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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by creepy on May 1, 2012, at 7:23:41
In reply to How my mind works and methamphetamine, posted by rjlockhart04-08 on April 30, 2012, at 12:40:49
meth bought on the street is not a pure drug. Makes for a great way to fry your brain. Even prescription desoxyn is probably bad over the long haul. But its a lot safer than street drugs for sure.
Question is.. could you take a prescription stim at a given dose and remain at that dose even when tolerance set in?
Posted by Shes_Initforthemoney on May 1, 2012, at 9:27:22
In reply to Re: How my mind works and methamphetamine » linkadge, posted by SLS on April 30, 2012, at 22:39:02
> > The amphetamines reverse the transport of serotonin norepinephrine and dopamine - effectively causing both reuptake inhibition and release.
> >
> > They can cause serotonin syndrome in combination with MAOIs.
>
> I know that methamphetamine is a potent serotonin releaser, but what about d-amphetamine?
>
> I have been on Parnate 120 mg and added 40 mg of Dexedrine. I was also taking desipramine at the time. I have also added Dexedrine to Nardil 90 mg while also taking nortriptyline. Maybe I just got lucky, but these combinations have been considered safe for many years.
>
>
> - ScottDoesn't Parnate partially convert to amphetamine as a metabolite?
Jay
Posted by SLS on May 1, 2012, at 9:56:48
In reply to Re: methamphetamine + Parnate » SLS, posted by Shes_Initforthemoney on May 1, 2012, at 9:27:22
> > > The amphetamines reverse the transport of serotonin norepinephrine and dopamine - effectively causing both reuptake inhibition and release.
> > >
> > > They can cause serotonin syndrome in combination with MAOIs.
> >
> > I know that methamphetamine is a potent serotonin releaser, but what about d-amphetamine?
> >
> > I have been on Parnate 120 mg and added 40 mg of Dexedrine. I was also taking desipramine at the time. I have also added Dexedrine to Nardil 90 mg while also taking nortriptyline. Maybe I just got lucky, but these combinations have been considered safe for many years.
> >
> >
> > - Scott
>
> Doesn't Parnate partially convert to amphetamine as a metabolite?
>
> Jay
This has been the subject of debate for over 40 years. Most believe that there are no amphetamine metabolites of Parnate. However, one study of a person who overdosed on Parnate showed amphetamine in their blood stream.http://www.ncbi.nlm.nih.gov/pubmed?term=tranylcypromine%20amphetamine%20overdose
- Scott
Posted by rjlockhart04-08 on May 1, 2012, at 13:18:20
In reply to Re: How my mind works and methamphetamine, posted by creepy on May 1, 2012, at 7:23:41
could you take a prescription stim at a given dose and remain at that dose even when tolerance set in?
Well, yea...of course, that's what Im doing with my currenlt meds right now like Prozac and Nuvigil they don't have any effect on me. Of course If was taking a real stimulant at given dose...I just have a tendency to find the most optimium effect it will give me. And I can't put it to any other words...many people maybe have this same thinking but I have been labeled a substance abuser and a drug addict too. You have to move and get away from all those bad labels.
Posted by linkadge on May 1, 2012, at 16:58:35
In reply to Re: link, posted by rjlockhart04-08 on April 30, 2012, at 22:23:00
>this is a widespread thing alot of people do, >and have the same substance in their systems >when either they are studying for a final, or >needing it to get them going.
Oh sorry, I didn't realize a lot of people were doing it. I guess its ok then.
My appoligies,
Linkadge
Posted by linkadge on May 1, 2012, at 17:02:57
In reply to Re: creepy, posted by rjlockhart04-08 on May 1, 2012, at 13:18:20
I do believe d-amphetamine has effects on serotonin like meth. Not sure why it has been combined with parnate.
MAOIs have been combined safely with even SSRIs in some cases. I wonder if treatment resistance produces resistance to serotonin syndrome?
Linkadge
Posted by rjlockhart04-08 on May 2, 2012, at 0:55:02
In reply to Re: creepy, posted by linkadge on May 1, 2012, at 17:02:57
People do it all the time...I have deal with my consequences and exposing it to the truth, I have posted basically my life here on dr-bob. Give or leave it...I am not trying to be offensive but I have had to deal with alot of skeptism from people and im trying to convey a point that this is a act to achieve a balance that I do not have..im still in the process of working with a vary difficult doctor. If methamphetamine was used daily, and at high amounts yes, it would be nuerotoxic and it would begin to deterate the brain because its like stepping on the gas on car and running it down until the engine fades and eventually does not work anymore.
Posted by SLS on May 2, 2012, at 5:59:16
In reply to Re: creepy, posted by linkadge on May 1, 2012, at 17:02:57
> MAOIs have been combined safely with even SSRIs in some cases.
I have seen this reported for the reversible moclobemide - Joffe; Bakish - but not for the irreversibles Parnate and Nardil. MAOIs are weird. They are unpredictable with respect to drug and food interactions. Therefore, I wouldn't dismiss any reports of such a combination.
> I wonder if treatment resistance produces resistance to serotonin syndrome?
That's an interesting idea. For me, however, this is not the case.
One day, in great desperation, I took a very small (approximately 6.25 mg) test dose of Effexor while in the midst of Parnate treatment at 80 mg. I wanted to test for serotonin syndrome. I chose Effexor because of its relatively short half life. Within an hour of dosing, I developed the classic symptoms of SS, including muscle rigidity and an incoherent altered state. My parents said that I was saying things that were unintelligible. As I was just beginning to come out of it, I asked that they take my temperature. It was elevated by 1.5°F. That is not very much, but certainly unusual for me. I can only imagine what would have happened had I taken the whole 75 mg tablet of Effexor.
- Scott
Posted by SLS on May 2, 2012, at 6:04:27
In reply to Re: creepy, posted by linkadge on May 1, 2012, at 17:02:57
Hi Linkadge.
> I do believe d-amphetamine has effects on serotonin like meth. Not sure why it has been combined with parnate.
I am still baffled as to why I never heard of d-amphetamine being serotonergic. I can't find anything on Medline Pubmed indicating this. In any event, I never reacted badly to adding Dexedrine to either Parnate or Nardil in dosages of at least 20 mg. More recently, I added Adderal to Nardil without sequalae.
This is an important issue. Some doctors have been combining MAOIs and d-amphetamine for years. If you can find something definitive on this point, I would be grateful. I found paraphrasing on Google, but no references to scientific literature.
Thanks.
- Scott
Posted by SLS on May 2, 2012, at 7:05:49
In reply to Re: creepy, posted by linkadge on May 1, 2012, at 17:02:57
Hi Linkadge.
All in all, most of the literature I found states that amphetamine releases serotonin. You were right (as usual).
I found some referenced literature on Wiki indicating serotonin release is a property of d-amphetamine. Unfortunately, the conclusions reached in these investigations rely upon inferences based on indirect in vivo observations using pharmacological probes rather than direct in vitro measurements using synaptosomes.
The following study is interesting:
http://www.ncbi.nlm.nih.gov/pubmed/21615721
It reported actual measurements of serotonin concentrations in response to different drugs. Amphetamine was the weakest at increasing extracellular serotonin. This is not an insignificant finding. However, again, it is an in vivo measurement. It is possible that this measurement represents an indirect increase of serotonin activity resulting from negative feedback loops that are wired to attenuate hyperlocomotion
http://www.ncbi.nlm.nih.gov/pubmed/15545015
Obviously, I am cherry-picking.
- Scott
Posted by SLS on May 2, 2012, at 7:17:03
In reply to How my mind works and methamphetamine, posted by rjlockhart04-08 on April 30, 2012, at 12:40:49
I agree with Linkadge.
It is an established fact that methamphetamine is highly neurotoxic and irreversibly damages dopaminergic AND serotonergic brain cells. This leads to both neurological and psychiatric abnormalities.
I am sad.
- Scott
Posted by herpills on May 2, 2012, at 14:47:33
In reply to Re: link, posted by rjlockhart04-08 on May 2, 2012, at 0:55:02
> im still in the process of working with a vary difficult doctor.
You've mentioned this before that you don't have a good doctor or good relationship with your doctor. In my opinion you really aren't going to make progress if this is the kind of situation you have with your doctor. What are your options for finding a new doc? Is this pdoc private practice? Is there a community mental health clinic you could go to? herpills
Posted by linkadge on May 2, 2012, at 16:17:23
In reply to Re: link » rjlockhart04-08, posted by herpills on May 2, 2012, at 14:47:33
If somebody has a problem with meth, I am very sympathetic. However, I'm not as sympathetic when somebody refuses to see it as a problem.
A lot of people with drug problems try and justify it by saying that "everybody does it".
If everybody jumped off a cliff that wouldn't make it a good idea.
Linkadge
Posted by rjlockhart04-08 on May 2, 2012, at 18:00:38
In reply to Re: link, posted by linkadge on May 2, 2012, at 16:17:23
Well I do ... have a problem but its not .. a serious everyday thing, its only used once and while to get me back to functioning normally, and being able to have a deeper intellict for a temporary period of time. I have been accussed many times of things that where not exactly the case, yet I do admit that I am an addict from all the desperation of times that I have had abuse of substances. I do it either to find relief from current situation or to enhance my mental motivation to study, and do things I would not normally do like clean, talk much faster and better, and feel content with myself. You know? My usage in the past and present are usally stimulants and then having to have something to calm down after they where off, I've already tried Cannabis, it makes me derealized and I have to lock myself up away from people because I am not with reality and I freak out. In the past I was precribed various benzos for both anxiety and for sleep that would use for treatment of the insomnia..
So...its vary hard working with a doctor that constantly thinks about the abuse potential of any med, I admit I do have big tendency to take more and take pills through out the day, and I admit that is my problem...im not content of who I am so that's why I mask the problems with subsitutes and crutches and right now I have no crutches...so I have deal with this misery 24/7, and that's why I have gotten envolved in getting spiritual help.Anyways, thanks link. It's hard to not be irritated when I see other people do this kinda buisness like its part of thier lives go to parties and their pills being passed around like its beer and they get away with it. Anyways...see ya around
Matt
Posted by SLS on May 2, 2012, at 19:54:24
In reply to Re: link, posted by rjlockhart04-08 on May 2, 2012, at 18:00:38
> its only used once and while to get me back to functioning normally, and being able to have a deeper intellict for a temporary period of time.
It is entirely understandable that you should be trapped into using methamphetamine in order to feel better. I am more angry at your illness than I am with you. It is not your fault. It must be an irresistible temptation to take anything that will bring you out of depression - even for a few hours. However, that makes it no less damaging to your brain to take methamphetamine. Taking methamphetamine now might make you less apt to respond to treatment in the future. I have no evidence of this to present you with, though.
I have no suggestions.
Well, maybe one. Have you tried Abilify yet?
- Scott
Posted by Shes_Initforthemoney on May 2, 2012, at 20:30:00
In reply to Re: link, posted by linkadge on May 2, 2012, at 16:17:23
> If somebody has a problem with meth, I am very sympathetic. However, I'm not as sympathetic when somebody refuses to see it as a problem.
>
> A lot of people with drug problems try and justify it by saying that "everybody does it".
>
> If everybody jumped off a cliff that wouldn't make it a good idea.
>
> LinkadgeNow C'mon. Denial is a part of addiction. I've worked Detox and heard so much of this. I need a stim every day..dexedrine...have for years and will likely continue until my expiry (lol). Some forms of amphetamines are prescribed...some are illegal. There is a grey area..and I believe in Harm Reduction more than anything. If there is a safer alternative...do it...even if it has some risks. I see small..controled doses of Dexedrine as "methadone" is to heroin. Maybe even better risk wise. IF RJ wants help...what his addiction is treating has to be replaced..and again..if he can find a good addiction specialist..I have seen doctors prescribe a dose of dexedrine (usually spansules) that the client has to take in his/her office every day. Now that Vyvanse is around..it is much safer to dispense this med.
I am NOT saying your concerns are invalid...but anger has done nothing than but propel stigma and intollerance.
Jay
Posted by psychobot5000 on May 4, 2012, at 19:11:49
In reply to Re: link, posted by rjlockhart04-08 on May 2, 2012, at 18:00:38
Hi Matt,
I'm very sympathetic to your situation. Being depressed like that is hard, and I, like others, grasp at almost anything to try to get out of it. You shouldn't feel bad.
That said, I don't know your case well, but there's good evidence that large doses of methamphetamine are very, very bad for your brain--to the point of putting large holes in it, as has been previously mentioned. And that's not even getting to its hyperthermic (i.e. feverish) effects on the rest of your body, even with occasional use. Or the poisonous substances that tend to occur with it in its street form. Simply put, crystal is horrible for you, and in 'recreational' doses (as you're quite clearly taking it), even more so. It's not worth it. Not under any circumstances I can think of. It damages the dopamine nerve terminals in your brain, which will, in the medium and long term, make you even worse.
Best of luck,
Psychbot
Posted by linkadge on May 4, 2012, at 21:09:44
In reply to Re: link, posted by Shes_Initforthemoney on May 2, 2012, at 20:30:00
>Now C'mon. Denial is a part of addiction.
No. Stupidity is part of denial. I have met pleny of intellegent smokers (for example) who know full well (and believe) what the risks are. They don't downplay them. They don't chalk them up to propeganda. They understand and accept responsibility regardless of being addicted. Denial is stupidity. This is a separate affliction.
>Some forms of amphetamines are prescribed...some >are illegal. There is a grey area..and I believe >in Harm Reduction more than anything. If there >is a safer alternative...do it...even if it has >some risks. I see small..controled doses of >Dexedrine as "methadone" is to heroin.
Yeah, but call it what it is. It is addiction. I'm not a fan of people coming onto the board talking all about how good this or that illegal drug makes them feel. Duh, its a powerfully reinforcing addictive substance. The fact that it makes you "feel" good doesn't change the nature of the beast.
Some people can't logically separate the positive effects of the drug from the negative health consequences. How could something 'so good' be so bad. Thats lack of ablity to think, IMHO, not addiction.
>Now that Vyvanse is around..it is much safer to >dispense this med.
IIRC, vyvanse didn't do it for RJ
>I am NOT saying your concerns are invalid...but >anger has done nothing than but propel stigma >and intollerance.
Addicts will not get better until they hate the drug more than they love it.
Linakdge
Posted by rjlockhart04-08 on May 4, 2012, at 22:59:08
In reply to Re: link, posted by linkadge on May 4, 2012, at 21:09:44
You have made this into a situation where you have had an opinion of something is exaggerated. Do you even read the other stuff in my posts? .. well either way, that's sad you have view of me, and its not my responsiblity.
Now, the choices that I made which choose to use a substance that can vary well be obtained through presciption. I mean there is a person who uses Ketamine and do you see any people accusing that poster of bad actions, and of a drug addict...no they just go along with whole f*ck*ng delusion that its ok, now im my case yes its diffrent, I have deal with biggest b*llsh*t from people who don't even realize the real situation, and there's one poster and I cannot STAND emanual98 how how ever the f*ck you spell her name, that's all she or he does is sit there and point out my faults and repremand me of something that I did and use me as a bad expample to posters of my situations. Now yes, I abused presciption amphetamines in past...and yes I took Vyvanse..I took 2 70mg in the morning for about almost a 6 months to a year...and switched to Dexedrine Spansules 60mg. Vyvnase only lasted about 8 hours and I had to start the spaunsules...you shouldnt make statementsa about me until you know my full history. And after that if you want to have your own opinion of who I am...you can do that, it will make me happy..:)
Am I in denial? well I let you figure that out...but the thing I know that have behavior to alter my mood, but I am vary sure that is what most of the people and the US and maybe the world use in regular day life. GET OVER IT.
Posted by sigismund on May 5, 2012, at 2:03:41
In reply to Re: link, posted by rjlockhart04-08 on May 4, 2012, at 22:59:08
Matt, have you given any more thought to lowering the dose of one of the non-abusable drugs your doc prescribes? Like that large dose of Zyprexa? Or the huge dose of Prozac?
I could well understand that lowering the dose of one of these could lead to you feeling worse, but then again it might not.
I don't quite see what is in it for you with this doctor. If you didn't need any of her less than pleasant drugs, you wouldn't need to see her.
The reason I got off methadone was that I was sick of being treated like dirt. I'd rather live under a bridge than be treated like that.
You don't seem inclined to try this option. But you are in this hole and need to find a way out. No need to admit you are an addict and do a public repentance...you have already done that in spades. What you need to do is to look after yourself. Because you are young you do not realise how fragile life is.
That is my 2 bob's worth, anyway.
Posted by rjlockhart04-08 on May 5, 2012, at 15:20:52
In reply to Re: link » rjlockhart04-08, posted by sigismund on May 5, 2012, at 2:03:41
Yea...some here told me I take a large amount, it just frustrates me because everything that I do people point it out and I have walk on my tip toes explaining it. I mean really there's people here who take Parnate at high doses which is not even close to Prozac at 60mg. Yes I do take Zyprexa 20mg and there's really no need to continue it, it does nothing. I am on Nuvigil 250mg which maybe is better than nothing. I'm just in sadness alot, every night I go to sleep...before entering dream state, my longing for things that I have desired so badly will come up, memories and thoughts that I still have that are at a child level... and I just hold a pillow and create a thought adjuster to hold on too while this state of pain comes and I can never express it during the day because I know someone will use it against me and my whole persou will be abandoned. Anyways, yes..you know I can't say how much I would Love a script to Seconal at night, but I have to create a mental sedation to get away from this feeling of dread, its kinda like a primitive form of biofeedback.
Matt
Posted by Solstice on May 6, 2012, at 8:31:04
In reply to Re: link, posted by rjlockhart04-08 on May 4, 2012, at 22:59:08
> Now yes, I abused presciption amphetamines in past...and yes I took Vyvanse..I took 2 70mg in the morning for about almost a 6 months to a year...and switched to Dexedrine Spansules 60mg. Vyvnase only lasted about 8 hours and I had to start the spaunsules...you shouldnt make statementsa about me until you know my full history.
Matt -
You've talked about abusing amphetamines, but this is the first time you've been specific. Two 70mg Vyvanse in the morning? That's all? Now I'm curious about the specific dosing habits you've had that have been labeled abusive.
I say this because several years ago I got ahold of an article written by an MD, found it on the web, and he was explaining the studies that lead to FDA approval of stimulants, and how the "maximum dosages" are typically tied to studies only done on children. His belief was that it should be more based on weight, and he also believed that higher dosages of stimulants were often warranted. He also had a chart that listed all of the stimulants and their comparable dosages. He also included info about the higher-than-FDA-approved dosages he had used in his practice and found to be effective.
I tried to do a quick google search to see if I could find it, and don't have time to search through all the results - I'm not remembering the right search terms to pull it up in the first few pages. Point is, that I printed that thing and showed it to my children's ultra-conservative psychiatrist. As a result, she agreed to allow mine to exceed FDA approved dosages. One is taking 100mg Vyvanse, plus two afternoon 20mg of Adderall. Mind you.. she has been treating my kids for some 12 yrs and does not have one iota of concern about stimulants being distributed or whether more than what's prescribed is being taken.
Anyway, your report of two 70mg Vyvanse daily just does not seem excessive enough to qualify as "abuse." That, of course, doesn't mean you don't have other things that have genuinely reached abusive levels.. but I'm just saying...
Solstice
Posted by 10derheart on May 6, 2012, at 11:40:28
In reply to Matt - question + comment from Solstice » rjlockhart04-08, posted by Solstice on May 6, 2012, at 8:31:04
I don't think Matt was/is referring to the Vyvanse in particular as a med he abused. From this very honest post:
http://www.dr-bob.org/babble/20111208/msgs/1004727.html
>>I was on 60mg of dextoamphetamine for about 2 years. It was fine I just tended to want to get high on amphetamine. I would go a couple weeks without abusing it and then I would have a binge period where i would repeatdly take them over again after they wore off. I HATED the crash. Before this I was on adderall and ofcourse I abused that.
>>I abused stimulants until I had a siezure that casued me to forget everything that I was doing that day. I couldnt talk for a couple minites because I lost my speech capibility for a couple min.
Just helping clarify, I hope - 10der
PS - Matt - Plz, plz do anything you can to stay away from street meth. This drug is nasty, evil. It will NEVER be the answer. I am scared for you. I want you to stay around. The stuff is potentially deadly in many ways. Plz ask someone you trust for help if you think you will keep turning to this. Occasional use can change to daily so fast you won't know what happened. I am praying for you.
Posted by rjlockhart04-08 on May 8, 2012, at 2:52:24
In reply to Matt - question + comment from Solstice » rjlockhart04-08, posted by Solstice on May 6, 2012, at 8:31:04
Vyvanse is a little less likely to abuse, it works slower...you don't get the rush from plain d-amphetamine, or better methamphetamine. I did pop more than I should of...but what happened when everyone in my family found out I was doing this they really got mad, and still today I'm exiled from part of my family. See what really gets me just disappointed is that there are people taking 100-140mg of Vyvanse and then they take like 10-20mg of Rilitin for the evening...that is so totally the effective treatment that would work, but I know high doses cause side effects and irrtiblity. But I took 140 [2 70mg] and that was it ... people implied I was taking too much...after that my doctor at the time switched me to dexamphetamine spanusles 60mgs, I took fine for a couple months and then I figured out ways to take more, or crush the spansule pallets. I'm admitting everything, there's no need for me to hide stuff anymore. Thanks Solstice for your post.
Matt
Posted by psychobot5000 on May 14, 2012, at 18:09:56
In reply to D-amphetamine (Dexedrine; Adderal) = Serotonin? » linkadge, posted by SLS on May 2, 2012, at 7:05:49
Scott, I found these numbers for binding affinity of d-amphetamine in the wikipedia article on neurotransmitter releasing agents:
(d)-Amphetamine NA: 7.07 DA: 24.8 SE: 1,765
Since l-amphetamine does not much affect the DA transporter, wikipedia was willing to state unequivocally that that molecule is selective for the NA transporter.
In general, you need a substantial effect on serotonin, above and beyond that provided by a powerful MAOi, to cause serotonin syndrome. I very much doubt amphetamine has an effect of that size; in any case, in patients of the level of treatment resistance likely to be present when MAOis are combined with stimulants, the risk is almost certainly worth it.
-P
> Hi Linkadge.
>
> All in all, most of the literature I found states that amphetamine releases serotonin. You were right (as usual).
>
> I found some referenced literature on Wiki indicating serotonin release is a property of d-amphetamine. Unfortunately, the conclusions reached in these investigations rely upon inferences based on indirect in vivo observations using pharmacological probes rather than direct in vitro measurements using synaptosomes.
>
> The following study is interesting:
>
> http://www.ncbi.nlm.nih.gov/pubmed/21615721
>
> It reported actual measurements of serotonin concentrations in response to different drugs. Amphetamine was the weakest at increasing extracellular serotonin. This is not an insignificant finding. However, again, it is an in vivo measurement. It is possible that this measurement represents an indirect increase of serotonin activity resulting from negative feedback loops that are wired to attenuate hyperlocomotion
>
> http://www.ncbi.nlm.nih.gov/pubmed/15545015
>
> Obviously, I am cherry-picking.
>
>
> - Scott
>
This is the end of the thread.
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