Possible interaction between LSD and Etifoxine/Stresam

[IttVagyok]

Hi there! I need your advice, but first of all please pardon me if I don't use the correct terms, I'm obviously not as knowledgeable as you people here, it's my first time with "mental health medication" (no idea how to put it otherwise), and it's also my first time posting here (apart from my introduction to the forum earlier). Thank you.

I've been having a depression episode since late November after a couple of stressing life events. I am feeling way better today, but still am on some medication (lighter than the previous one), which is: Etifoxine/Stresam 200mg daily (100 in the morning, 100 in the evening), + Atarax 25mg daily (before sleeping). I don't feel the Atarax does much (don't care either), but I can feel that the Stresam does have an effect, which is that I can feel sadness in the background, but it's not expressed physically that much. In other terms, things that would normally make me cry do not.

I would like to have a sort of therapeutic LSD trip (actually, probably 1P-LSD but I don't believe it makes a difference). It's worked with me a couple of times in the past, and I also believe it would help me quit cigarettes, a stupid habit that I resumed one month ago (that too worked on me one day). Now my question is, what do you think the interactions with the Stresam could be? I've searched on the internet but couldn't find an answer to that question, just explanation of how the drug works, but that doesn't really help me at all. Would you advise me against the whole idea? Would you advise me to stop taking the pills a couple of days before?

Thank you

 

[Snafu in the Void]

I have never heard of this drug before, probably because it isn't available in the US. I looked into a possible interaction:

Etifoxine and the serotonergic system​

.....it is relevant to investigate possible interactions between etifoxine and serotonergic receptor ligands. Bourin et al, demonstrated in a mouse model of anxiety that the anxiolytic effect of etifoxine is modulated by the co-administration of 5-HT2A ligands.46 A serotonergic mechanism is thus involved in the anxiolytic effect of etifoxine. As etifoxine has no direct interaction with the serotonergic system, these results suggest that the anxiolytic activity of etifoxine is subtended by a relationship between the serotonergic and GABAergic systems.

So, it has no direct action on serotonin, but certainly may interact with LSD. "Modulated by 5-HT2A coadministration." LSD hits 5-HT1A, 5-HT2A and several other sites, but those are the main ones. So yes, it could interact with LSD.

I'm actually immediately fascinated with this medication you are taking!! Very intriguing.

But to answer your question: I just don't know yet. There is very very likely an interaction that could occur. It could be minor, nothing, or it could be potentially dangerous. It could even be a desired, beneficial interaction. I just don't know. I can't find any anecdotal information. I need to do more research, this is exotic pharmacology to me (anxiolytic as potent as benzos but works on serotonin!?!? so intriguing!)

You would likely be just fine if you stopped taking the etifoxine for a day or two before taking the LSD. Maybe a few days just to be safer.

It is not the same mechanism as antipsychotics which block LSD completely. Nor is it the same mechanism which makes certain SSRIs dangerous with LSD. This is unique.

As for the hydroxyzine there is no worry for interaction there.

In my psuedo-educated opinion, I think if there is a major interaction, etifoxine would probably reduce the effects of LSD if anything, but I could be wrong.

Let me ask you, does etifoxine have a cumulative effect? or is it like hydroxyzine in that you feel it immediately and build a tolerance?

 

[IttVagyok]

Thank you very much @Negentropic for this detailed reply.

Let me ask you, does etifoxine have a cumulative effect? or is it like hydroxyzine in that you feel it immediately and build a tolerance?

Sorry I'm not sure I really understand the question. What does "a cumulative effect" mean?
Let me explain how I understand it (and keep in mind it's the first time I experienced with all that). The first prescription that was given to me late November was some SSRIs (I forgot the name) and benzodiazepines (Seresta 50, one tablet before bedtime). I wasn't properly monitored (literally left alone) and had no one to talk to to discuss the side effect that I was experiencing (I wish I knew Bluelight!) and that I found very unsettling, if not outright distressing. After about three/four weeks I halved the dose for five days, and stopped taking them. Apparently it is surprising for most people when I tell it, but I believe that three/four weeks of benzodiazepines were enough to really really mess with my sleep. I literally couldn't fall asleep, and after three days of sleep deprivation I started almost hallucinating, went to the doctor and then was prescribed the Stresam and Atarax. I tell you all that because that's all I can compare with to explain how I feel the Stresam works.
First, while the Seresta really made me sleep, and sleep well, I'm not sure the Stresam works as well on it. I sleep lightly, often wakes up, but that's generally how I sleep anyway. Also, I don't feel "crushed" like I was with the Seresta. Finally, I have the impression that the effect of the Stresam took some time to hit, maybe two or three days. They calmed my general anxiety, and above all, I do not feel like crying, even if I feel some sadness.
Curiously, I don't feel that the hydroxyzine has any actual effect, or maybe it's very subtle. I forgot to take it once and did not notice any difference.

 

[Snafu in the Void]

Sorry I'm not sure I really understand the question. What does "a cumulative effect" mean?

I'm just curious about it's pharmacology. Is it like a benzo with an acute effect that ends after a few hours? Or does it cause a gradual change such as an SSRI antidepressant? Did you get an immediate effect on your first dose? Did you build a tolerance to Stresam?

I believe that three/four weeks of benzodiazepines were enough to really really mess with my sleep. I literally couldn't fall asleep, and after three days of sleep deprivation I started almost hallucinating,

Completely possible, very normal. You were experiencing rebound symptoms, which are the precursor to physical dependence/addiction

benzos are very potent drugs with a very potent effect, I never recommend anyone take them for more than 2-3 weeks

and yes, after 3 days of no sleep any human brain would start hallucinating, after 4 days it starts becoming severe! Hallucinations start at around 48 hours of insomnia. It's toxins building up in your brain (that only get removed when you sleep). And you were likely experiencing benzo rebound which will only serve to increase any hallucinations.

Stresam is so intresting, because I don't know how it works! But it's just as good as benzos, if not better, you say?

I haven't had time to look into stresam more

Curiously, I don't feel that the hydroxyzine has any actual effect, or maybe it's very subtle. I forgot to take it once and did not notice any difference.

I thought hydroxyzine was great for the first day or two, by day 3 tolerance was painfully obvious

it has a very rapid tolerance gain which is why you don't feel anything anymore

I would suggest you stop taking it every night, only take it when you really need to sleep, taking it daily becomes useless very quickly with no benefit

 

[Jabberwocky]

Apparently Etifoxine has very low rebound anxiety when abruptly ceased (compared to most other GABA drugs but particularly benzos) so it should not be too difficult to stop for a few days in preparation for a trip. However although the half-life of Etifoxine is only about 6 hours (so does not stay in your system for long) one of its psychoactive metabolites has a half-life of 20 hours - so stopping for several days before taking other drugs might not be a bad idea.

However, though I am not an expert in neuroscience at all, I did not see anything that immediately suggested it might interact dangerously with LSD in the few articles I glanced through when I saw this post. It seems Etifoxine only interacts with the serotonin system in a second hand way via the GABA system (though serotonin often has lots of downstream effects in other systems once activated) . It’s hard to say what it’s GABA activity might do to effect an LSD experience. If it is benzo-like it might greatly reduce the intensity of the experience.

Generally the GABA system is inhibitatory. It modulates the excitability of the brain, muscle tonus, vigilance, circadian rhythms, learning and memory and other stuff. Whereas LSD tends to remove inhibitory constraints within the brain (in terms of brain activity not necessarily external behaviour). It’s the switching off of these inhibitatory mechanisms that are thought to create the sensory distortions and psychedelic experiences characteristic of LSD.

So likely not a dangerous mix but one that will reduce the effects of LSD.

 

[IttVagyok]

@Negentropic

it like a benzo with an acute effect that ends after a few hours? Or does it cause a gradual change such as an SSRI antidepressant? Did you get an immediate effect on your first dose? Did you build a tolerance to Stresam?

Well, I have the impression that it is more "accumulative" then that the benzodiazepines that I was prescribed before. But I can't tell for sure. I believe it took me two days to realize that my anxiety was fading away and that sadness would not be expressed physically. Compared to it, indeed, the benzodiazepines were acting fast and strong.
I don't think I have built a tolerance, but it's been only not even two weeks that I'm taking it.

Completely possible, very normal. You were experiencing rebound symptoms, which are the precursor to physical dependence/addiction

I forgot to mention that the day I began (actually, not really hallucinating, more like being delirious) I also had the third shot of vaccine. Maybe it has something to do with it.

Stresam is so intresting, because I don't know how it works! But it's just as good as benzos, if not better, you say?

I'm not sure. When I was prescribed the benzos I was very, very agitated. I would cry for absolutely nothing and everything, twist my hands, roll my eyes around, jump at any minor sound, etc. The benzos really stopped that horrible behavior, but I was feeling very estranged, not myself. There was still a little me helplessly crying inside but I was keeping a straight face. I hated it, but it was a necessary improvement. I'm not sure if the Stresam would have been strong enough to do so the same.

@Perforated
Thank you for your reply. I'll follow your advice and take some days off the med before my scheduled trip.

 

[Snafu in the Void]

@IttVagyok worst case scenario, I'm sure you will be fine if you take LSD, but the smart thing to do would be to stop taking the stresam for at least a few days beofre you take the LSD

 

[Jabberwocky]

@IttVagyok do you have much experience with LSD and it’s analogues?

If you have a lot of untreated anxiety it is quite possible that the LSD might tap into that part of your psychology and give you a very deep and intense emotion trip. Personally I like cathartic trips where I end up having a good cry about shit in my life - but be prepared!

 

[IttVagyok]

@IttVagyok do you have much experience with LSD and it’s analogues?

If you have a lot of untreated anxiety it is quite possible that the LSD might tap into that part of your psychology and give you a very deep and intense emotion trip. Personally I like cathartic trips where I end up having a good cry about shit in my life - but be prepared!

You never have enough experience, haha! I did it maybe 20 or 30 times, I never counted. I indeed often end up crying but it's always very cathartic and… good. I feel generally feel relieved. I even sometimes experienced a sort of inner voice telling me to calm the fuck down (and I did) cause the world keeps spinning and doesn't need you to be so anxious. I remember one day during the first total lockdown (in France), I felt so relieved, it was amazing.
I was super anxious about a month ago when the depression hit, now I'm feeling way better. I'm still on a sick leave and would like that LSD trip to help me settle all this and help me resume a normal life.