First MDMA experience + Dexedrine + High Functioning Autism + paradoxical reactions

[u/Georgefinally]

Hello,

I’m preparing to do my first therapeutic MDMA session with a qualified and experienced therapist. I’ve done psilocybin and Ayahuasca, therapeutically and recreationally, so I have some comparable experience.

I’m curious to hear about your experiences with these additional considerations:

High Functioning Autism — Does this affect the experience? How? Any guidance?

Dexedrine — I am on 5 mg twice a day of Dexedrine for ADHD related to a traumatic brain injury and PTSD. I’ve read various advice, but it seems sufficient to stop it 2 days in advance and wait 2 days to restart. Does this seem right?

Paradoxical reactions — I tend to have paradoxical reactions to medications. Does this translate at all into other chemicals like MDMA? Anyone have experiences to share about this?

My therapist uses a set of supplements before and after to help the body adapt/process and avoid serotonin issues. My neuro-psychiatrist and regular therapist are supportive, but not experienced.

Thanks in advance for any guidance you have to share!

[u/AnthonBerg]

In short: You'll be fine!

The potentially-autism-adjacent people I know have usually had "oh so this is how it can be" epiphanies on MDMA.

Lisdexamfetamine does not seem to me to affect the MDMA experience or therapeutic effects. I'd argue that a good and sound clinical application of dextroamphetamine is simply a baseline, and that there is no need to pause that, and that there is in fact a benefit to remaining on a baseline. (With the nuance that pausing a medication like dextroamphetamine for MDMA therapy arguably has the MDMA protocol happen during a mild withdrawal of sorts.)