PSA: The Scary Reality of 5-MeO-DMT+Harmalas

[What Am I]

So I've seen this question asked a million times in various forms: "Can 5-MeO-DMT be used with MAOIs such as harmalas to enhance and extend the experience?" The questioner would usually be met with a bunch of responses stating that it's inherently dangerous and can cause medical emergency-level reactions. Usually the answers are kept vague, but sometimes they get more detailed and specific, naming serotonin syndrome as a potential result. The one thing missing in all my research was a firsthand description from somebody who'd actually experienced these negative and dangerous effects themselves. There was always reference a few obscure recorded deaths whenever the question came up, but never anything overly convincing or verifiable, which is why the question was kept in a gray zone in my mind where it may or may not be a myth of sorts. Well I'm here to affirm the warning and give that firsthand report I wish I'd had before being crazy enough to actually try this combo.

It's not an especially long story. I've used harmalas plenty of times with DMT, and I love the enhancements and added psychedelic flavor they provide. In my ignorance, stupidity, and lack of a convincing counterexample, I decided to give it a try using 30mg sublingual caapi harmalas (harmine+THH) followed ~20 minutes later by a relatively low dose of 2mg IM 5-MeO-DMT. Within a few minutes of the injection, I started to feel a panic that kept building and building. It wasn't the type of panic we're probably all familiar with which results from something like a bad trip though. This was a physiological panic where my body was giving strong signals that something was going terribly wrong. I felt an extreme form of hypertension throughout my whole body, and especially in my chest. It's hard to put words to the sensation, but it felt like a true risk of physical death as opposed to the ego death produced by psychedelics. I was indeed not even tripping very hard, but I was giving myself decent odds that I was about to actually lose consciousness and die. Thankfully I was able to hold out and it started receding after around 30-40 minutes. It was harrowing and possibly the closest I've ever been to a life threatening emergency.

Please let my example be a lesson to anyone who's considering actually trying the combo. The dangers it poses are the real deal. If my dose of 5meo had been any higher, I may not be here to type out this warning. And maybe I'd become just another statistic that people cite when the question gets asked.

[Davino]

Lol

Happy you got through it, sometimes you can learn from the wisdom of others and sometimes you have to learn it yourself, just don't die in the process!

[OBEler]

@What Am I that must be a lifetime lesson. Congratulations for overcome it without damaging yourself.

[Leo Gura]

Combining 5-MeO with harmalas can cause internal bleeding and bruising.

It's very physically dangerous. Don't do it. This is not some online myth.

Edited April 21 by Leo Gura

[Thought Art]

“I tried the thing people told me would kill me” 

[Davino]

@Leo Gura I read you used something to expand the duration of 5meo trips. What was that? I can't find the post

[What Am I]

It might be worth mentioning that this occurred years ago when I was more naive and when there just wasn't the same level of detailed information that's available now. The current version of myself with the resources I have may have made a different decision in that scenario.

Here's a link to the type of guide I wish I'd had: https://five-meo.education/risks-and-cautions/

If you scroll down on the page, there's both a downloadable and embedded copy of the excellent document "FIVE GUIDE" written by the credentialed and knowledgeable Benjamin Malcolm. Beyond detailing the contraindications, it's an amazing resource for 5-MeO-DMT information in general.

Edited April 21 by What Am I

[What Am I]

4 hours ago, Thought Art said:

“I tried the thing people told me would kill me” 

I should have made this the thread title lol.

[What Am I]

I realized this thread, acting as a warning based on firsthand experience, could also benefit from a scientific description of the dangers.

See below for an excerpt from the FIVE GUIDE, which I linked a few posts ago.
 

5-MeO-DMT and Serotonin Toxicity

Serotonin Toxicity is best understood as a type of poisoning or adverse effect of serotonergic drugs
involving excessive intrasynaptic serotonin that results in toxic levels of signaling via the 5HT2A receptor
[29]. It is often discussed as Serotonin Syndrome which is less accurate as it’s not a group of symptoms
that define a condition and it can occur along a spectrum . Therefore, substances that increase
intrasynaptic serotonin such as monoamine oxidase inhibitors (e.g., MAOIs), serotonin reuptake
inhibitors (SRIs e.g., SSRIs, SNRIs) as well as serotonin releasing agents (SRAs e.g., MDMA) are most
implicated in the development of Serotonin Toxicity [30]. However, the underlying mechanisms of each
substance and their abilities to act additively, synergistically, or diminutively in combination require
evaluation to understand if the combination is truly high risk for Serotonin Toxicity [9].

Relative to other tryptamine psychedelics, 5-MeO-DMT appears to be a stronger serotonin stimulating
substance and may even be able to activate 5HT receptors to a greater extent that serotonin itself,
whereas classic tryptamines (LSD, psilocybin, DMT) are only partially able to stimulate serotonin
receptors [4, 25]. It is also a full agonist at the 5HT1A receptor. This may explain why it appears
Serotonin Toxicity can occur with 5-MeO-DMT (particularly in combination with MAOIs) whereas it has
not been reported with LSD, psilocybin, or DMT. Other contributing aspects of 5-MeO-DMT’s
pharmacology to risk of Serotonin Toxicity could include its serotonin reuptake inhibition as well as the
presence of its active metabolite bufotenine (more probable with toad venom).

Edited April 21 by What Am I

[RamPhoenix]

Agreed it is dicey & best not to pursue

500mg mushrooms

1:2 5meodmt pen 2 full 10 sec draws

150 mg harmaline (way to much) thinking should of went with 30-50 mg

at the end/ 15 min after comedown, started to feel the very beginnings of serotonin syndrome. 

[What Am I]

1 hour ago, RamPhoenix said:

Agreed it is dicey & best not to pursue

500mg mushrooms

1:2 5meodmt pen 2 full 10 sec draws

150 mg harmaline (way to much) thinking should of went with 30-50 mg

at the end/ 15 min after comedown, started to feel the very beginnings of serotonin syndrome. 

That's interesting though, it sounds like you were pretty resistant to the potential negative effects. Your dose of 5meo and harmalas was massive compared to mine, and it sounds like it only gave you a minor case of serotonin syndrome if anything at all.

I've actually read a few reports of people using the combo successfully and without issue, which is part of what prompted me to try it in the first place. I guess what I've learned is that individual factors may determine whether you're prone to a great experience or a deadly one. Unfortunately, the dangers of figuring out how you'll respond are just way too serious to recommend anyone ever try it. My warning (and the original intention of this thread) remains.

Here's another relevant excerpt from the FIVE GUIDE I linked above:

It is recommended to avoid the combination of MAOIs with 5-MeO-DMT. However, there are many
existing reports from online forums (erowid, bluelight, reddit) that document individuals taking these
types of combinations without serious injury and sometimes with an endorsement of a profound
experience. The discrepancy in information between anecdotal reporting and scientific sources could be
explained on a statistical basis for a bad outcome. If the particular drug combination of 5-MeO-DMT and
drug X has a risk of death of 1% then you would have to use the combination one hundred times (1/0.01
= 100) to expect a single death to occur.

[Yimpa]

I am glad you are OK. Lesson learned: harmalas is NOT harmless.

[Oppositionless]

@What Am I his 5 meo dose was probably the same as yours. IM is exponentially more potent than smoked (for anything)

there's a reason that once addicts start injecting they don't go back 

Edited June 18 by Oppositionless

[What Am I]

2 hours ago, Oppositionless said:

@What Am I his 5 meo dose was probably the same as yours. IM is exponentially more potent than smoked (for anything)

there's a reason that once addicts start injecting they don't go back 

Sure, in general you're correct that the bioavailability for injection is typically a lot higher. And if we were talking about intravenous injection of 5-MeO-DMT, 3mg would be a breakthrough dose. But for IM, a breakthrough is closer to 15mg. Since I only used 2mg IM, it was a relatively tame dose that wouldn't produce significant effects. If RamPhoenix took two 10 second draws on a 1:2 pen, that'd be a way higher dose.

Edited June 18 by What Am I

[Oppositionless]

On 6/18/2024 at 9:36 AM, What Am I said:

Sure, in general you're correct that the bioavailability for injection is typically a lot higher. And if we were talking about intravenous injection of 5-MeO-DMT, 3mg would be a breakthrough dose. But for IM, a breakthrough is closer to 15mg. Since I only used 2mg IM, it was a relatively tame dose that wouldn't produce significant effects. If RamPhoenix took two 10 second draws on a 1:2 pen, that'd be a way higher dose.

@What Am I. Oh yes, I see. I didn't realize there was a significant difference between IM and IV