The Risk of Serotonin Syndrome from MDMA and 5-HTP

The Concern Many users take 5-HTP after MDMA to help with the comedown by replenishing serotonin. There's a theoretical risk: combining these could cause serotonin syndrome, a dangerous condition from too much serotonin activity.

Why It Could Be Dangerous (In Theory) MDMA floods your brain with serotonin while blocking its removal. 5-HTP is converted directly into more serotonin. Together, they could theoretically create a dangerous serotonin overload.

What The Evidence Actually Shows There are ZERO documented cases of serotonin syndrome from MDMA + 5-HTP alone. A 2021 FDA database review found 20 serotonin syndrome cases involving MDMA, but every single one also involved other drugs (usually antidepressants or other stimulants). Not one case was from MDMA + 5-HTP.

Why Timing Matters The key is WHEN you take 5-HTP:

  • During MDMA's peak (0-4 hours): Dangerous - you're adding fuel to an already raging fire

  • After MDMA wears off (4+ hours): Much safer - MDMA's serotonin-releasing effects have ended, and your brain is now depleted and trying to recover

The Bottom Line Based on available evidence, taking 5-HTP 4 or more hours after a standard MDMA dose (100mg x2) should not put users at risk of serotonin syndrome. The acute serotonin-releasing effects have passed, and you're simply helping your depleted brain rebuild its stores. 

If you took a larger dose of MDMA or want to exercise an abundance of caution, wait 24 hours to take ALCHEMIZE. This timing-based approach likely explains why, despite widespread use, we see no clinical cases of this theoretical risk becoming reality.

References:

  1. Mayo Clinic. (n.d.). Serotonin syndrome. Retrieved from https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

  2. National Institute on Drug Abuse. (2020, June 1). What are the effects of MDMA? Retrieved from https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-are-effects-mdma

  3. Simon, N. (2020, December 22). 5-HTP (5-Hydroxytryptophan). Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/your-brain-on-food/202012/5-htp-5-hydroxytryptophan

  4. Boyer, E. W., & Shannon, M. (2005). The Serotonin Syndrome. The New England Journal of Medicine, 352(11), 1112–1120. doi:10.1056/NEJMra041867

  5. Smilkstein, M. J., Smolinske, S. C., & Rumack, B. H. (1987). A case of MAO inhibitor/MDMA interaction: a new complication of designer drugs. Journal of Toxicology. Clinical Toxicology, 25(1-2), 149–159.

  6. Isbister, G. K., & Buckley, N. A. (2005). The pathophysiology of serotonin toxicity in animals and1
    humans: implications for diagnosis and treatment. Clinical Neuropharmacology, 28(5), 205–214. doi:10.1097/01.wnf.0000179377.92592.59

  7. Prashanth R, Gillman PK. (2006). Qualitative Review of Serotonin Syndrome, Ecstasy (MDMA) and the use of Other Serotonergic Substances: Hierarchy of Risk. ResearchGate. Retrieved from https://www.researchgate.net/publication/6218081_Qualitative_Review_of_Serotonin_Syndrome_Ecstasy_MDMA_and_the_use_of_Other_Serotonergic_Substances_Hierarchy_of_Risk

  8. DanceSafe. (n.d.). MDMA Contraindications. Retrieved from https://dancesafe.org/mdma-contraindications/

  9. TACO, Inc. (n.d.). Why am I hungover from MDMA? Retrieved from https://www.tacoinc.org/drugeducation/why-am-i-hungover-from-mdma/

Sferios, E. (2001). MDMA & Serotonin Syndrome. Erowid. Retrieved from https://erowid.org/chemicals/mdma/mdma_info_serotonin_syndrome.shtml