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MDMA Recovery (Stories & Support - 4)

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Just a quick question, when people say they've been suffering from head pressure, what exactly do they mean? I've been suffering from daily headaches since my overdose, and I can understand how the head pain can be referred to as head pressure, but is head pressure even painful? I'm just trying to understand if there are similar traits between what is happening to me and other users who are suffering from LTC's. I just returned from London where I saw a top neurologist and we went over my case. He told me I have new daily persistent headache as a result of either a neck problem, or very likely the MDMA overdose. He gave me a prescription for Clonodine which I have yet to carry out. It's been 4 months and I've seen improvement in terms of anxiety, sleep and cognitive function, so I basically feel normal, but I've still got debilitating head pain.. So I'm trying to establish whether it is related to a LTC or something else.. Cheers guys and keep believing in yourselves, this feels like a never ending marathon, but hopefully we'll make it.
 
Headaches can often be related to scalene muscles (in front of the neck). You might also find your headaches are related to standing up too quickly and getting low blood pressure. The anterior neck can contribute to that via compressing the arteries.

Scalene issues are common with anxiety because of chest breathing. Scalenes are kicked in as accessory inhalation muscles during panic breathing (they elevate the 1st rib and allow the lungs to expand further).

The other thing to consider is occipifrontalis type muscle tension headaches, often from jaw tension (temporalis) as well. With raising the eyebrows in an attempt to compensate for fatigue from insomnia and having the eyes open for long periods, headaches. So trying to relax your eyes, eyebrows and jaw, especially while reading, may help.
 
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shugenja said:
You do realize that those are actual bits of stuff (blood, proteins from normal aging, microscopic bits of tissue, etc) that is floating in the vitreous humor of your eyeball and is COMPLETELY NORMAL. You are just noticing them.

Don't you?
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Umm they're not normal.....sure they might have always been there, but my LTC brought them to the surface. Honestly everyone was telling me floaters are fine and not to worry after my OD, so I took that advice and partied hard for 2 days and drank since I was feeling fine otherwise.....and hell broke loose and I noticed even more floaters....so surez they were probably always there...but IMO they become more noticeable because of changes in your brain. I was told by Dr. Abraham they're a HPPD symptom, since they're so large and not something within my eye. They're just annoying, not something I worry about.
 
So my headaches don't have anything to do with head pressure? I just don't see how I lived so long with no headaches and then suddenly I have an overdose on a 4MA drug and then a few days later I have daily headaches, bit of a coincidence? I'm going to try Clonidine for two weeks to see if it helps and if it doesn't my neurologist has suggested an occipital nerve block. He said they used to administer Clonidine a lot in the 70's for people suffering the aftermath of ecstasy and sometimes it can work even in just a few weeks. Otherwise he said a nerve block should work. Thanks for replying so quick Cotcha.
 
Sounds like you have a good doc, I wish I was prescribed clonodine early during my LTC but none of the docs I saw knew anything about X damage, just thought I was depressed.
 
He's pretty good yeah, he knew all about MDMA and ecstasy related damage, had lots of patients like that. What medication have you tried and how is your recovery going?
 
I was prescribed mirtazapine, a low dose, but the first day after taking it I saw visual snow and waving walls. I took it for a couple months cuz it helped me sleep, but I wish I didn't. I'm sleeping relatively ok now with no pills, but I still have tinnitus, bad floaters, tingling face, and muscle twitching. I'm a lot better than first month that was absolute hell, but still a long way to go. 5 months in.
 
ADubbs said:
Umm they're not normal.....sure they might have always been there, but my LTC brought them to the surface.
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Even typical floaters (particles, not HPPD color blobs) can worsen with dehydration, so it may not be the best to assert that they've always been there and someone is just noticing them more because of anxiety when they're known to be worsened after dehydration and someone had used 2 very dehydrating substances right before they got worse.

And they could certainly become even more noticeable because of changes in the brain, MDMA users have been shown to have hyper-excitability visual systems (as well as auditory systems).
 
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BelgianBear said:
So my headaches don't have anything to do with head pressure?
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I'm not sure what's going on with your headaches, but I imagine it's either due to musculoskeletal issues or vascular issues (vasodilation is the cause of migraines, there are actually no real pain sensors in the brain). But if it's not consistent with migraine, it could be more musculoskeletal. Occipital muscles do supposedly contribute in many cases.
 
That's interesting, for a while I thought of head pressure as what I had but I guess it's a totally different thing. Yes my doctor thinks it's musculoskeletal/caused from ecstasy. In the first case due to sever muscle spasms in my neck caused from my overdose. In the second case prescribing me clonodine to bring my metabolic blood pressure back to baseline. So you are right, I'm just not responding to treatment that well and it's really quite depressing. Either way I need to make my mind up if I'm going to start taking clonodine sooner or later, even if I'm not fond of the various side effects..
 
To me personally, just going off of the term "head pressure", it sounds more like an occipifrontalis type thing (if its in the front of the head by the eyes), but I'm not sure.

What side effects are you getting from the Clonidine?
 
ADubbs said:
I was prescribed mirtazapine, a low dose, but the first day after taking it I saw visual snow and waving walls. I took it for a couple months cuz it helped me sleep, but I wish I didn't. I'm sleeping relatively ok now with no pills, but I still have tinnitus, bad floaters, tingling face, and muscle twitching. I'm a lot better than first month that was absolute hell, but still a long way to go. 5 months in.
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It seems like there is an incredibly wide variation with what meds help HPPD in what people. There also seems to be issues regarding how one describes HPPD in the literature. For example, HPPD used to be considered "LSD flashbacks", which are a bit different than having constant visual snow etc., at least in my opinion, although they may overlap.

So clonidine for example seems to help with LSD flashbacks in one study, and mirtazapine is opposite in one particular effect to clonidine. Clonidine will still be good for sleep, but the mechanism that may have caused increased visuals with mirtazapine may be the opposite mechanism that you see with clonidine.
 
Belgian have you had any sort of brain scans? Might be worth it to rule anything else out.
 
fnono33 said:
Cotcha, can you expand on how clonidine will affect visuals?
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Sure, so we have this study in particular https://www.ncbi.nlm.nih.gov/pubmed/10836284/ "LSD-induced hallucinogen persisting perception disorder treatment with clonidine: an open pilot study." "LSD-related flashbacks associated with excessive sympathetic nervous activity may be alleviated with clonidine in some patients." So there is some evidence there.

As far as the mechanism, Mirtazapine is an agonist at adrenergic a2a receptors, while clonidine is an antagonist at a2a receptors. A2a receptors are pre-synaptic inhibitory autoreceptors, meaning that when an agonist (like mirtazapine) binds to a2a receptors, the pre-synaptic cell releases more norepinephrine and serotonin. When an antagonist (like clonidine binds to a2a receptors and blocks them, the pre-synaptic cell releases less norepinephrine and serotonin, which has a sedative effect. The a2a agonism of mirtazapine becomes more and more relevant at higher doses, which can be good for depression but can also cause insomnia. The sedative effect of mirtazapine at lower doses (like 15-30mg) is due to the antihistamine effect for the most part.

If we assume that the worsening of visuals with mirtazapine was due to its a2a agonism, then its possible that clonidine's a2a antagonism could have the opposite effect. The issue is that mirtazapine is not a selective a2a agonist, so we may not be able to say what effect of mirtazapine was causing increased visuals.

There seems to be an incredible amount of variety when it comes to reactions to medication in HPPD patients, this is noted in the literature, so there may be no hard and fast rules here.
 
Thank you. So clonidine works on the serotonin receptor? or is the a2a something else? I wonder if it's possible to have the opposite effect as well. Could it clonidine actually increase visuals?
 
So this a2a receptor is expressed on different cell types, including serotonergic cells, meaning that if mirtazapine binds to an a2a autoreceptor on a serotonin cell, it's going to cause increased release of serotonin. Same thing for if it binds to an a2a receptor on a different cell type, it'll cause increased release of whatever neurotransmitter(s) that cell releases. The increase in serotonin and norepinephrine (among other neurotransmitters) seen with mirtazapine via agonism of these a2a receptors is thought to underlie it's antidepressant effect.

I personally think Clonidine is an okay bet, I would've taken it if I didn't get low blood pressure from it (it's great for sleep). But you will gain tolerance eventually, and I'd expect insomnia on the withdrawal. They used very low doses in the study regarding HPPD though. I would expect too much issue coming off of .1mg after being on it for a couple weeks.

As always any questions are welcome.. How is the mindfulness/cardio going?
 
Cotcha Yankinov said:
So this a2a receptor is expressed on different cell types, including serotonergic cells, meaning that if mirtazapine binds to an a2a autoreceptor on a serotonin cell, it's going to cause increased release of serotonin. Same thing for if it binds to an a2a receptor on a different cell type, it'll cause increased release of whatever neurotransmitter(s) that cell releases. The increase in serotonin and norepinephrine (among other neurotransmitters) seen with mirtazapine via agonism of these a2a receptors is thought to underlie it's antidepressant effect.

I personally think Clonidine is an okay bet, I would've taken it if I didn't get low blood pressure from it (it's great for sleep). But you will gain tolerance eventually, and I'd expect insomnia on the withdrawal. They used very low doses in the study regarding HPPD though. I would expect too much issue coming off of .1mg after being on it for a couple weeks.

As always any questions are welcome.. How is the mindfulness/cardio going?
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Ok, I may go off of it soon. Man, it's so hard to know. My visuals I think are leveling off. They were getting worse for a while. The clonidine really does help me sleep though. Overall, I got every symptom and I'm emotionally and physically pretty drained. Hoping to get some relief soon from the bad couple days that I've had. I am trying with both mindfulness and cardio. Mindfulness gets really difficult at time because I really have nothing going on in my life. My legs fee like jello so its hard to get on the bike for cardio.
 
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Unfortunately both mindfulness and cardio take some time to work their magic, so its easy to get discouraged when you don't see progress right away. I encourage you to remind yourself that these things will take time to make a difference, but that because it takes time and is not easy, the difference will be long lasting.

Cardio especially when one is chronically deconditioned doesn't work miracles overnight, but will work miracles over many months. But its probably going to take a couple weeks of cardio 3-4 times a week to see much difference and get that momentum rolling. Muscle growth can take a little while to get rolling, the first month I wouldn't expect much difference, although that could be different for everyone. Make sure you eat enough carbs and protein.

Hang in there.
 
It's funny you wrote that because i just ate some food (carbs and protein) and my mood improved a bunch.
 
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