Compound: Sertraline (Zoloft), Escitalopram (Lexapro), Fluoxetine (Prozac), Venlafaxine (Effexor), Duloxetine (Cymbalta), Moclobemide (Aurorix - MAOI), and many more…
Other names: Cymbalta, Effexor, Lexapro, MAOI, Prozac, Zoloft
Download Antidepressants flyer here

Antidepressants include a wide variety of drugs including, but not limited to, selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). They are generally prescribed for depression and anxiety disorders, among other conditions. They are rarely used recreationally but they do interact with many recreational drugs.

Know Your Body & Mind — ‘Set’

Know Your Environment — ‘Setting’

Know Your Drug — Practice Harm Reduction

Dosage & Safer Using Tips

• It’s important to take antidepressants every day, as prescribed, to experience the positive effects on your mental health.

• Some people report reduced sex drive, difficulty reaching orgasm, and erectile dysfunction.

• Antidepressants have been linked to increased suicidal thoughts and behaviours, especially in people under 25.

• Abruptly quitting antidepressants or missing multiple doses can lead to some nasty withdrawal symptoms. If considering discontinuing your use of antidepressants, speak to your doctor about how you can taper off safely.


• Regardless of medication, partying is not always the best idea when you are unwell, whether it’s a mental or physical health issue. If it’s physical, give your body a chance to rest and recover. If you suffer from poor mental health, think about how recreational drugs might affect you.

 • If you are prescribed medication, follow your doctor’s instructions.

• Discuss recreational drug use with your doctor to help them find the medication to suit you.

• If using medications recreationally or self-medicating, start with a small dose and allow plenty of time for it to work.

• Effects vary from person to person; sharing your prescription may seem like a nice way to help your friends recover from a bender, but their tolerance may be different from your own, so start with a smaller dose.

• Just because your friend is experiencing similar symptoms, does not mean it’s a good idea to share your prescription with them.

• It’s easy to forget to take your meds when partying; set a reminder in your phone.

Physical effects

  • headaches
  • dizziness
  • nausea
  • weight gain
  • indigestion and stomach aches
  • diarrhoea or constipation
  • sexual problems eg. difficulties achieving orgasm during sex or masturbation or difficulties obtaining/ maintaining an erection

Emotional effects

  • Emotional Blunting – feelings of extreme sadness can sometimes be replaced by an emotional numbness in which you are neither able to cry nor enjoy a real belly laugh.

Psychological effects

  • anxiety
  • restlessness
  • difficulty sleeping, or excessive sleepiness
  • low sex drive
  • In rare cases, some people experience suicidal thoughts and a desire to self-harm when they first take antidepressants. Young people under 25 seem particularly at risk.

Antidepressant use is not recommended if you suffer (or have suffered) from:

• Seizure disorders

• Hyponatremia

• Renal dysfunction

• Psychosis

• Hypotension

Drug combinations

Possible outcomes. What works for one person may not work for another. We recommend you proceed with caution.

Unsafe combinations

Benzos/antipsychotics + depressants (opiates, GHB, alcohol) = risk of overdose, loss of consciousness, difficulty breathing, respiratory failure leading to death

SSRI/SNRI + MAOI = extreme risk of serotonin syndrome – always taper completely off one antidepressant before starting on another

SSRI + MDMA/DXM = SSRI can counter the effects of MDMA. Risk of serotonin syndrome

MAOI + MDMA/DXM/cocaine = extreme risk of serotonin syndrome

SSRI/SNRI + alcohol = increased effects of alcohol

MAOI + 2C-x/DOx/amphetamines/ketamine/MXE = unpredictably intensified effects

Antibiotics + MDMA = amoxicillin, clarithromycin, doxycycline, erythromycin, ketoconazole, lansoprazole, primaquine, tetracycline, and troleandomycin may be dangerous to take with MDMA as they inhibit an enzyme that breaks down MDMA

Cautionary combinations

Low risk effects

Check out the TripSit drug combinations chart here for info on other combinations.

Call 000 if experiencing adverse effects, feel unwell or concerned in any way


This educational resource has been developed collaboratively by healthcare workers and people who use drugs for their peers and the wider community. The role of Hi-Ground is to provide practical, evidence-based, unbiased information to assist you to make educated choices and to promote harm reduction, community care, and wellbeing. In an unregulated market it’s impossible to know the purity or dose of any substance. Taking drugs from an unregulated market carries its own risk, and you can educate yourself and practice harm reduction to reduce this risk.

Knowledge is power.

This resource is produced by DanceWize & Hi-Ground