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NeuroDoc1, Doctor
Category: Mental Health
Satisfied Customers: 211
Experience:  Board Certification by American Board of Psychiatry and Neurology
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I am due to start taking an MAOI for depression in about a

Customer Question

I am due to start taking an MAOI for depression in about a weeks time however about a week ago I stupidly took some MDMA and cocaine (something which I will not be repeating). I have recently read that when changing from an SSRI to an MAOI you need to wait at least 5 weeks eg in the case of prozac before taking an MAOI to reduce the risk of a hyperpyrexic crisis or serotonin syndrome and that you should definitely not take mdma or cocaine whilst on an MAOI. My question is bearing in mind that I took these drugs only a week ago and that they could have potentially been cut with other unknown substances do you think it will be safe for me to start taking an MAOI in a weeks time, only 14 days after I took the cocaine and mdma. I am worried that these drugs may still be in my system and that I may be at risk from serotonin syndrome. Could you also tell me how long these drugs are detectable in the blood and urine?
Submitted: 8 years ago.
Category: Mental Health
Expert:  Carol Kryder LMFT replied 8 years ago.
Hello Lewis, and thanks for using

You need to talk to your doctor immediately about this -- just come clean and be honest. The negative effects of mixing those substances with an MAOI inhibitor is nothing to fool with. Please put your embarrassment aside and talk candidly with your doctor. I am sure s/he can come up with a schedule for safe transition to the new drug.

As for how long cocaine is detectable, most of the time it is gone in three days. As for MDMA it appears from this link it is 2-3 days.

Finally, you say that you will not being doing these drugs again, but are you really sure? Combining those drugs with an MAOI inhibitor could be life-threatening. Again, I urge you to be honest with your doctor. Your life could depend on it.

Good luck.
Customer: replied 8 years ago.
I really don't want to ask my doctor that is why I am using this site. Are there no medical doctors who can respond to my question on this site? There must be someone apart from my own doctor who can answer this question?
Expert:  Carol Kryder LMFT replied 8 years ago.
I have opted out of answering this question and will refer it to the doctors. Good luck.
Customer: replied 8 years ago.

Thanks for your help. I'm not sure where to go from here? Asking my Doctor isn't an option that I am willing to take and that is why I am using this site. Since I have read that there are highly qualafied doctors who can answer medical questions on this site will it now be possible to get an answer from one of them? Since my question wasn't really answered will I have to pay again and how can I make sure that a medical doctor will respond to my question? Thanks again for your help.

Customer: replied 8 years ago.
Is it possible for you to refer me to a medical doctor or psychiatrist who would be able to answer my question? As you have stated my life could depend on it and I don't feel able to talk to my own doctor about this. I would be very grateful if you could advise me on how to go about finding someone who could answer my question.
Expert:  Carol Kryder LMFT replied 8 years ago.
You will not need to pay again, since I have opted out. We will wait for a medical doctor from this site to answer your question.
Customer: replied 8 years ago.
I'm not exactly sure how this site works as I have never used it before. Are you able to refer me on to someone else who will be able to answer my question or do I need to start again from the beginning and find a medical doctor on this site myself who can answer this question. I'm not sure what I am to do next. Should I do nothing and just wait for a reply or do I need to actively seek out someone else who can answer my question. I have been waiting quite a long time now and am not sure what to do? I think this is a good site and I am sure there must be someone on here with the medical expertise who will be able to help. Thanks again for keeping me informed.
Expert:  Carol Kryder LMFT replied 8 years ago.
You should stick with this question, because if you start another one you will be expected to pay again. I will contact some of the doctors and see if they can answer your question.
Expert:  NeuroDoc1 replied 8 years ago.


I believe that Carol Kryder's information to you above was very accurate, but she has asked me to take a look at your question and answer it. I am certified by the American Board of Psychiatry and Neurology.

Both cocaine and MDMA will be essentially cleared out from your system within 3-4 days, assuming you have normal liver function and kidney function. SSRI medications have a much longer "washout period" than these two drugs, which is why there is a 4-5 week wait recommended when transitioning between SSRI and MAOI medications.

If it will be 14 days after you took the cocaine and MDMA before you start the MAOI medication, I do not think you need to be concerned about the risk of an adverse reaction such as serotonin syndrome or hyperpyrexia. However, your concerns about these potentially fatal interactions are valid if you were ever to use cocaine, MDMA or other stimulant drugs such as amphetamine/methamphetamine while you are on an MAOI.

Best wishes.

NeuroDoc1, Doctor
Category: Mental Health
Satisfied Customers: 211
Experience: Board Certification by American Board of Psychiatry and Neurology
NeuroDoc1 and other Mental Health Specialists are ready to help you
Customer: replied 8 years ago.
Thank you NeuroDoc1 for such a great reply. I tried to find this information out for myself on the Internet but couldn't. The only other drug I have ever tried is cannabis and that was a long time ago. This was the first time I had ever tried class A drugs and I regret doing so. I had been feeling so depressed and just wanted to take something to make me feel better but it didn't work and I won't be doing it again. I have tried a lot of medications but none of them have worked hopefully an MAOI will help me.
Thanks for all your help Carol. I tend to be a bit skeptical about sites such as these but your help has been nothing short of amazing and considering the seriousness of my question I am very grateful for all your kind help. For obvious reasons I would appreciate it if this information and my details were kept private and not made public or passed on to anyone else. Thanks again!
Expert:  Carol Kryder LMFT replied 8 years ago.
It was a pleasure. Your confidentiality is assured.