Q: Will having sex on uppers make it impossible for me to enjoy sober sex?
A: If you only have sex on uppers for an extended period, then there is some risk that you will struggle to enjoy sober sex later – although this condition is probably not permanent and can be resolved by abstaining from drugs for a long time. However, as long as you continue to have sober sex as well, and don't always use uppers when having sex on drugs (GHB/GBL, cannabis and psychedelics can all be highly enjoyable on their own with the right dosage), you should not feel the need to use uppers or other drugs every time.
Q: Will I need Viagra in order to have sex on uppers?
A: If you are just taking enough of an upper to balance out the sedating effects from GHB, and not planning on having sex for hours on end, you might manage without it. If you're taking even a moderate dose of MDMA, however, or a high dose of another upper, you will probably need some pharmaceutical assistance to maintain or even achieve an erection.
Q: Is it true that combining uppers with Viagra or poppers is dangerous?
A: This has not been thoroughly studied, but the short answer would be probably not. If anything, there is good reason to believe that Viagra might reduce some of the risks associated with uppers, since it counteracts contraction of the blood vessels and therefore attenuates the increase in blood pressure and strain on the vessels that uppers can cause. However, both Viagra and poppers can increase your heart rate, so if you are not in good cardiovascular shape, you still might want to pace yourself. Combining Viagra with poppers is probably more dangerous, however, as both of these drugs lower blood pressure.
Q: Is it a bad idea to combine several uppers?
A: Yes. While the risks will depend on the specific combination, most uppers become more dangerous when combined with other uppers. This is not just due to increased hyperthermia or cardiovascular strain, as increased brain toxicity has also been demonstrated in animal studies, for instance when combining MDMA with caffeine or mephedrone with MDMA or meth. For this reason, it is better to choose one upper for a session and stick with.
Q: What about combining uppers and downers?
A: There is nothing inherently dangerous about the combined effect of an upper and a downer; in fact, they might negate some (but not all) of each other's adverse effects. The biggest danger of such drug combinations lies in one drug wearing off before the other, which can lead to the remaining drug's effects suddenly becoming overwhelming if this is not taken into account when dosing. (Since both drug types are more easily tolerated in the presence of the other, it becomes easier to get carried away and take too much.)
Q: Do uppers have any dangerous interactions with my meds?
A: You will have to research any interactions that a drug may have with your particular meds, but most common uppers are also used medically, and their interactions with other pharmaceutical drugs can be found by searching in databases like EKSEMPEL. (For questions about mephedrone, check out THIS article.)
When it comes to HIV meds, modern drugs like cobicistat do not have any known interactions with common recreational drugs, but older drugs like ritonavir may affect blood concentrations of various uppers due to the drugs competing for the same enzymes.
Q: My SSRI-based antidepressants reduce the effects of MDMA, can I just take more MDMA to experience the full effect?
A: No, that is not a good idea. While SSRIs block most of the effects of MDMA, they do not block all effects equally. By taking a larger dose of MDMA, you can therefore still experience toxic effects even if the desired drug effects are not very strong.