Amphetamine + MDMA

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bubble_chart Synergistic tendency

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Additive

These substances do not interact significantly. Their effects are similar and add up.
Reliability: inferred.
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error_outline Estimated risk

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Unsafe

The combination of these substances presents non-negligible physical or mental risks.
Reliability: inferred.
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flare About effects

According to testimonials on Reddit (such as here and here), it looks like amphetamine makes the experience of MDMA more lucid and energetic, and for some, less empathogenic. Side effects are also said to be more pronounced, particularly physical effects and after-effects. There are reports of convulsions, such as here.

Amphetamine and MDMA have in common their action on dopamine and, to a lesser extent, on noradrenalin and serotonin. They have many similar effects, such as stimulation and hyperthermia, and these effects and their consequences logically add up.

menu_book About risks

Although the combination seems generally well tolerated, several trip reports of overdoses posted on Erowid (here, here and there) call for vigilance. The symptoms reported (anxiety, tremors, hallucination, confusion and convulsions) suggest serotonin toxicity, which this qualitative review classifies as "intermediate risk".

As this systematic review shows, amphetamine and MDMA both have cardiotoxic effects. Combining them could therefore lead to greater cardiovascular risks.

This study in vitro showed increased toxicity to cells (in this case, the liver). According to this other study, the cause is hyperthermia (40.5°C), a frequent side effect of both products. This hyperthermia would also be responsible for MDMA's neurotoxicity (according to this study). Limiting hot flashes therefore seems an important measure to reduce the risks of this mix.

However, some HR websites such as TripSit present it as safe. It could be that the popularity of this blend leads to an underestimation of the risks.