if only supportive treatment is given (controlling body temperature was achieved by a multi-hour ice bath on the difficult ocassion which I entirely believe saved my friends life. It seems MXE can be used safely and the negative effects aborted by cyproheptadine if they occur. I strongly recommend discontinuing use of everything for at least a week or so and following an MAOI compliant diet for at least a couple days to be cautious and avoid recurring symptoms.

Please share this information with anyone you know who partakes in MXE. I would not wish these symptoms upon my worst enemy. Knowledge is power, and this information may save someones life.

An additional thought.. Entirely speculation here; but, perhaps the ill effects are related to the strong and rapid anti-depressent effects/action currently being researched in Ketamine to grasp a better understanding of the method/mode of action.. which MXE seems to share in common according to numerous reports. Perhaps its related to that ketone substitution on the cyclohexal ring (SSRI downstream?) and a paramethoxy type substitution is the wrong way to go on that benzene ring making this longer acting ethyl analog all the more dangerous... I just know I too wholeheartedly agree with those who believe whatever is occuring is also very dangerous and seemingly unique to the pharmacology of Methoxetamine.
 
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bolt151

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this thread is interesting I had a similar reaction to mxe, high temp, high heart rate, lasting about 10 - 20 mins . although I had taken a much higher dose (1 gram EXTREMELY STUPID). also I've ruled out panic attack as it happened quite a while after ingestion and I was not overly high (built up stupidly high tolerance)
 

romiir

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this thread is interesting I had a similar reaction to mxe, high temp, high heart rate, lasting about 10 - 20 mins . although I had taken a much higher dose (1 gram EXTREMELY STUPID). also I've ruled out panic attack as it happened quite a while after ingestion and I was not overly high (built up stupidly high tolerance)

I at first thought it was a panic attack in hindsight too. But the high temp experiences seem more like mild SS. It annoys me that SS has been over used as of late and now many mods and users alike are making anti-harm reduction posts here on BL and elsewhere that aren't helping others believe/understand the dangers and caution urged by those who had these symptoms and/or diagnosis by a physician first hand. I don't think the murky and poorly understood situation is going to be better understood anytime soon unless the current Ketamine research happens to shed light on a novel method of action which these drugs may or may not have in common. Perhaps MXE is doing the same thing as K but is more effective with the paramethoxy substitution... My friend believes the anti-depressant effects of Methoxetamine are far stronger then Ketamine's anecdotally. My friend also believes that use of this stuff is ok (responsible dosing far apart combined with abstinence of other compounds that act on the dopamine/serotonin systems), but abuse and certain combinations are gambling with ones life.

In addition to the issues in this thread there seem to be kidney issues/pain among other things for some abusers with this class of compounds, and then if you consider Olney's lesions, etc. It screams BAD DRUG for long term/frequent use. If you need an anti-depressant and you need this stuff more then weekly or you experience these symptoms with bi-weekly or less frequent use, you need to heavily consider using something different, and probally should get a check up with a physician.

I hope we are able to get some answers backed by hard science facts soon... Though we may never, especially considering the grey market nature of this stuff.
 
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whoseanb

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I've smoked pure JWH while on MXE many times now, and haven't had many problems. But my JWH tolerance is pretty high, I rarely get panicky, and I have my dose down well.
It's frightening to hear all of these experiences though. I was thinking of trying a balls-to-the-wall dose of MXE to try to hit a hole, but now I think I'll just stick to what I'm used to.[/QUOTE

Yeah, I think I'm going to pass on this idea also..
 

romiir

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Guys, while this is not a definitive answer, I believe I may have figured out some hard science which points toward my hypothesis being correct!!!

Check this out..

Neuropharmacology. 1982 Feb;21(2):113-8.
Ketamine inhibits serotonin uptake in vivo.
Martin LL, Bouchal RL, Smith DJ.
Abstract

Anesthetic (120 and 160 mg/kg. i.p.) and subanesthetic (80 mg/kg) doses of ketamine HCl were found to prevent completely the depletion of whole brain serotonin (5-HT) by p-chloramphetamine (PCA). Furthermore, ketamine HCl (160 mg/kg) completely blocked the depletion of 5-HT by PCA in every individual brain region studied (Midbrain-thalamus, hypothalamus, striatum, hippocampus and cortex). Administration of ketamine alone had no effect on brain 5-HT levels. Nialamide (a monoamine oxidase (MAO) inhibitor) and fluoxetine (a selective 5-HT uptake inhibitor) also prevented the depletion of 5-HT by PCA. However, of these three agents, only nialamide prevented the depletion of 5-HT by reserpine. These results suggest that ketamine blocks PCA-induced 5-HT depletion by inhibiting 5-HT uptake and not by inhibiting MAO. Ketamine only weakly affected either [3H]5-HT or [3H]spiroperidol binding to 5-HT1 and 5-HT2 receptors respectively even at concentrations as high as 1 mM. These data support the contention that the primary direct effect of ketamine on serotonergic systems is the blockade of 5-HT uptake and that blockade of 5-HT uptake may mediate some of the behavioral effects of ketamine, such as analgesia.

Source: http://www.ncbi.nlm.nih.gov/pubmed/6460944

In a recent experiment my friend has discovered that cyproheptadine (less so), benzos, and methoxetamine (low dose) are all effective treatments for the effects described in this thread. My friend is unfortunately having another bout with the recurring symptoms after a few days of MXE abuse again and further experiments will be performed on an as-needed basis to control the symptoms, hopefully outside of the ER this time. Tapering off may be a valid option here!!! Further research is required, but if you have nothing else on hand, perhaps trying 5-25mg of MXE or Ketamine (depending on previous dosing and tolerance, using the SMALLEST EFFECTIVE AMOUNT) could also abort the attack while you give your body time to metabolize the deadly para-methoxy crap that MXE is making down the line in binge/repeated/frequent use (theory only).

I have a feeling in the next few days my friend may have more anecdotal answers for you folks (due to these symptoms again precipitated by MXE use over a few days earlier in the week building tolerance without anything else besides some 2C-P). However, he is no longer going to even considering using MXE more then bi-weekly at this point (other then to treat these attacks), this shit is too scary and he values his life. This most definitely is what happened to that person who did MDAI + MXE. If it looks like a duck, walks like a duck, and sounds like a duck, ITS A DUCK!!!

Methoxetamine or MXE HAS THE ABILITY TO CAUSE SOMETHING THAT SEEMS TO 100% MATCH THE DESCRIPTION OF SEROTONIN SYNDROME IN MAN, the symptoms may occur over 24 hours after previous use and may be recurring depending on diet and other factors! This is VERY BAD and I would not wish it upon my worst enemy! PLEASE DO NOT ABUSE THIS STUFF!!! YOU COULD DIE!!!

Be safe, and good luck to all of you!

I wanted to add some additional harm reduction information here...

Sorry to double post, but the mods haven't approved my previous post yet and I am new here (after lurking for years), feel free to merge these...

It seems according to my recent research that Ketamine may also be an effective treatment (without worry of causing further rebound possibly?), but this is untested. I have not ever heard of symptoms like these from Ketamine withdrawal, but that doesn't mean it isn't possible...

All speculation here, but this could simply be another withdraw mechanism where the drug it self protects you from its toxic metabolites, but the metabolites are longer lived in man then the drug.

Here is some really good information about treating SS written by someone else who seems to be well informed with references which seem very relevant to the symptoms experienced here..

I urge and caution that quick treatment can easily save your life from this possibly fatal situation. No matter what the medical bills come to, you can't put a price on your life. But I also will say that I believe it is very possible to treat these symptoms without professional help if you are equipped to do so as described below and in my previous post.

I think it's quite ironic that the poison is also the cure in this case... But then again, isn't that the definition of withdrawals?

Serotonin Syndrome and SSRI Overdose

Posted by Patrick Lickiss on Jun 11, 2010 in Assessment, Research, Treatment | 0 comments

INTRODUCTION
Selective serotonin reuptake inhibitors (SSRIs) are a common class of anti depressant prescribed in the United States and most of the first world. With the prevalence of SSRI use increasing, so too has the risk for interaction with other prescribed medications (1). One of the most dangerous, and rare, interactions is a condition referred to as “serotonin syndrome” or “serotonin toxicity”. Serotonin syndrome refers to the symptoms associated with an increase in the presence of the neurotransmitter 5-hydroxytryptamine (5-HT) (2).

SEROTONIN SYNDROME
Serotonin syndrome generally presents within hour to days of an initial dose of an SSRI, an increase in dose or an intentional overdose. Intentional overdoses causing serotonin syndrome can result from a single medication but are generally limited to poly-pharmacy overdoses. Serotonin syndrome itself results from increased serotonergic neurotransmission (2).

SSRIs work by decreasing the pre-synaptic uptake of serotonin, a neurotransmitter involved in the regulation of aggression, pain, sleep, depression and anxiety (3). Serotonin syndrome most often occurs as a result of mixing an SSRI with another form of anti-depressant, often a monoamine oxidase inhibitor (MAOI). MAOIs work by decreasing the action of the enzyme responsible for breaking down synaptic serotonin (3). As one may guess, the combination of these two medications would result in an unchecked flood of serotonin into the brain.

As mentioned above, serotonin syndrome is a collection of symptoms resulting from an increase in serotonin and occurs in approximately 16% of intentional overdose cases involving an SSRI (3). Symptoms noted fall into one of three categories: alteration of mental status, neuromuscular hyperactivity and autonomic instability (4). Altered mental status can range from confusion to coma and can include agitation, anxiety, delirium, hallucinations and drowsiness. Neuromuscular hyperactivity includes myoclonus (irregular involuntary contraction of a muscle (5)), hyper-reflexia (overactivity of physiological reflexes (5)), muscle rigidity, shivering and tremors. Lastly, and potentially most serious, autonomic instability can present as hyperthermia, diaphoresis, sinus tachycardia, hypertension/hypotension, flushing of the skin, diarrhea and vomiting. Indications of a life-threatening presentation include coma, seizures, rhabdomyolysis and disseminated intravascular coagulation.

DIFFERENTIAL DIAGNOSIS
The two most common differential diagnoses for serotonin syndrome are neuroleptic malignant syndrome (NMS) and malignant hyperthermia (6). NMS results from ingestion of dopamenergic drugs and symptoms develop over a period of days rather than hours (7). Given this limited pool of drugs from which to draw, a good history and assessment on scene, as well as determining the times of ingestion and onset of symptoms will effectively rule out NMS. Malignant hyperthermia, a potentially life-threatening reaction to anesthetic gasses and certain paralytics used in rapid-sequence induction, can be easily ruled out by responders assuming that none of these medications has been given (8).

Diagnostic diagram for Serotonin Syndrome based on Hunter Toxicity Criteria (3)

TREATMENT
In an emergency room setting, serotonin syndrome is treated by discontinuing the medication(s) in question and by providing supportive care to the patient (2). In the pre-hospital setting, the care is the same.

In order to discontinue the ingestion of medication, activated charcoal is considered indicated if given within 60 minutes of ingestion (1). Supportive care consists of administration of intravenous fluids to combat dehydration from hyperthermia, benzodiazepines to control tremors and delirium, cooling measures to manage hyperthermia, and intubation and respiratory management as appropriate (9).

TAKE HOME LESSONS FOR EMS
In the pre-hospital setting, the key to care for patients with serotonin syndrome is early recognition. A thorough history and physical examination will offer a patient the best opportunity to receive timely treatment. By being aware of the symptoms of serotonin syndrome and knowing the possible causes, pre-hospital practitioners can begin appropriate care as soon as possible.

Similarly to in-hospital care, treatment for serotonin syndrome is largely supportive. Airway management and ventilatory support including OPA/NPA, intubation, use of a rescue airway (such as a King LTD), administration of supplemental oxygen and positive pressure ventilation may all be utilized as appropriate. Fluid resuscitation can help to combat dehydration and active cooling measures can help to manage hyperthermia. Methods of active cooling can include, but are not limited to ice packs in the groin, axillae and behind the neck, moistening the patient’s skin with sterile water or saline and turning the air conditioner on in the back of the ambulance. Care must be taken to reduce shivering which will increase core temperature. Finally, the patient should be rapidly transported to the appropriate receiving facility.

CONCLUSION
Serotonin syndrome is the collection of symptoms resulting from an intrasynaptic increase of the neurotransmitter 5-HT. This increase generally results from a combination of drugs but can rarely be the result of a single overdose. Symptoms of serotonin syndrome include alteration of mental status, neuromuscular hyperactivity and autonomic instability. Serotonin syndrome can range from mild to life-threatening in severity. Care for patients suffering from serotonin syndrome is largely supportive. Presence of serotonin syndrome is determined by a thorough history and physical examination and, due to its potential severity, should be considered in the differential diagnosis of patients who are prescribed psychiatric medications.

NOTE: The opinions expressed here are those of the author alone and do not represent the views of any company or organization. Use common sense and check with your local accrediting agency before making treatment decisions based on anything written here. This article is not a substitute for protocols or policy and procedure manuals.

CITED ARTICLES:
1. Isbister GK, Buckley NA, Whyte IM. “Serotonin toxicity: a practical approach to diagnosis and treatment.” MJA. 2007 Sep;187(6):361-5.
2. Evans CE, Sebastian J. “Serotonin Syndrome.” Emerg Med J. 2007;24:e20
3. Dunkley EJC, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. “The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity.” Q J Med. 2003;96:635-42.
4. Mills KC. “Serotonin Syndrome: a clinical update.” Crit Care Clin. 1997;13:763-83.
5. http://www.merriam-webster.com
6. Boyer EW, Shannon M. “The serotonin syndrome.” N Engl J Med. 2005;352:1112-1120.
7. Gupta S, Nihalani ND. “Neuroleptic malignant syndrome: a primary care perspective.” Prim Care Companion J Clin Psychiatry. 2004;6:191-194.
8. Litman RS, Rosenberg H. “Malignant hyperthermia: update on susceptibility testing.” JAMA. 2005;293:2918-2924.
9. Canan F, Korkmaz U, Kocer E, Onder E, Yildirim S, Ataoglu A. “Serotonin Syndrome with Paroxetine Overdose: A Case Report.” Prim Care Companion J Clin Psychiatry. 2008;10(2):165-7.

Source: http://510medic.com/2010/06/11/serotonin-syndrome-and-ssri-overdose/

--------------------------------------
EDIT 3: I NOW RECOMMEND AGAINST FOLLOWING THE ADVICE BELOW IN QUOTES, I EXPLAIN WHY BELOW THIS QUOTE OF TEXT FROM THIS ORIGINAL POST:

Also I can now confirm 100% that Methoxetamine is 100% effective in treating the symptoms in my friends case (without benzos or cyproheptadine). Time will tell if these low doses can be used safely to recover without using cyproheptadine and/or ER services this time. But I strongly suspect the small doses titrated downward will be successful in treating the condition from the currently available data.

[SCRATCH THIS, here is some text from one of my later posts in this thread about the text in this post I edited into quotes to prevent misinforming people:

Also I'd like to note that I retract my previous statement (going to edit it after I post this post) that MXE tapering is effective/safe. While it does seem somewhat effective, once the runaway condition starts, it really just doesn't control it fast enough like Peractin (cyproheptadine) does, and ultimately it is just adding onto the negative effects in the long run. (though it does seem that if one was very careful they could taper down with MXE, but my friend is unwilling to risk their life further to do so and is going to continue treatment with Peractin as needed which is able to stall the SS symptoms off immediately and much longer then a small dose of MXE which ultimately metabolizes to/causes something making it worse if too much is taken, and you will die of SS if not enough is taken....)

END OF NEW POST EDITED INTO THIS ONE]
--------------------------------------

It seems about 6 hours between micro-doses is about right for the treatment to prevent symptoms completely (they seem to get off the chart at around the 7 hour mark), and so far tapering down seems to be effective. Drinking plenty of fluids helps prevent and diminish the kidney pain sometimes experienced too my friend reports. I will post more information after my friend and I figure this out. Also going to experiment with eating some protein (tapering up slowly to judge physical effects) and seeing if this makes symptoms worse or not while on this tapering down of MXE program. I strongly suspect that it will not effect it. The initial attack in my friend that resulted in an ER visit some months ago was able to be triggered due to protein/cheese because of a lack of serotonin availability after Methylone use is the best current hypothesis.

According to my friend: In the serve cases, the attacks come on rather quickly and over the course of a few minutes heart rate and other symptoms can go from baseline to crazy, a metered nasal dosage spray system for MXE is now being developed for my friend to carry with him to manage the attacks while tapering down to none.

If all goes well I will followup in this thread with the results.

I also wanted to add my friend has noticed that low dose MXE is an excellent sleep aid, and it seems that about 6 or 8 hours later he would wake up feeling energetic, well rested, and refreshed (that long lasting anti-depressant effect seems to awaken him at that point), I am guessing that this is related to all of the above, but when amplified 10x or so it can be VERY BAD, along the lines of serotonin syndrome bad.

Though it also means if you find yourself in this difficult situation you could take some MXE and get a good nights sleep without fear of dieing!! =D

That's all for now...

Be safe,
-Romiir
 
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eLeSaH

Bluelighter
Joined
Dec 30, 2010
Messages
140
MXE is the money maker in the scene. There are many impure batches floating around as I heard. The more ppl touch a batch the more is the risk of it becoming impure, due to synth rests or cut. Maybe you have a bad batch(?)
 

romiir

Greenlighter
Joined
Sep 25, 2011
Messages
20
MXE is the money maker in the scene. There are many impure batches floating around as I heard. The more ppl touch a batch the more is the risk of it becoming impure, due to synth rests or cut. Maybe you have a bad batch(?)

Or maybe, MXE DEFINITELY CAUSES SEROTONIN SYNDROME WHEN OVERUSED. If you don't believe me and my friends medical bills, and the ER doctor who diagnosed SS after doing a full lab workup, then fine, go kill yourself since we can't stop you... But seriously, please don't be stupid. Anyone else, flush this stuff, seriously. Or use bi-weekly at most!!! The long lasting anti-depressant effect that trails drugs like Ketamine and Methoxetamine seems to be particularly long lived after Methoxetamine use and users may develop a DEADLY CASE OF SEROTONIN SYNDROME UP TO 72 HOURS AFTER LAST USE.

Is it really worth risking your life over this?!! @eLeSaH Your comment seems to be the exact kind of opinion that has caused the current worldwide stigma associated with most drug use and has pushed this industry into the grey market and total illegalization of these things rather then one of education and harm reduction!!! Does anyone else want to end up like the swede who combined MDAI and MXE and DIED from this combination?! IT IS SERIOUSLY NOT WORTH IT!!!

To elaborate further, my friend has had negative experiences from multiple batches which appear as a clean white powder with a very sharp melting point (it all melts within a couple degrees). I sincerely believe Methoxetamine is a bad drug to abuse, period. Very moderate responsible use can be safe, but binge use and/or combination with MDxx or other compounds that effect serotonin is a definite NO NO!!! (Unless you are trying to kill yourself in one of the only ways worse then dieing in a fire... It is like your body is burning out and overloading from the inside in a runaway cascade!)

If you are wondering about this, try this simple experiment. Take a rather high dose of MXE, a SINGLE DOSE, and see how your pulse the next morning compares to your baseline. The reason it is elevated is due to higher serotonin levels which are causing the anti-depressant effect after taking this compound. How it is happening we do not know, since there have been no studies on MXE. But once again I will mention that there is ongoing research right now to try to figure out the mode of action of the anti-depressant effects of Ketamine which is causing this same result, but perhaps in a less dangerous and/or less potent way... I can't say why no one has noticed this issue with K, all I can say is that several individuals have had this issue with MXE, and it put a close friend of mine in the hospital fearing for his life after being in an ICE WATER BATH FOR A FEW HOURS BEFORE CALLING THE PROFESSIONALS.

MXE induced SS is treatable like all SS, but it also has the potential to be DEADLY if you get carried away with your Methoxetamine use from a couple/few days ago and do not have the proper treatment available IMMEDIATELY.

I can't speculate on how long someone has to seek treatment when these symptoms start to occur, but I would bet everything my friend and I own that in less then an hour or two, untreated, a person could easily die.

THIS IS SERIOUSLY BAD.

-----

An update:
My friends current ongoing condition (second recurring attack this time) was treated with about ~10 mg of MXE, which brought the SS back under control for just under 4 hours (lets say 3, and prior report above from about 7 hours earlier was successfully treated with ~25mg MXE + 6 mg Peractin (cyclobenzaprine), after which another [third attack at T+14h from initial attack] (this time metered nasal rather then sub-lingual) administration of MXE to the tune of 15mg seemed to stall things, but was ultimately ineffective and we had to go back onto treatment with Peractin (Cyclobenzaprine) 4 mg this time, which has brought the symptoms back down close to baseline (his heartrate is about 8 bpm over baseline, actually as I was editing this post, the Peractin has brought it down to 4 bpm over baseline). We will try one further experiment with the MXE (10 mg metered nasal this time, in advance of symptoms around the 3 hour mark from last Peractin dose) to see if tapering is possible, but at this point it seems it may not be effective, but it could just be the lag time on the MXE where as the sub-lingual and potent Peractin takes a hold of the situation almost instantly.

This is not something to fuck around with, if we didn't have a serotonin antagonist on hand, my friend would be in the ER again with another DR who may or may not be able to understand what is going on.

DON'T GAMBLE WITH YOUR LIFE PEOPLE! OK? THANKS!

Be safe,
-romiir

Also I wanted to mention that Cannabis, and probably most synthetics too have been experimentally confirmed in numerous whitepapers to play with the Serotonin system. Low doses cause the release of more Serotonin, while high doses cause the effect to reverse and then a lower then baseline amount of serotonin is found in the brain tissue of laboratory animals...

The following study explains why there are mixed opinions and experiences when combining MXE with cannabinoids, ranging from a "panic attack" (mild SS) to pleasant to enjoyable. The experience is probably very dose dependent.

It has been known for many years that depletion of the neurotransmitter serotonin in the brain leads to depression, so SSRI-class anti-depressants like Prozac and Celexa work by enhancing the available concentration of serotonin in the brain. However, this study offers the first evidence that cannabis can also increase serotonin, at least at lower doses.

Laboratory animals were injected with the synthetic cannabinoid WIN55,212-2 and then tested with the Forced Swim test -- a test to measure "depression" in animals; the researchers observed an antidepressant effect of cannabinoids paralleled by an increased activity in the neurons that produce serotonin. However, increasing the cannabinoid dose beyond a set point completely undid the benefits, said Dr. Gabriella Gobbi of McGill University.

"Low doses had a potent anti-depressant effect, but when we increased the dose, the serotonin in the rats' brains actually dropped below the level of those in the control group. So we actually demonstrated a double effect: At low doses it increases serotonin, but at higher doses the effect is devastating, completely reversed."

Read more about cannabis and cannabinoids effects on serotonin here:

(my quotes are from here) http://www.sciencedaily.com/releases/2007/10/071023183937.htm

(and bluelight discussion here) http://www.bluelight.ru/vb/threads/451611-Cannabis-and-Serotonin
 
Last edited:

eLeSaH

Bluelighter
Joined
Dec 30, 2010
Messages
140
"@eLeSaH Your comment seems to be the exact kind of opinion that has caused the current worldwide stigma associated with most drug use and has pushed this industry into the grey market and total illegalization of these things rather then one of education and harm reduction!!! "

My comment:
"MXE is the money maker in the scene. There are many impure batches floating around as I heard. The more ppl touch a batch the more is the risk of it becoming impure, due to synth rests or cut. Maybe you have a bad batch(?) "

So because I say that there are impure batches with unknown amounts of unkown chemicals, drugs became illegal? Also why all the shouting with caps and all the !!! ? Does that make you look professional in any way or what?
Did I say somewhere that it was NOT a SS?

"MXE DEFINITELY CAUSES SEROTONIN SYNDROME WHEN OVERUSED. " "combination with MDxx or other compounds that effect serotonin is a definite NO NO!!!"
- Everything can be poisonous when overdone. If you are dead, you are dead. Just look around if people combined Serotonergics and MXE together in the Big MXE topics and ask them if the effect felt dangerous. Maybe they say the same as you and you could research together.

"which appear as a clean white powder"
- Do you really think clean white powder means it is pure? I don't think so.

Also:
"DEADLY CASE OF SEROTONIN SYNDROME UP TO 72 HOURS AFTER LAST USE."
"Take a rather high dose of MXE, a SINGLE DOSE"

From your logic you want me to kill myself? Why?

And No i've never done MXE because I see how people binge it. They binge it because it's good maybe but I'm fine with my situation and don't need too much chemical fun.

"The experience is probably very dose dependent."
Why probably? It is always dose dependent. Even the same dosage can create different subjective effects so on different dosages it should be clear that the effect differs.

I hope your friend gets better. Good luck and take care.
 
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