Custom Search

[N,N-ShamaN]

Since this forum contains information on entheogens, I wanted to make a topic about Serotonin Syndrome. I decided to post it here because the Aya forum is where people talk most about MAOI's, such as Syrian Rue and Banisteriopsis Caapi. Serotonin Syndrome is a reaction caused from mixing certain drugs with MAOIs or caused by taking too much of one drug. From my understanding, if you take too much of one drug, it releases too much serotonin into your brain. The real issue here though is to inform people of the dangers of MAOIs. Here is a list of the symptoms of Serotonin Syndrome:

Cognitive Effects: mental confusion, hypomania, hallucinations, agitation, headache, coma

Autonomic Effects: shivering, sweating, hyperthermia, hypertension, tachycardia, nausea, diarrhea

Somatic Effects: myoclonus (muscle twitching), hyperreflexia (manifested by clonus), tremor.

As research shows, there are 3 severeties of Serotonin Syndrome. I have Broken them down here as Mild, Moderate, and Severe, each with there own list of symptoms.

Mild Symptoms May Include: Increased Heart Rate
                                      Shivering
                                      Sweating
                                      Dialated Pupils
                                      Involuntary Muscle Twitching
                                      Overresponsive Reflexes
                                      Headache

Moderate Symptoms: Hyperactive Bowel Sounds
                             High Blood Pressure
                             Hyperthermia (Tempurature of 104 °F)
                             Clonus Throughout the Body, More so in the Lower Limbs (Series of involuntary muscle spasms)
                             Hypervigilance & Agitation

Severe Symptoms: Severe Increase in Heart Rate and Blood Pressure (This may lead to Shock)
                          Tempurature May Rise to 106 °F (Or above in Life Threatening Cases)
                          Metabolic acidosis (Can lead to Coma and Death
                          Rhabdomyolysis (Rapid Breakdown of Skeletal Muscle)
                          Seizures
                          Renal Failure (Kidney Failure)
                          Disseminated Intravascular Coagulation (Blood Clots form Throughout the Body)
                             

Now, Syrian Rue and Caapi are reversable MAOIs, which means they are very short acting. I'm not sure about Caapi, but Syrian Rue only stays in the gut for about 6 hours. Two other plant forms of MAOIs include Passionflower and Yohimbe. Other, irr-reversible MAOIs include are Nardil and Parnate. Withe the irriversables, you shouldn't take anything that can compromise your health, be it food, SSRIs, or certain drugs, for two weeks before or after the MAOI. Moclobemide is said to be reversible, but I am unsure of this and caution should be taken anyways. While taking any MAOI, the following drugs should be avoided:

All SSRIs (prozac, zoloft, and several other anti-depressants)
Demerol
Cold preparations (tablets, capsules, or liquids such as Comtrex)
Cough medications containing decongestants, Dextromethorphan (DXM)1, or Demerol
Sinus medications
Nose drops or nasal sprays
Nasal decongestants
Hay fever medications
Diet pills
Amphetamines --- speed
MDMA --- Ecstasy
MDE, MDA, and other "MD" compounds
Cocaine --- crack

While taking a reversible MAOI, such as Syrian Rue and Caapi, it is OK to eat these foods. These MAOIs do not block your body from breaking down tryamine. Ott talks about it in his Tihkal entry on Syrian Rue. If you are taking a irreversable MAOI, the following food should  be avoided:

Alcoholic beverages
Avoid Chianti wine and vermouth.
Consumption of red, white, and port wine in quantities less than 120 mL present little risk (Anon, 1989; Da Prada et al, 1988; McCabe, 1986).
Beer and ale should also be avoided (McCabe, 1986), however other investigators feel major domestic (US) brands of beer is safe in small quantities (½ cup or less than 120 mL) (Anon, 1989; Da Prada, 1988), but imported beer should not be consumed unless a specific brand is known to be safe.
Whiskey and liqueurs such as Drambuie and Chartreuse have caused reactions.
Nonalcoholic beverages (alcohol-free beer and wines) may contain tyramine and should be avoided (Anon, 1989; Stockley, 1993).


Banana peels
A single case report implicates a banana as the causative agent, which involved the consumption of whole stewed green banana, including the peel. Ripe banana pulp contains 7 µg/gram of tyramine compared to a peel which contains 65 µg/gram and 700 µg of tyramine and dopamine, respectively (McCabe, 1986).


Bean curd
Fermented bean curd, fermented soya bean, soya bean pastes contain a significant amount of tyramine (Anon, 1989).


Broad (fava) bean pods
These beans contain dopa, not tyramine, which is metabolized to dopamine and may cause a pressor reaction and therefore should not be eaten particularly if overripe (McCabe, 1986; Anon, 1989; Brown & Bryant, 1988).


Cheese
Tyramine content cannot be predicted based on appearance, flavor, or variety and therefore should be avoided.
Cream cheese and cottage cheese have no detectable level of tyramine (McCabe, 1986; Anon, 1989, Brown & Bryant, 1988).


Fish
Fresh fish (Anon, 1989; McCabe, 1986) and vacuum-packed pickled fish or caviar contain only small amounts of tyramine and are safe if consumed promptly or refrigerated for short periods; longer storage may be dangerous (Anon, 1989).
Smoked, fermented, pickled (Herring) and otherwise aged fish, meat, or any spoiled food may contain high levels of tyramine and should be avoided (Anon, 1989; Brown & Bryant, 1988).


Ginseng
Some preparations have resulted in a headache, tremulousness, and manic-like symptoms (Anon, 1989).


Protein extracts
Three brands of meat extract contained 95, 206, and 304 µg/gram of tyramine and therefore meat extracts should be avoided (McCabe, 1986).
Avoid liquid and powdered protein dietary supplements (Anon, 1989).


Meat
nonfresh or liver
no detectable levels identified in fresh chicken livers
high tyramine content found in spoiled or unfresh livers (McCabe, 1986).
Fresh meat is safe, caution suggested in restaurants (Anon, 1989; Da Prada et al, 1988).
Sausage, bologna, pepperoni and salami contain large amounts of tyramine (Anon, 1989; Da Prada et al, 1988; McCabe, 1986).
No detectable tyramine levels were identified in country cured ham (McCabe, 1986).


Sauerkraut
Tyramine content has varied from 20 to 95 µg/gram and should be avoided (McCabe, 1986).


Shrimp paste
Contain a large amount of tyramine (Anon, 1989).

Soups
Should be avoided as protein extracts may be present; miso soup is prepared from fermented bean curd and contain tyramine in large amounts and should not be consumed (Anon, 1989).

Yeast
Brewer's or extracts - yeast extracts (Marmite) which are spread on bread or mixed with water,
Brewer's yeast, or Yeast vitamin supplements should not be consumed.
Yeast used in baking is safe (Anon, 1989; Da Prada et al, 1988; McCabe, 1986).


Please take the time to inform yourself about Serotonin Syndrome! It is very important, especially if you decide to igest an MAOI. I give much credit to Erowid and Wikipedia for my information, and the links to the info are posted below. Stay safe everyone!

If the mods read this, could you please sticky it? This is a very important topic and everyone should read it.

http://www.erowid.org/chemicals/maois/maois.shtml
http://en.wikipedia.org/wiki/Serotonin_syndrome

[spacehippy]

Thanks for the post!
By reading this, I'm guessing it's ok if I last took a small amount of an SSRi (Kanna) 2 days before syrian rue ?
Thanks,
S.H.

[N,N-ShamaN]

Yes, you should be OK, but be careful! I've experienced Serotonin Syndrome before and it is no joke.

[Carvelo89]

so its not wise to eat bean curd while making ayahuasca with jurema? i tend to eat a semi-vegetarian diet. i try not to eat meats as often etc. i read also to avoid grape fruit? is that right? hm.

im more worried about my friends health more than my own...is this just a minor risk one is taking? ill deff inform him about this so he can diet properly

[quantum]

It really doesn't take much effort to avoid serotonin syndrome. Just keep your head about you and use a little care with your medicines and food intake. Basically your only worrying about what you have eaten in the past 24 hours. Harmaline type alkaloids are short acting maoi's,so by the time the effects wear off the maoi effects are subsided. I have used ayahuasca and harmaline allot and have never had any problems. The concerns are real but ayahuasca has been used safely for thousands of years.

[N,N-ShamaN]

No, your right, it doesn't take that much effort. I'm just going off of my own experience though, because I used to be stubborn and hard headed. I payed for it with SS lol. When I was 16 I had taken Ayahuasca one night, and the next day I used DXM. It was mild, but the fact of the matter is I didn't heed to the warnings, and I also didn't know. I didn't research it or look it up, so hopefully if there are people on this board that are like me they read it. I also agree with you in the fact that Ayahuasca has been used safely for thousands of years, so I just wanted to point out the dangers of it. Everyone could use a little refreshment

[quantum]

I agree,people should always educate themselves first no matter what they do. That point can't be stressed enough. Freedom without knowledge is just another form of enslavement.

[grandma]

Great article!
Serotonin Syndrom:  see also, www.ajp.psychiatryo nline.org/cgi/content/full/161/6/1129                             

[gkawas]

Great post,very helpful

The whole topic of the Ayahuasca diet is commonly misunderstood.

It is important to note that Harmaline and Harmine, the active compunds  in Syrian Rue and the Caapi Vine, are REVERSIBLE MAOI'S, so the level of risk is not the same as the typical MAOI'S Warnings and Information on the web,

however, there are some measures of safety to take into account before and after an Ayahuasca experience (specially when it comes to the drugs one must not take before and after drinking ayahuasca) but this has been covered in this post,

I would also like to add something barely mentioned about Dieting on Ayahuasca, and it is the liver:

an ayahuasca experience is a powerful one, and I always feel my body releasing blocked energy and toxins; I think many of you with experience with ayahuasca would agree... The problem is that we have a physical body, and as these toxins don't disappear into the magical ayahuasca realm, the liver has to do a little extra work to eliminate all that was released, and it is a bad idea to get to this point with a liver already loaded with heavy-stuff from junk food and other drugs.

My take on it is this: even if the ayahuasca diet is not necessarily as strict and risky as some people and websites make it sound, it doesn't hurt to approach a powerful healing experience with a clean body and mind

G Kawas

[grandma]

Thanks!  and welcome to the DB community!!

[erhard]

thanks for compiling all these precious info and sharing them with us

[grandma]

You are very welcome.  I love to do research.  Hey, my Parkseed order finally came and soon I will plant the yellow Datura seeds, one to each pot, and maybe by August the flowers will bloom--or at least one will; I plan on collecting the others before they bloom, scald them, dry them, and save them for a dreary winter day...