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Memantine vs. DXM against Methamphetamine tolerance

vanboy5

Bluelighter
Joined
Oct 24, 2010
Messages
54
I am using long-acting dextromethorphan 120mg once daily as an NMDA antagonist to counter methamphetamine tolerance.

Yesterday, I bought a packet of memantine at a pharmacy, 10mg pills each. Memantine is interesting in that it not only is an NMDA antagonist, but also a serotonergic (5-HT3) antagonist and dopaminic (d2 recepter) agonist as well!

So in theory (hopefully someone out there could help hypothesise):

a) Would taking an extra 5mg or 10mg of memantine with long acting 120mg of dextromethorphan be enough to induce neurotoxicity (eg olney's lesions)?

b) Wouldn't this combo technically block methamphetamine's effects on serotonin and increase its dopaminic effects hence potentiate the usual symptoms of dopaminic hyperactivity (eg paranoid ideation, auditory/visual hallucinations, psychosis)?
 
I have no idea what memantine will or won't do, but why would you want to block meths affects on serotonin? Isn't that what makes it so much more enoyablethan regular amphetamine?
 
i think for me it's mostly the dopaminic and adrenergic effects of meth that does it for me, the latter effect amphetamine does not really produce. i'm more interested tho in how much memantine is enough to block nmda recepters and whether or not its dopaminic agonising effect will potentiate that of methamphetamines... thus leading to likelier to anxiety, paranoia etc.
 
I'm also starting a DXM regimen... 30mg of Delsym twice a day... until my memantine gets here - then I'm going to move to 40mg (20mg twice a day) - and I'm going to quit my benzos with the NMDA antagonism.

See this thread for more information (which I really think should be in ADD instead of other drugs because I've wondered about NMDA antagonism for awhile in regards to withdrawing from benzos and when I was looking for information on Lyrica, I stumbled on the NMDA thread which I would have missed entirely otherwise) http://www.bluelight.ru/vb/showthread.php?t=501875

Its very comprehensive. Memantine is a weak NMDA antagonist though so you will likely need 40mg for the desired effects though some seem to get away with 20-30mg. DXM, on the other hand, is a much stronger NMDA antagonist.

160mg of DXM seems like overkill. I've seen nothing but 60mg as being required. Its day one and I can already feel the effect its having on my valium (I'm about to pass the hell out) so I have a feeling that I will end up off the valium entirely by the time my memantine, which I ordered yesterday, gets here.
 
serotonin

Isn't that what makes it so much more enoyablethan regular amphetamine?

No. Methamphetamine has never been demonstrated in any among the few drug discrimination trials employing both stimulants for comparison to be more euphoric or 'recreational' than its N-desmethyl analogue. Nor is its affinity for the 5-HT transporter relevant in typically administered [read: in the naive or mildly habituated user] doses.

Would taking an extra 5mg or 10mg of memantine with long acting 120mg of dextromethorphan be enough to induce neurotoxicity (eg olney's lesions)?

Even if the occurrence of Olney's lesions in human users were to be compellingly demonstrated beyond all shadow of doubt, I would still respond: in those dosages, very likely not, so long as you're not coadministering substantial amounts of cholinergic drugs. But, as Dr. Kat777 so adequately put it, 120mg is indeed overkill. 50-80mg should suffice, especially if combined with the aforementioned dose of memantine (though that drug's inclusion in a regimen tailored toward reduction/prevention of tachyphylaxis is questionable).

The adamantanes' affinity for the NMDA ionophore is minuscule when compared to the more commonly employed reference agents for neurobiological research. Dizocilpine, ketamine, phencyclidine, and to a lesser extent, methorphan are the typical standards by which we make sense of the NMDA antagonists' properties and glean their many intricate interactions with the central nervous system. Given their evident and time-honored status as clinically effective dissociative anesthetics (minus the dizocilpine), it's unsurprising that these would be the go-to drugs for such purposes. While memantine may very well be helpful in slowing the advance of glutamate-mediated neurodegenerative diseases, the relative paucity of clinical data outside of that context gives me pause when considering it as a means of tolerance reduction. Its seeming lack of dissociative, amnesic, and anesthetic properties also makes me (and, as I recall, the authors of a recent review of the drug) suspicious as to whether it possesses the same gainful properties in humans as it does in rats. And yeah, I've heard the Goldilocks sales pitch more times than I can count - "Low enough affinity to cause no/few side effects, high enough to incur benefits x, y and z...juuuuust right." The often psychiatrically afflicted (and I mean that in no disparaging way) proponents of this wonder-drug frequently sound far too much like the fat kid expecting to have his cake and eat it without any concern as to its many varying consequences upon his blood glucose, insulin resistance, and burgeoning abdomen. Not to mention the ostensible lack of nutritional value.

While many will recommend that you try memantine monotherapy upwards of 30mg as a side-effect-lite alternative to the DXM, I actually think your idea is superb, provided that you have enough money to blow on a prescription for low-dose Namenda and a metric fuckton of cough syrup. Give it a shot, and if the side effects persist after 2 weeks, drop that shit licketysplit and keep up the DXM.

Also, any concerns regarding the completely theoretical risk of neurotoxicity should be swiftly swept from the mind so long as you're consistently coingesting amphetamines. Agonism of the postsynaptic alpha-2A adrenoceptors substantially lessens the neurotoxic impact of even the very highest doses of intravenous NMDA antagonists upon those poor rats' brains. As an added plus, the NMDA antagonists reflexively antagonize the neurotoxicity of the amphetamines (which unfortunately is a very real and practical threat to any non-antioxidant user) as well via an unrelated mechanism. This is a double win for you.

dopaminic (d2 recepter) agonist as well!

Memantine's affinity for the D2 receptor is restricted to its aberrant high-affinity conformation, the D2HIGH variant, a protein implicated in the pathogenesis of psychoses and other sorts of dopaminergic morbidity. Such binding is likely insignificant in 'normals,' and potentially quite precarious for the neuropsychiatrically vulnerable.
 
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5HT3 antagonism plays a role in amphetamine's induced monoamine release but i beleive the effects of at are minimal and should not interfere with any effects of meth. Also it appears that memantine reduces the anxiety induced by stimulants altough this effect is mild.

For a real drug binge i would gues DXM would be superior as its a much stronger NMDA antagonist, memantine does have a cleaner side effect profile and is a better choice when using to to slow tolerance to therapeutic doses of certain drugs.
 
No. Methamphetamine has never been demonstrated in any among the few drug discrimination trials employing both stimulants for comparison to be more euphoric or 'recreational' than its N-desmethyl analogue. Nor is its affinity for the 5-HT transporter relevant in typically administered [read: in the naive or mildly habituated user] doses.
Perhaps the problem is that I'm far from naive or mildly habituated, but meth is FAR more recreational for me.
 
Perhaps the problem is that I'm far from naive or mildly habituated, but meth is FAR more recreational for me.


Though I'm not metaphysically pretentious enough to deny or attempt a refutation of your personal experiences as a conscious subject (the object, I suppose, being meth), such anecdotal methods of assessment are [not to sound condescending] statistically meaningless when considered in the light of the available scientific literature. The trials I mentioned made good use of placebo and/or active controls, thereby minimizing the well-known confounds so common to inquiries such as these. By comparison, your fully uncontrolled 'experiments,' yielded 'results' that bear no statistical relevance to the so-called "average individual," and as such, won't be considered as reliable as the enumerations made within the (again, so-called) "hard science" discussed above.

That being said, there certainly is a reason for your brain's eccentric, inconsistent response. Ignoring for a moment the most likely explanation - the placebo effect - we could consider a few other less likely alternatives: selective cue- and context-dependent sensitization to the meth in specific; chronic hyper-responsiveness of the basal ganglia to periodic, massive dopaminergic influx (a common phenomenon in long-term stim users that likely predated their use in some capacity) that renders you supersensitive to even the slightest variance in drug effect (like, say, slightly quicker uptake or minutely higher affinity for a transporter), regardless of mechanistic similarity; or just a simple fluke of interdividual drug metabolism (like the rather common anomaly of CYP2D6 null humans, which appear to constitute ~10% of the Caucasian population, and are perhaps even more common among other races - incidentally, amphetamines are partially metabolized by this enzyme, as are a few other locomotor stimulants in common use).
 
No. Methamphetamine has never been demonstrated in any among the few drug discrimination trials employing both stimulants for comparison to be more euphoric or 'recreational' than its N-desmethyl analogue. Nor is its affinity for the 5-HT transporter relevant in typically administered [read: in the naive or mildly habituated user] doses.



Even if the occurrence of Olney's lesions in human users were to be compellingly demonstrated beyond all shadow of doubt, I would still respond: in those dosages, very likely not, so long as you're not coadministering substantial amounts of cholinergic drugs. But, as Dr. Kat777 so adequately put it, 120mg is indeed overkill. 50-80mg should suffice, especially if combined with the aforementioned dose of memantine (though that drug's inclusion in a regimen tailored toward reduction/prevention of tachyphylaxis is questionable).

The adamantanes' affinity for the NMDA ionophore is minuscule when compared to the more commonly employed reference agents for neurobiological research. Dizocilpine, ketamine, phencyclidine, and to a lesser extent, methorphan are the typical standards by which we make sense of the NMDA antagonists' properties and glean their many intricate interactions with the central nervous system. Given their evident and time-honored status as clinically effective dissociative anesthetics (minus the dizocilpine), it's unsurprising that these would be the go-to drugs for such purposes. While memantine may very well be helpful in slowing the advance of glutamate-mediated neurodegenerative diseases, the relative paucity of clinical data outside of that context gives me pause when considering it as a means of tolerance reduction. Its seeming lack of dissociative, amnesic, and anesthetic properties also makes me (and, as I recall, the authors of a recent review of the drug) suspicious as to whether it possesses the same gainful properties in humans as it does in rats. And yeah, I've heard the Goldilocks sales pitch more times than I can count - "Low enough affinity to cause no/few side effects, high enough to incur benefits x, y and z...juuuuust right." The often psychiatrically afflicted (and I mean that in no disparaging way) proponents of this wonder-drug frequently sound far too much like the fat kid expecting to have his cake and eat it without any concern as to its many varying consequences upon his blood glucose, insulin resistance, and burgeoning abdomen. Not to mention the ostensible lack of nutritional value.

While many will recommend that you try memantine monotherapy upwards of 30mg as a side-effect-lite alternative to the DXM, I actually think your idea is superb, provided that you have enough money to blow on a prescription for low-dose Namenda and a metric fuckton of cough syrup. Give it a shot, and if the side effects persist after 2 weeks, drop that shit licketysplit and keep up the DXM.

Also, any concerns regarding the completely theoretical risk of neurotoxicity should be swiftly swept from the mind so long as you're consistently coingesting amphetamines. Agonism of the postsynaptic alpha-2A adrenoceptors substantially lessens the neurotoxic impact of even the very highest doses of intravenous NMDA antagonists upon those poor rats' brains. As an added plus, the NMDA antagonists reflexively antagonize the neurotoxicity of the amphetamines (which unfortunately is a very real and practical threat to any non-antioxidant user) as well via an unrelated mechanism. This is a double win for you.



Memantine's affinity for the D2 receptor is restricted to its aberrant high-affinity conformation, the D2HIGH variant, a protein implicated in the pathogenesis of psychoses and other sorts of dopaminergic morbidity. Such binding is likely insignificant in 'normals,' and potentially quite precarious for the neuropsychiatrically vulnerable.

PA: It is an honour for me to see your responses to my thread. I don't think 120mg of dxm is overkill is it? It is long-acting... the recommended dose is 60mg in long-acting formulations. By overkill, are you referring to disassociation? I didn't realise Memantine is a weaker nmda antagonist than dxm. i suppose; however, as you say, with its fewer side effects and seemingly anti-amnesic properties, perhaps I could titrate myself weekly up to 20-30mg, starting with 5mg first & per week.

Sorry to go slightly off-topic, but I'm still trying to find a solution to stimulant-induced anxiety towards late afternoon. My limited knowledge (though ironically much wider boundary in terms of medicinal resources) has not yet enabled me to treat this with pharmacotherapy. Re-administration of the stimulant worsens anxiety, and so I now going to add psychotherapy, perhaps CBT into treatment.

By the way, what does OP stand for?
 
Pa:

I just tried sending you a Private Message... but then i realised I couldn't until i reached bluelight status. It went something like this:

I would still like to send you an invite as a gesture of my gratitude despite the fact that you are unlikely to make it!

However, I am also aware of the dangers for me and/or you if we were to exchange emails/addresses. So, just know that you are on my guest list as "P A".

It's been a grueling period. How safe is it would you say to post threads on this site? Mind you, this is probably paranoid ideation, for which I thank heaven I still have some insight.

Thanks again buddy. It's so nice to finally meet someone not only profoundly better versed in not only the English language than I but seemingly possess the same passion in pharmacology.

You've been a great help... not only to my knowledge, but my anxiety as well.
 
I don't think 120mg of dxm is overkill is it?

My apologies. I again spoke too soon, drawing upon my feeble, drug-addled memory to suit needs better served by a cursory review of the literature. 120 milligrams is indeed an optimal dosage that would likely marginalize side effects and subjective properties while maximizing therapeutic gain. The only concern of apparent verisimilitude relates less to the drug's debatable physical toxicity and more to its frequently bizarre effects upon the human psyche, and the subsequent behavioral toxicity that might ensue. However, I sincerely doubt that doses under 150mg will produce any long- or short-term complications - but caveat emptor: the endless tide of tachyphylactic progression remains of constant concern when even the most well-minded user stacks one ameliorative compound upon another. Each problem solved often leads by extension to yet another dilemma in need of another problematic solvent, and so on, ad infinitum.

Not to be a total buzzkill, but tolerance to the NMDA antagonists themselves via the classic [and apparently poorly reversible once instated] phenomenon of progressive ionophore upregulation and sensitization in response to the continued presence of the antagonist. Withdrawal of the anesthetic following chronic use can be far more injurious than most other drugs with less obtrusive actions upon such fundamental mediators of neurochemical homeostasis; it can be permanently incapacitating and assuredly life-threatening. Of course, this is highly dependent upon dosage, duration of use, and the individual in question. The dosages that you intend to take would very likely cause few serious issues, but given their gravity, the concerns are hard to dismiss.

While I understand that your ambitious goals may preclude a more conservative strategy, I strongly advise the adoption of a 5-on/2-off cycling schedule, wherein weekdays are populated by perpetual drug use, followed by total weekend abstinence (and perhaps with full weeks off every 35 days, just "to be safe"). This will hopefully stifle any potential adaptation to the methorphan (the tolerance to which is rather rapidly reversible) and further compensate for any heavy weekday amphetamine use.

Also, I forgot to mention last post: I'm sure you've come across posts on this site (among others) recommending the supplementation of magnesium as part of a tolerance-reducing regimen. Though a first glance at the literature makes it sound like little more than pseudoscientific absorption of silly marketing ploys, I'm beginning to wonder whether the idea truly does have merit when taken to the extreme. The divalent magnesium cation plays a crucial role in the inhibitory regulation of glutamatergic transmission at the NMDA complex. By 'stopping up' the ionophore in an entirely voltage-dependent manner, Mg++ ions act as a handy sort of atomic plug that is 'uncorked' following action potential allowing influx of calcium ions following the binding of an agonistic ligand (typically glutamate and its co-agonist, glycine). Magnesium is thus often referred to as an 'NMDA antagonist,' even though it bears little pharmacodynamic similarity to the class of powerful dissociative anesthetics, of which DXM is a member. These drugs bind at an entirely separate location within the pore itself, the 'PCP site,' uncompetitively blocking influx of Ca++ ions into the postsynaptic neuron, an effect that is fully independent of voltage. On the other hand, the adamantane drugs appear to have surprisingly similar actions as magnesium, allowing for their contrastingly side-effect-free profile.

As magnesium is an essential dietary nutrient whose supplemental administration has little noticeable impact upon vital biomarkers (let alone conscious mental state) in non-deficient individuals, conventional wisdom suggests that the animal studies in which clinically relevant effects were observed are merely representative of the many artifacts present in rodent research into the mammalian nervous system, and were likely obtained by unrealistic routes of administration (intraventricular injection, for instance) or insane dosing protocols (3424732894655739790 mg/kg). I quickly dismissed the 'magnesium is a functional NMDA antagonist' hype for these reasons. However, after reading that massive doses of magnesium salts have been efficaciously used as anesthetics and that the often life-threatening effects of such treatment were consistent with those of other centrally numbing agents (and bore some similarity to the reported effects of memantine overdose), I was forced to reconsider whether highly bioavailable salts of magnesium could indeed provide additive benefit when taken concomitantly with a sensible dose of methorphan. As it appears that memantine is essentially nothing more than a molecularly fancier and pharmacologically dirtier version of magnesium on steroids, you could probably save quite a bit of cash by just ordering some magnesium malate (or some comparable form) online. This could, of course, be administered consistently, and fully without regard to concerns of tolerance. Just a thought. Some links for verification/interesting info/relevant reading:

Magnesium deficiency increases ketamine sensitivity in rats

http://www.springerlink.com/content/064612695h4130l4/fulltext.pdf

http://jama.ama-assn.org/cgi/content/summary/LXVII/16/1131
 
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By the way, what does OP stand for?

As the case may be - alternately the object, Original Post; or the subject, Original Poster.

However, I am also aware of the dangers for me and/or you if we were to exchange emails/addresses. So, just know that you are on my guest list as "P A".

I suppose that now the honor is all mine, as I appear to have earned a spot on a guest list simply for offering knowledge and advice, something for which any sensible person expects no reward. I am again moved by your seemingly heartfelt sincerity, something that's becoming decidedly harder and harder to come upon these days. As I have myself been going through a rather bizarre and shitty set of life circumstances for quite some time now (seemingly with no one available to lend effectual support), your frank and personal tone take me aback somewhat, and instill some strange kind of hope within the realization that there is at least one thoughtful person in the world, no matter how many continents away, with whom I can directly share and converse at the click of a mouse and stroke of a key.

It's been a grueling period. How safe is it would you say to post threads on this site?

Reasonably so, depending entirely upon what you intend to keep concealed and from whom it must be kept.
 
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P A, it is very interesting that you bring up magnesium because I was wondering about that as well. I was thinking 1,000mg of magnesium a day in combination with the DXM would be a wise idea. Your explanation as to how it works admittedly flew over my head for the most part but it seems that magnesium might be a better idea than memantine for the purposes listed herein.

The question that I have is within this quote:

Not to be a total buzzkill, but tolerance to the NMDA antagonists themselves via the classic [and apparently poorly reversible once instated] phenomenon of progressive ionophore upregulation and sensitization in response to the continued presence of the antagonist. Withdrawal of the anesthetic following chronic use can be far more injurious than most other drugs with less obtrusive actions upon such fundamental mediators of neurochemical homeostasis; it can be permanently incapacitating and assuredly life-threatening. Of course, this is highly dependent upon dosage, duration of use, and the individual in question. The dosages that you intend to take would very likely cause few serious issues, but given their gravity, the concerns are hard to dismiss.

You seem to say that withdrawing an NMDA antagonist is dangerous? I am curious as to why you say this as I went through over a year of using DXM daily and quit cold turkey to no ill effects whatsoever. I also never gained a tolerance to DXM unlike ketamine, which seems to produce a rather rapid and permanent tolerance although with DXM I have now hit a wall in which I can not get any of the desired recreational effects from it at all (the fabled "50 trip limit"). It did not seem to have any negative repercussions when I abruptly discontinued its use and it was still very much recreational for me when I made the decision to stop using it. Surely it is far more dangerous to withdraw a GABAergic drug than an NMDA antagonist?
 
I went through over a year of using DXM daily and quit cold turkey to no ill effects whatsoever. I also never gained a tolerance to DXM

At what I can only assume were sub-anesthetic/-recreational doses, your experience was likely typical, as I've heard quite a few similarly unconcerned testimonials referencing the generally benign nature of methorphan as opposed to ketamine, nitrous oxide, or PCP. Perhaps dextrorphan's lower affinity for the NMDA receptor in comparison to the other commonly used antagonists limits its tendency to induce sensitization and, somewhat like memantine, prevents it from causing a meaningful degree of upregulation. This is something into which I need to further investigate before commenting didactically, so as to avoid, uh, talking out of my ass.

Surely it is far more dangerous to withdraw a GABAergic drug than an NMDA antagonist?

Arguably so. But this is strictly a matter of dosage and MOA, as "GABAergic" isn't exactly the most descriptive moniker when one considers the massive profusion of clinical/recreational drugs bearing that modality.
 
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I think the concern may have shifted from tolerance to stimulants to tolerance to nmda antagonists such as dxm. I think, like p a expressed, it is a concern one should not regard so lightly.
 
At what I can only assume were sub-anesthetic/-recreational doses, your experience was likely typical, as I've heard quite a few similarly unconcerned testimonials referencing the generally benign nature of methorphan as opposed to ketamine, nitrous oxide, or PCP. Perhaps dextrorphan's lower affinity for the NMDA receptor in comparison to the other commonly used antagonists limits its tendency to induce sensitization and, somewhat like memantine, prevents it from causing a meaningful degree of upregulation. This is something into which I need to further investigate before commenting didactically, so as to avoid, uh, talking out of my ass.

Just out of curiosity did you manage to find any evidence that dxm has a lower affinity for the NMDA receptor? What else out there could I use in place of dextromethorphan and memantine (exc. pcp, ketamine, or nitrious oxide) with more begnin unwanted side effects and less likelihood to develop tolerance?
 
Depending upon whom you ask, methorphan's affinity falls within the range of about 7,000nm.

http://www.ncbi.nlm.nih.gov/pubmed/18812887

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T0G-485RKXY-KM&_user=10&_coverDate=02/29/1988&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=97f1f3818337f165a25b592be2134a24&searchtype=a

What else out there could I use in place of dextromethorphan and memantine (exc. pcp, ketamine, or nitrious oxide) with more begnin unwanted side effects and less likelihood to develop tolerance?

My drug of choice: dextrorphan tartrate.
 
PA!! goood to hear from ya! will check out dextrorphan tartrate.... am on the 5-day on/2-day off cycle you recommended buddy. thx again.%)
 
PA!! goood to hear from ya! will check out dextrorphan tartrate.... am on the 5-day on/2-day off cycle you recommended buddy. thx again.%)

actually... dextrophan... may possess too strong dissociative properties than one would rather tolerate when taken with say desoxyn.
 
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