Alcohol: Combining alcohol with stimulants is considered risky as it diminishes the sedative effects of alcohol that typically help gauge intoxication levels. This often leads to excessive drinking with reduced inhibitions, raising the risk of liver damage and dehydration. Stimulants can also delay the onset of passing out from alcohol, further increasing risk. If combined, it's advisable to set hourly drinking limits, considering that the effects of both substances may be less noticeable.
GHB/GBL: Stimulants increase respiration rate, allowing for higher sedative doses. If the stimulant wears off before the depressant effects of GHB/GBL, respiratory arrest may occur.
Opioids: Stimulants also increase respiration rate, potentially permitting higher opioid doses. If the stimulant effects diminish first, the opioid may overpower the individual, leading to respiratory arrest.
Cocaine: The rewarding effects of cocaine involve dopamine activity inhibition. Amphetamines alter dopamine transport, counteracting normal dopamine release mechanisms, and potentially leading to cardiac issues due to serotonin-related valve complications. This combination may induce hypertension and increase syncope risk due to turbulent blood flow during valve operation.
Cannabis: Stimulants heighten anxiety levels, thought loops, and paranoia, potentially leading to negative experiences when combined with cannabis.
Caffeine: Combining stimulants like caffeine is generally unnecessary and may strain the heart, induce anxiety, and cause physical discomfort.
Tramadol: Both tramadol and stimulants increase seizure risk.
DXM: Both substances elevate heart rate, with panic attacks potentially leading to serious heart issues in extreme cases.
Ketamine: Combining amphetamine and ketamine may result in psychosis resembling schizophrenia, mainly due to their effects on dopamine activity and executive functioning disruption.
PCP and Methoxetamine: Both increase the risk of tachycardia, hypertension, and manic states.
Psychedelics (e.g., LSD, mescaline, psilocybin): Stimulants heighten the risk of anxiety, paranoia, and thought loops when combined with psychedelics.
25x-NBOMe: The combined stimulation of amphetamines and NBOMes may lead to tachycardia, hypertension, vasoconstriction, and potential heart failure. Stimulants' anxiogenic effects may exacerbate negative experiences with psychedelics.
2C-T-x and 5-MeO-xxT: Suspected of having mild MAOI properties, increasing the risk of hypertensive crisis.
DOx and aMT: Both have MAOI properties that may interact unfavourably with amphetamines.
MAOIs: MAO-B inhibitors can potentiate phenethylamines unpredictably, while MAO-A inhibitors with amphetamines may lead to hypertensive crises.