NutriStack
Citalopram and MDMA, contraindicated.
Citalopram blocks the serotonin transporter MDMA uses to release serotonin, blunting the subjective effect while still permitting serotonergic load. Combined use risks serotonin syndrome and hyperthermia, and citalopram independently prolongs the QT interval, adding cardiac risk when MDMA causes catecholamine surges.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
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At a glance
- Substances
- Citalopram and MDMA
- Pair type
- Contraindicated
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Moderate evidence
Contraindicated
What is happening. Citalopram blocks the serotonin transporter MDMA uses to release serotonin, blunting the subjective effect while still permitting serotonergic load. Combined use risks serotonin syndrome and hyperthermia, and citalopram independently prolongs the QT interval, adding cardiac risk when MDMA causes catecholamine surges.
Mechanism. Citalopram occupies SERT, blunting MDMA-induced reverse transport of serotonin. Cumulative serotonergic activity with impaired clearance can trigger serotonin toxicity; concurrent QT prolongation magnifies arrhythmia risk.
Recommendation. Do not combine MDMA with citalopram. Wait at least 1-2 weeks after stopping citalopram before any MDMA exposure.
Sources (2)
- Dobry Y, Rice T, Sher L. Ecstasy use and serotonin syndrome: a neglected danger to adolescents and young adults prescribed selective serotonin reuptake inhibitors. Int J Adolesc Med Health. 2013;25(3):193-9. PMID 24006318
- Beach SR, Kostis WJ, Celano CM, et al. Meta-analysis of selective serotonin reuptake inhibitor-associated QTc prolongation. J Clin Psychiatry. 2014;75(5):e441-9. PMID 24922496
Stack Score
How this pair moves the number.
Effect on the composite score
If both Citalopram and MDMA are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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