Intriguing Case Report: Physician?s Attempt to Self-Medicate BP Depression w/DMT

[thatjournalist]

I came across an intriguing case report today published in the Journal of Psychoactive Drugs in March 2017 about a retired psychiatrist with bipolar depression who tried, largely unsuccessfully, to self-treat himself with a combination of DMT and the MAOI Phenelzine. Link to article: https://drive.google.com/file/d/1sjXrT0V7UMh-XMvjAzMh_t0POoxZ0Mcs/view?usp=sharing.

Here's the abstract: "N,N-dimethyltryptamine (DMT) is a psychoactive substance that has been gaining popularity in therapeutic and recreational use. This is a case of a physician who chronically took DMT aug-mented with phenelzine in an attempt to self-medicate refractory bipolar depression. His presentation of altered mental status, mania, and psychosis is examined in regards to his DMT use. This case discusses DMT, the possible uses of DMT, and the theorized mechanism of DMT in psychosis and treatment of depression, particularly involving its agonist activity at 5-HT1A,5-HT2A, and 5-HT2C. It is also important to recognize the dangers of self-medication, particularly amongst physicians."

I found the adverse effects of this drug combination in conjunction with BP depression particularly intriguing, especially considering the traditional composition of Amazonian ayahuasca involves the use of Banisteriopsis caapi. To the best of my knowledge, the specific combination of synthetic DMT (he vaporized ~1g per day) and phenelzine hasn't been reported on in humans in medical literature prior to this. I imagine the retired doctor discussed in this article was attempting to achieve similar results to those using ayahuasca for severe depression but failed to properly consider his increased risk of mania, psychosis, etc. with this drug combo.

It's worth noting this all happened after he suddenly and abruptly ceased daily use of DMT, phenelzine and clonazepam. I'd personally guess that going cold turkey on clonazepam with no taper likely largely contributed to his mental breakdown.

I'd love to hear anyone's thoughts on this article.

 

[sekio]

A little voice (machine elf?) in my ear says that DMT is probably not the best drug to be using for psych problems beyond a lack of cosmic perspective.

Doubly so if you're adding a MAOI. I mean, jeez, you'd need some klonopins just to be able to go buy groceries without looking like a raving maniac.

 

[thatjournalist]

A little voice (machine elf?) in my ear says that DMT is probably not the best drug to be using for psych problems beyond a lack of cosmic perspective.

Doubly so if you're adding a MAOI. I mean, jeez, you'd need some klonopins just to be able to go buy groceries without looking like a raving maniac.

What's interesting for me about this story about is that as someone with treatment-resistant depression, without any other diagnoses, DMT & Ayahuasca have both proven to be significantly beneficial for me in relieving my symptoms temporarily. This is with the right dose, set and setting of course. But I agree, for someone with a history of manic episodes, psychosis, BP disorder, schizophrenia, etc. DMT is inadvisable, esp. in combination with an MAOI. The fact that he was allegedly vaping 1g of DMT per day raised my eyebrows as well.

 

[AlphaMethylPhenyl]

Very terrible thing he did to his brain.

I'd guess that immediate cessation of klonopin, despite its half-life, if taken for several months or longer, would create rebound agitation, mania, and very well could lead to psychotic symptoms itself. Stopping 4mg- 6mg means mortal danger via seizure territory--very foolhardy.

These psychedelics are very serious business. No one should attempt to self-medicate with them. Trials have accounted for many variables before super cautious administration.

Holy moley: midazolam, ketamine, propofol, fentanyl, and diazepam yielded "little effect" on calming him down.

Six months of daily use itself would break most people. But with an MAOI added, that's on a new level of harm. They're not effective as a daily thing at such doses (if daily at all). It's a very periodical thing.