INTERACTIONS
WITH OTHER DRUGS
Many people who experiment with hallucinogens
combine them with other drugs. For
example, it is not uncommon for people to take LSD or mushrooms and smoke marijuana at the same time.
The effect of these combinations is
highly individual and depends on the previous drug experience of the user, the doses, and the particular drugs involved. For example, smoking marijuana often
triggers PHPD (flashbacks) in heavy
LSD users. Many of these combinations produce bizarre, anxiety-provoking—but not dangerous—states.
The most troublesome reactions are those that are
caused by the user taking something
without knowing it. PCP is a frequent culprit in this regard. Marijuana can be adulterated with PCP
without the user's knowledge and can
induce a terrifying or dangerous state in the unsuspecting users.
What about interactions with prescription drugs?
Not surprisingly, other drugs that
influence serotonin systems have been involved in reported interactions. There are multiple reports
of serotonin-specific rcuptake inhibitors (SSRls) like Prozac (fluoxetine)
triggering flashbacks in heavy LSD
users. The opposite interaction also can happen: some patients who are taking SSRIs to treat depression
report that they do not experience the effects of LSD. A more dangerous
interaction could theoretically
happen if people combine SSRIs and avahuasca. The MAO inhibitor in the ayahuasca can synergize with the
increase in serotonin caused by the
SSRI, leading to the dangerous "serotonin syndrome" that we discuss
in the "Ecstasy" chapter.
