XTC and methylphenidate and dexamphetamine (English)

Hi there, I'm recently diagnosed ADHD, currently on Ritalin (Methylphenidate SR) 10mg x3 per day, but working with doctor to get right level so about to increase to 15mg 3x per day. We've also discussed moving to Dexamphetamine if we cannot get the dosage right. I like to do XTC occasionally (max 2/3 times per year). I'm very cautious with drugs and play it as safe as possible, I want to understand how I can be as safe as possible on both Ritalin and Dex if I have a party weekend planned. Also will these drugs change the effect of XTC even if come off my ADHD meds before and take a pause after before starting up again? I'm aware nothing is risk free, but I want to be as safe as possible.

XTC (MDMA) leads to an increased concentration of serotonin, noradrenaline, and dopamine in the (synapse of the) brain cells. Because dexamphetamine also affects the dopamine system, it can lead to overstimulation of the central nervous system. Consequences of this include arrhythmias, breathing problems, and dangerously high blood pressure. This is an important reason to dose much more cautiously (see here). If you have AD(H)D and maybe also anxiety or depression, the chances of things going wrong, in the form of, for example, a bad trip or longer-lasting effects on your mood, may be increased.

Taking Ritalin for a prolonged period can inhibit the enzymes that break down MDMA, resulting in stronger effects of MDMA. Therefore, you should take a lower dose than without Ritalin. Ritalin has a duration of action of 3 to 5 hours. Therefore, I would advise that if you are going to use XTC, only skip the last dose of the day. However, the effect of the Ritalin in the brain can still be present longer, so a lower dose remains safer.

Check if you have any side effects from Dexamphetamine. These can be amplified by XTC use. Commonly observed effects include decreased appetite, reduced weight gain and weight loss with long-term use, insomnia, nervousness, palpitations, and arrhythmias. Additionally, people sometimes feel very gloomy after the effect of dexamphetamine wears off. Taking XTC at that moment can suddenly increase this feeling and increase the likelihood of a bad trip. Dexamphetamine (Tentin or dexamphetamine) tablets are generally mostly out of your blood after 48 hours. Therefore, if you want to use XTC, take a 48-hour break between the last pill and the drugs.

Therefore, it may be good to take these experiences into account and observe a minimum 48-hour break after dexamphetamine. Also: always test the MDMA content, gain experience with the lowest dose of about 1 mg per kg of body weight, and if you want to take zero risks: better not to do it at all.

Kind regards,

Karin W, GP

14 februari 2025

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