trying to get the psychedelic experience despite SSRIs and other psych meds

[hollywood_cole]

A few months ago, my girlfriend and I (actually, not yet my girlfriend at that point) had planned to make an afternoon of eating LSD, but a few hours and some doses (and a couple mushroom chocolates) later, it was apparent that she was unable to trip (I'd had one tab and was doing just fine). We quickly came to the conclusion that at least one of the medications she was on, likely prozac, was blocking the ability of the psychedelic to work its usual serotonergic magic.

We were hoping people here could give us some advice on how she might obtain at least some of the important subjective aspects of the traditional psychedelic experience, hopefully without inviting more danger than ordinary careful use of psychedelics, while also not messing with her usual prescribed medication regimen (with some minor exceptions), since it works and she's stable and happy (as much as anyone, give or take).

Her current regimen is:

"morning" (after waking up and eating a little something):
250 mg disulfuram
60 mg stratera
30 mg buspar
100 mg lamictal
1.0 mg ativan

"night" (before going to sleep):
100 mg trazedone
4 mg risperidone
80 mg prozac
30 mg buspar
200 mg lamictal
0.5 mg ativan


the stratera is the skippable one. maybe the disulfuram.


The important parts of the psychedelic experience for her are:
-open, free associative, weird, deranged, metaphorical thinking
-greater sense of connectedness to the universe in general
-the sense of newness/awe/wonder at the ordinary
-giggles, enhanced enjoyment of music and art in general (kind of a natural side effect of the first three)
-enhanced tactile enjoyment
-visual and auditory distortions are icing on the cake, but not the main event


So basically, all the things people love about the classic tryptamine experience. Since it seems like interacting with 5HT2A receptors is central to how those drugs work, and since it seems like SSRIs would interfere with that, and since prozac is the part of the regimen she is definitely not messing with, do we have any other approaches? What other classes of chemicals have people used to get similar subjective effects?

She took two "strong hits" of acid, and felt nothing (along with a couple of reasonably strong mushroom chocolates). I don't know, let's say she took 400 or 500 mcg of LSD total? I took one hit and I was in a nicely wired (if often a bit intense) trip that went for a good 10 hours.

MXE works for her, though results are inconsistent, mostly good, but requiring larger doses than most people I know. She gets the fun loopiness that everyone loves, and there's a bit of the change in thought pattern that tripping brings, but not so much the connectedness and awe and whatnot. Not really the complete experience. Her three trials with MXE were as follows, totaling 100 to 120 mg over the course of the night each time:
1 & 2) take 10 to 20 mg at a time pretty much evenly spaced out over an 8 hour or so period. smooth sailing.
3) front load by starting with 40, otherwise the same. starts great, ends up way too intense, a bit of vomiting like what you'd get from drinking too much, effect lasts way longer than the first two times, residual into early afternoon the next day despite starting around 10 the prior night. like what i'd expect if i took that much (i think i took 30 to 40 mg in the same time span, and that was on the higher side for MXE with me).

Are we tempting fate as it is? Is it safe to go back and try again with MXE, but the slower and steadier approach again? Is there anything anyone can think of that would get at the other subjective elements of the tryptamine experience that are missing? Is it possible that MXE might potentiate tryptamines or ergolines? Is it worth trying other tryptamines (e.g., 4-HO-DET, 4-AcO-DMT, 5-MeO-DiPT, 5-MeO-MiPT, 4-AcO-DiPT)?

Also, should she just stay away from phenethylamines entirely? MDMA, MDA, 2C-x the various -escalines? I felt like it was safer to assume there was a risk of serotonin syndrome since so many of those are significant serotonin releasers, and since I'm not sure what to expect there. I know I've heard that people on SSRIs usually can't roll, and I remember some early college drug advice about an SSRI at the tail end of a roll warding off the next day blues (for which I did hear a reasonable mechanism of action proposed years later in ADD on BL, when it was still called ADD).

Any and all advice is welcome. Sorry if this is rambly or not as coherent as I'd like, it's late and it's been a long few weeks. I'm hoping that this makes the cut for NPD discussion, since it offers the opportunity to geek out over what receptors and pathways might be used to circumvent the ones that are already being utilized by other chemicals. We're trying to get some good advice on this before heading out for vacation week after next, between when she finishes school and starts work. I procrastinated as usual.

Thanks very much, everyone!

 

[sekio]

If she's on 4mg of risperidone that's... a pretty seriously heavy dose of an industrial strength anti-psychotic. I'm going to go so far as to say that's going to be a major hurdle. Way more than the SSRI. Risperidone is pretty much a chemical straightjacket, it will effectively kill a trip and probably immobilize the tripee. (I've been pumped with Haldol after a 3-MeO-PCP overdose, trust me, it wasn't fun)

I suspect those generally do not react well with dissociatives, having a tendency to result in people going catatonic. Or just curling up in the corner and passing out. But you could attempt it, especially if she's stabilized.

Honestly though, if she's on that many meds there's simply no way that any of the classical psychedelics are going to work effectively. Maybe you could try DMT which has a chance of simply overwhelming all the receptors. But even so, the presence of anti-psychotics and several mood stabilizers makes me think that her serotonin receptors are probably blockaded for a damn good reason.

You'd have to make major changes in medication to get any of the "classic" psychs working. MDxx is probably off the limits too. As well as most amphetamines, actually, if she's on risperidone and stuff like Strattera. Most of her monoamine transporters and receptors are gonna be busy dealing with the cocktail of a dozen other drugs. I wouldn't discontinue any meds just to trip, doubly so at the dosages she's on; that's how people lose their shit and end up in a hospital or mental ward, in general.

Even some of the the effects of MXE/ketamine etc will be blockaded by e.g. risperidone. I suspect that due to the large and diverse array of other chemicals she's on that the whole affair is probably going to be less fun than you'd expect. Maybe try taking up yoga?

(I guess salvinorin would work, too. The kappa opioid receptor is unblocked, so you're good to go in that aspect. But salvia is... unforgiving, to say the least.)

 

[adder]

Trazodone and buspirone are also 5-HT2A antagonists to an extent, so they'd inhibit a psychedelic trip in the absence of risperidone, I imagine. Also, in my opinion a psychedelic trip is not exclusively about 5-HT2A activation and a few other 5-HT receptors play an important role in creating the nature of the experience (at least these three: 5-HT2B, 5-HT2C, 5-HT1A). Thus if you're pumped with so many drugs and almost all of them interact with serotonin receptors in some way, the experience is always going to be ruined, I'm afraid.

 

[serotonin2A]

In addition to what the others said, Lamictal itself will likely block many of the effects of dissociative anesthetics (such as ketamine and PCP) and serotonergic hallucinogens.

http://www.hindawi.com/journals/cricc/2014/916360/

http://www.ncbi.nlm.nih.gov/pubmed/10711913

If she is taking risperidone, trazodone, and a pretty high dose of fluoxetine in addition to the lamotrigine then there is no way she is going to respond to LSD. Her medication is really a triple killer in regards to hallucinogens like LSD. First of all, chronic fluoxetine (and probably risperidone and trazodone) will cause 5-HT2A downregulation, so there will be fewer receptors for LSD to activate. That in itself will blunt her response. So even if she completely stopped all her meds then she still might not respond to LSD very well for a few weeks. But on top of that, she is taking a pretty substantial dose of risperidone (4 mg). Risperidone alone can completely block the effects of hallucinogens by occupying 5-HT2A. Franz Vollenweider was able to show that with psilocybin and I think he was able to do block it with a lower dose than your girlfriend is taking:

http://www.ncbi.nlm.nih.gov/pubmed/9875725

And then, on top of all that, there is the lamotrigine, which acts downstream from 5-HT2A. So even if she could somehow bypass all the other problems I listed above, the LSD probably wouldn't do anything.

 

[hollywood_cole]

Thanks for the info, everyone. Good to know about the lamotrigine and its possible attenuation of dissociatives. That one's also got no wiggle room, so I guess that is what it is. Is there any particular danger in continuing to experiment with MXE, esp if titrating up slowly? Besides the obvious dampened effect and possible unpredictability in responding to a given dose on a given occasion.

After reading the replies, she pointed out that the risperidone is taken off-label as an anxiolytic and sleep aid, and that she's comfortable skipping it for a short while (she's forgotten to take it along on vacations before, with no problem). I thought a safe(ish) plan of attack might be as follows (she also found this line of thinking reasonable): Don't take the risperidone for a couple days. If the first day after not taking it feels fine, dip a toe in with a small bit of a tryptamine (mushrooms are attractive for the lack of stimulation, but powdered ethocin is easier to dose accurately). My concern is that not only would she be omitting the risperidone, she'd be taking something that has a largely opposite effect. But since it was a later addition to her regimen, and since it's not central to it in the way that the fluoxetine and lamotrigine are, it feels like there might be a bit of wiggle room there. Is that wishful thinking? Are there particular gotchas we're not imagining? It sounds like ativan and risperidone can be taken as needed in the moment if things turn towards panic attack territory, and she's not taking risperidone for psychosis, so (right or wrong) we weren't too worried about an actual exacerbation of existing psychotic symptoms (since there weren't any to exacerbate).

To sekio's point about DMT maybe being able to break through, that thought had crossed my mind too, back when I first started thinking about this, but I had no idea whether that was reasonable. I was basically just thinking that DMT has such a reputation for its intensity that it might be worth considering. So maybe we'll look into that. Is it that DMT has a higher affinity for the receptor(s) than other things it'd be competing with? The fact that it's smoked and reaches such a high concentration so quickly? And not that we'd considered it, but it definitely seems like oral DMT is off the table, both for its ridiculous duration and intensity, and for the huge danger that MAOIs would seem to introduce.

And... she's not particularly interested in salvia, based on one very unpleasant experience in the past, and its generally poor reputation for any immediately pleasurable aspect (even if psychedelia is an inherently difficult experience to some degree). But I like the line of thinking here. Can anyone else think of any similarly atypical psychedelics?

To sekio's yoga recommendation, that's a funny coincidence since she was complaining the other day that it's been too long since she did yoga as a workout. Not the answer she was looking for, of course, but point taken. But the "artificial" route does have its unique charms (not actually being pejorative, I'm a fan of the artificial route myself, obviously).

 

[ovo1024]

Trazadone, risperidone, lamactil, prozac, AND a benzo? Ha good luck. Not tryna be rude but all those drugs except the ativan which dampen any trip in general, they all block the receptors needed. Unless she quit all cold turkey for a lil while (except the ativan) she pretty much has no chance of getting high. ijs

 

[MyExcuse]

Been on 200mg Lamotrigine for about 2 years now, no negative effect noticed on either MXE or any classical psychedelic.

I may be an exception, but I've read a number of anecdotes about people who have used both without negative (or no) effect.

 

[Arsenic_X]

i dont post much, but this topic has brought me out of the shadows. (and probably the weed)

when i was younger, around 16-17 (so bout 6-7 years ago) i was regulated on 200 mg lamotrigine 2x a day, along with 6mg paliperidone (9-hydroxy-risperidone) and of course SSRI's, NDRI's and countless benzos. i remember being able to use DXM, although at high doses (750-1000+mg) and it would almost always be a 24 hour or more ordeal.

If we're looking for non-classical psychedelics here, why not try marijuana edibles or even concentrates? It surely can cause a semi-psychedelic experience in certain cases.

 

[serotonin2A]

Been on 200mg Lamotrigine for about 2 years now, no negative effect noticed on either MXE or any classical psychedelic. I may be an exception, but I've read a number of anecdotes about people who have used both without negative (or no) effect.

I don't know if you would notice all that much change -- at 300 mg lamotrigine there was about a 50% reduction in the response to IV ketamine. With 200 mg you would see less of a reduction -- maybe 30%?? That might not be that much of a subjective difference. But for someone who is taking several other antidepressants, mood stabilizers, and antipsychotics, taking lamotrigine on top of everything else is just going to make it that much harder to experience any hallucinogen effects.