Anti-addictive agents

[Overcoming]

Addicts repeat particular behaviors over and over again because of reinforcement via the dopaminergic system, and eventually those behaviors begin to take up more and more of their time -- addicts don't randomly start exhibiting new behaviors or compulsions.

Escalation/Tolerance.

If you are constantly developing new obsessions or compulsions then you might have a disorder such as OCD.

Perhaps. Will have to wait for the doctor for that one.

The way you are describing what happened sounds like sexual assault, but you apparently chose to put yourself in that situation. So-called sex addicts may have more sex then they are happy with, but they don't loose the ability to control whether their partners are male or female (just like drug addicts don't loose control over which substances they ingest)

Again, tolerance/escalation in some people. Take a look at the NoFap forums - lots of men escalating to transexual escorts from that porn. BTW I COULD NOT STOP MYSELF FROM GOING THERE, ELSE I REALLY REALLY WOULD NOT BE IN THIS POSITION. Please, please take my word for this. My friend, if I could not have gone, I would have got back on that bus and gone home. It was absolutely irresistable.

It felt like a magnetic force dragging me there - seriously. I really believe this is consistent with a dopaminergic/opiate receptor issue, PERHAPS amongst other things.

You could have just walked away.

On my life, I could not. Absolutely 100 per cent impossible. This quote hits the nail on the head, like no other: It came on slowly, a clenching in the stomach, ''and then I was totally out of control -- I had to have a woman.''

Finally, a quote from Martin Kafka:

''I hate that idea,'' Kafka says. ''The paraphilias and P.R.D.'s are not a form of O.C.D. People who have O.C.D. do not have an appetite-disregulation disorder. O.C.D. is not about appetite. Sexual-impulse disorders are all about appetite.''

 

[d1nach]

Actually i felt great after having a guy in my butt. All im trying to say is there are people who have the opposite views as you and all the things you describe from my point of view dont seem like something wrong with you. I guess all im saying is even if you where addicted to sex it sounds like your not loving yourself because of it instead of loving yourself inspite of it independently because your more than your few brief lapses in desire.

If you feel really depressed maybe you could try ssris they reduce sex drive but also might help with feeling like you wanna die because that really sucks. I actually attempted suicide and since being on a snri and lithium feel muc mhhbetter.

 

[Overcoming]

You are also making a big assumption here, which is that I am not female, or a homosexual/bisexual man. Some people like to have sex with men. So much of your discomfort is based on a value judgement, namely that sex with other men is disgusting.

Absolutely it disturbs me. Because all of a sudden, out of nowhere, this happpens. You, yourself said it was traumatic. Can you see, or try to see, how de-stablising that could be? Just because you don't care, doesn't mean it is going to affect everyone the same.

Also, the craving, that magnetic force feeling, and the obsessive thoughts are 100 per cent un-live-able. Regardless, this has to go, and it is looking like part of that war, will require a chemical attack.

Hence my effort to source anti-craving medication, and really, the title of this thread.

BTW in reference to above, I am not saying that OCD is not also present. I am just saying that I don't think it is all of it. But what will the doctor say..

 

[Overcoming]

Well, I don't want same sex or biseuxal attractions. If that works for you, then great, I am not going to care. But this incident has added nothing to my life. It has only taken away. I was happy with women before.

 

[Overcoming]

Whatever is going on, I am just sick of it now, I want some help and I want to get better.

 

[serotonin2A]

The behavior you described is not how tolerance is expressed in addictions. The situation you described is akin to a heroin addict who starts using cocaine because heroin is less effective. Clearly that isn't what happens in heroin addicts -- tolerance causes addicts to use higher doses and more often. As another example, in people addicted to gambling, tolerance is displayed when they start to gamble more often, or for higher stakes. The entire framework of addiction is that a particular behavior is reinforced, and that behavior eventually becomes habitual. Drug use becomes habitual because the behavior becomes hardwired in a brain region known as the striatum, and that change is one of the primary factors underlying compulsive drug use. People who smoke cigarettes will litterally pick up a cigarette and light it with no conscious intent. That phenomenon is what is responsible for compulsive drug use. What you are describing is the complete opposite. You may have felt a compulsion to have sex with transexuals, but that wasn't driven by a habit, but rather by some other psychological factor. That is why it is problemmatic to think that ibogaine will help you. Ibogaine doesn't magically treat any behavior labeled as an "addiction", but rather it apparently acts on striatal circuits and other brain regions in a way that allows addicts to break away from their habitual behavior. There are many other types of compulsive behavior that individuals can exhibit that are not affected by ibogaine.

I'm not suprised that there are other people you found on the internet that moved from pornography to prostitutes or other uncommon sexual behaviors. But I don't understand what that really has to do with the validity of sex addiction as a diagnostic criterea? They may be suffering from exactly the same issues that are causing you to feel distress -- that doesn't mean that you or those other individuals are actually suffering from an addiction, as opposed to some other disorder.

The compulsion that you are describing to have sex doesn't strike me as being abberant. Many people feel an irresistible drive to have sex, and that causes any number of problems in our lives. There are plenty of happily married men who find themselves divorced because they met another woman who they could not resist. What you haven't said in your posts is that you were not attracted to the transexual prostitute. It is entirely possible for a man to be sexually aroused by other men, even if they believe that sexual contect between men is disgusting. Many bisexual/homosexual men feel the same way as you. And many of them go through situations like the one you described, where they felt an irrestible urge to have sex with another man even though in their mind they don't want to have sex with other men. If it was so easy to ignore homosexual impulses then very few closeted homosexuals would end up having sex with other men. I don't know if you are bisexual -- that is something only you can know -- but I do think that many bisexual men with homophobic beliefs have had similar experiences. Although some people have a fetish for transexuals, some men find it "less gay" to have sexual contact with other men that look like women. I would strongly encourage you to explore this possibility in therapy.

 

[Overcoming]

People who smoke cigarettes will litterally pick up a cigarette and light it with no conscious intent.

That's exactly what I felt. I would find myself just "doing" certain behaviours literally out of nowhere, particularly masturbation. It would be in my home or somewhere where I could act these out, but this is the pattern that I would undergo. I've explained this to you.

Many people feel an irresistible drive to have sex, and that causes any number of problems in our lives. There are plenty of happily married men who find themselves divorced because they met another woman who they could not resist. What you haven't said in your posts is that you were not attracted to the transexual prostitute.

Lul what. Those men are selfish and have a "freer" choice than an addict. They just want to fuck another women and don't care about their marriage. Should they really want to, they can stop. This is a totally different situation. Im doubting whether you understand that - no fault of your own, but if you haven't gone through what I have then it would be hard to have that experience.

rather by some other psychological factor.

I have had no desire to do this all my life and previously would have never done this (before it actually happened). How did this happen out of nowhere? For the 3 months before this happened, over the summer, I did feel arousal and attraction to lots of different women living near me. I cannot remember ever having a single thought about transexuals.

The compulsion that you are describing to have sex doesn't strike me as being abberant.

Lost job, extreme distress and depression, never-ending anxiety, and cravings. You can switch places with me, if you like.

So you could classify compulsive overeating as a food addiction, but it turns out that it is actually not an addiction, but rather bulimia.

Why has buproprion/naltrexone been officially approved for it? (this year I think).

Would it disturb you as much if the prostitute was a woman? What about if it had just been a man you met at a bar?

No, I have used female prostitutes extensively. I recommend them to you. I don't go to gay bars to look for men to have sex with.

 

[serotonin2A]

That's exactly what I felt. I would find myself just "doing" certain behaviours literally out of nowhere, particularly masturbation. It would be in my home or somewhere where I could act these out, but this is the pattern that I would undergo. I've explained this to you.

You completely missed the point that I was making. Almost everyone feels that way about sex -- humans are naturally biologically programmed to perform sexual behaviors. Feeling a compulsion to have sex is normal. By contrast, feeling a compulsion to smoke is not normal. Developing a compulsion to smoke requires specific brain changes, but that is not the case with the sex drive.

Lul what. Those men are selfish and have a "freer" choice than an addict. They just want to fuck another women and don't care about their marriage. Should they really want to, they can stop. This is a totally different situation. Im doubting whether you understand that - no fault of your own, but if you haven't gone through what I have then it would be hard to have that experience.

You are being extremely hypocritical. How do you know they can stop? You say you can't stop!

You have never been diagnosed with an addiction, and it is very self-serving to self-diagnose yourself with a disorder that you convieniently think would absolve you of any responsibility for your actions.

Being an addict doesn't mean that you are absolved of any personal responsibility for your actions. One of the steps of AA and other 12 step programs is taking responsibility for your actions.

I have had no desire to do this all my life and previously would have never done this (before it actually happened). How did this happen out of nowhere? For the 3 months before this happened, over the summer, I did feel arousal and attraction to lots of different women living near me. I cannot remember ever having a single thought about transexuals.

It is not unusual for people to repress feelings and desires that they do not like. It happens often with sex because people have very strong opinions about what sexual behaviors are good and what behaviors are wrong -- views that may not match with what actually arouses them sexually.

Lost job, extreme distress and depression, never-ending anxiety, and cravings. You can switch places with me, if you like.

Did you loose your job as a direct response to the incident?

Why has buproprion/naltrexone been officially approved for it? (this year I think).

Because they are effective at reducing the symptoms of the illness. The argument that you are trying to make, which is basically that any disorder effectively treated by buproprion and naltrexone must be an addiction, is not valid. Buproprion is a antidepressant; monoamine and opioid pathways regulate eating, which would explain why this drug combination is effective. The approval doesn't mean that bulemia is a form of addiction, just as depression isn't an addiction.

 

[Overcoming]

Pretty much all you have done, is decided to argue my case with me in this entire thread.

Feeling a compulsion to have sex is normal. By contrast, feeling a compulsion to smoke is not normal. Developing a compulsion to smoke requires specific brain changes, but that is not the case with the sex drive.

This is getting extremely tedious now. Compulsive sexual behaviour is recognised as a problem. If if bothers you that much, go and argue with the psychotherapists and psychiatrists.

You can read this: https://www.amazon.co.uk/CBT-Compulsive-Sexual-Behaviour-professionals/dp/0415723809

You have never been diagnosed with an addiction, and it is very self-serving to self-diagnose yourself with a disorder that would absolve you of any responsibility for your actions.

1) Are you a psychiatrist? Serious question
2) Yes I have. Official dx: "sexual addiction with behavioural difficulties and DPDR disorder". I can't be bothered to retrieve the ICD codes. I am waiting to see the specialist because so far I have been seen by general psychiatrists who admit they do not know for sure in this area.
3) How am I absolving myself if I am on here reaching for help?

You are being extremely hypocritical. How do you know they can stop? You say you can't stop!

Okay, fine, I will take that back.

It is not unusual for people to repress feelings and desires that they do not like. It happens often with sex because people have very strong opinions about what sexual behaviours are good and what behaviours are wrong -- views that may not match with what actually arouses them sexually.

True, I can see how that makes sense, but I don't think it explains this too well. I really can't ever say that I wanted to fuck a transexual before this - hand on heart. It wasn't even on my mind. So how could it randomly come out. Then after ibogaine, the craving goes away for about 8 weeks completely.

Yeah I lost my job. I fucked that opportunity up big time in every way. That's not the worst. The worst thing is the FACT that this has happened and I feel suicidal nearly every minute of my day. My mind has completely broken.

 

[Overcoming]

I don't want to derail the thread but outta interest...what would you say if somebody was doing illegal things? I actually did an exhibitionist act which nobody saw...that's what made my psychiatrists so worried.

 

[serotonin2A]

Pretty much all you have done, is decided to argue my case with me in this entire thread.

I'm not arguing your case, I'm arguing about some of your assumptions. If you think the discussion is tedious then you certainly don't have to respond to my comments. I don't think I have derailed any discussions that you have been having with others, so feel free to ignore me.

This is getting extremely tedious now. Compulsive sexual behaviour is recognised as a problem. If if bothers you that much, go and argue with the psychotherapists and psychiatrists.

I never said that compulsive sexual behavior doesn't exist. I am arguing that sex addiction currently is not a valid medical diagnosis. The position that I am advocating is the current consensus in the psychiatric field, and you are the one who is arguing against it. That is all I am trying to point out, but you seem to think I am arguing that you don't have a problem. Whether or not sex addiction is a valid diagnosis does not mean that you don't suffer from a disorder, but it does have implications for whether you should be using ibogaine for self-treatment.

1) Are you a psychiatrist? Serious question

I work in a psychiatry/addiction-relevant field (I have a PhD in a medical field of study and I teach/conduct research on topics relevant to psychopharmacology and psychiatry).

2) Yes I have. Official dx: "sexual addiction with behavioural difficulties and DPDR disorder". I can't be bothered to retrieve the ICD codes. I am waiting to see the specialist because so far I have been seen by general psychiatrists who admit they do not know for sure in this area.

The relevant ICD diagnosis is probably F52.8 "Other sexual dysfunction not due to a substance or known physiological condition" and F48.1 "depersonalization-derealization". There is no ICD diagnosis of "sex addiction". You may think my comments are annoying, but you expressed interest in treating your illness with ibogaine. You are convinced that ibogaine will help with sex addiction because it helps with other addictions, so it is very important for you to consider whether sex addiction is really an addictive disorder that is likely to be helped by ibogaine. I think your approach of using ibogaine is a mistake, and so I am trying to get you to think about whether your planned approach is actually based on a good rationale. Ibogaine is not the safest medication -- a few people die after taking it every year -- so if there is no evidence that it would help a particular disorder then it is not an appropriate treatment for those individuals.

Yeah I lost my job. I fucked that opportunity up big time in every way. That's not the worst. The worst thing is the FACT that this has happened and I feel suicidal nearly every minute of my day. My mind has completely broken.

I might not have been clear, but I was asking whether you lost your job directly as a result of the incident (i.e, your boss found out, you were arrested due to the incident, etc), or whether the effect was indirect (e.g., not being able to concentrate caused you to receive a bad performance review). Whether or not your behavior directly caused you to loose your job likely has implications for how to best approach and treat your disorder.

I don't want to derail the thread but outta interest...what would you say if somebody was doing illegal things? I actually did an exhibitionist act which nobody saw...that's what made my psychiatrists so worried.

They would be right to be worried if you were planning to do something that is potentially harmful to yourself or others.

 

[Overcoming]

That is all I am trying to point out, but you seem to think I am arguing that you don't have a problem.

What do you think my problem is? (if not "sex addiction").

. Whether or not sex addiction is a valid diagnosis does not mean that you don't suffer from a disorder, but it does have implications for whether you should be using ibogaine for self-treatment.

What are the implications? Why do you think it would be such a bad idea (ignoring the deaths: very unlikely, I would only do micro-dose regimen). Or what about safer ibogaine derivatives like 18-MC or 18-MAC?

I might not have been clear, but I was asking whether you lost your job directly as a result of the incident (i.e, your boss found out, you were arrested due to the incident, etc), or whether the effect was indirect

Indirectly. I also stole money from them to pay for the prostitutes. But the worst thing for me is the transexual thing. About three years ago today, I remember going to a female prostitute. It was good. It was fun. I don't regret it at all and other than feeling a bit paranoid somebody would see me, there were no issues (somebody I knew did see me near the area but in the end it was fine - I said I was going to somebody's house).

I have been so stressed and so unwell with this Dp/Dr it actually feels like brain damage. I am half tempted to just say "fuck it, i will accept the transexual thing" if not to just preserve my once-fantastic memory and intelligence. There again, I don't want to very much.

I know a man who could not quit porn through a 12-step program, trying for 7 years, until he did ibogaine. He said that ibogaine was the only thing that sorted out his craving and gave him a chance. Why did ibogaine work for him? If "sex addiction" or "porn addiction" does not exist then how/why did it work? I know he is telling the truth, so rule out lying/exaggerating.

 

[Weltmeister]

I am half tempted to just say "fuck it, i will accept the transexual thing" if not to just preserve my once-fantastic memory and intelligence. There again, I don't want to very much.

Why? I genuinely dont understand whats wrong with transexuals.

 

[d1nach]

Im deff no doctor. All im saying is from my perspective watching porn daily is no big deal. So, there are people who feel like porn is bad and thats cool and people who use it and dont see it as a problem. Stopping porn could improve yourself. But, i think the problem is when you treat it like a medical issue instead of personal belief it can leave you feeling like something wrong with you when your sexual desire interferes with your ability to act how you ideally feel you should.

 

[Overcoming]

I'm a hell of a lot better without it in my life. It has caused enough problems and once I start watching it, I cannot stop.

I don't know about the transexuals.

What I can say abut all of this, is that I would very much like to address this now and get rid of the cravings/obsessive thoughts. Their magnitude and damage that they have caused is horrendous.

I have struggled immensely with confidence issues all of my life, but I have reached the point, where if I want sex, then I will meet somebody and go on a date or do something normal.

 

[Cotcha Yankinov]

RE: this guy with a porn addiction who was helped by ibogaine - I should point out that just because e.g. ibogaine helps somebody with "behavioral addictions", it doesn't necessarily mean that the a3b4 blockade portion of ibogaine did the trick. The benefits could have been from other effects, be it NMDA antagonism, kappa opioid agonism or the mystical experience.

Similar benefits could have even been derived from a classical hallucinogen such as mushrooms.

 

[Overcoming]

That is a good point. I think something in the pharmacology helped him because he did say that the craving aspect really dropped off, but the mystical could have been a key component as well (he trips out every now and again on other things, since that event).

The alpha3b4 thing sounds promising, hbased on studies I have seen. For me, it is good, because it avoids NMDA antagonism and kappa agonism.

I have DP-DR disorder, and the neurobiology suggests that NMDA antagonism and kappa agonism are key to this disorder. I did take some ibogaine total alkaloid, just after I developed DR. So in terms of timing, nothing could have been worse. But I genuinely felt like I needed something.

I think I should make a thread about DP-DR in the mental health section.

 

[Seppi]

I haven't read the first two pages of this thread, but there's a few things I want to comment on.

1. Compulsions are never "normal". If you can't stop performing a particular behavior at any point in time while performing it, your behavior is compulsive.

2. Compulsive sexual behavior is an addiction because it involves all the pathophysiological hallmarks of an addiction (i.e., amplified incentive salience [cravings] for sexual activity, impaired inhibitory control [inability to stop sexual behavior], conditioned reinforcement of sexual behavior [cue-triggered wanting/craving], and the induction of ΔFosB in D1-type medium spiny neurons in the nucleus accumbens). It really doesn't fucking matter if there's diagnostic criteria for "sexual addiction" because diagnostic criteria for mental health disorders are not based upon pathophysiological research; they're based upon clinical observations of people with a given disorder phenotype. Consequently, the diagnostic classification of mental health disorders in general lack validity.

3. Anti-androgenic compounds and depo-provera are probably the most effective, but also the most extreme, pharmacotherapies for inhibiting incentive salience for sexual activity (i.e., sexual desire and motivation for sexual activity) and therefore sexual behavior. Some less extreme pharmacotherapies can be found here: http://www.sepec.ca/docs/hypersex.pdf

 

[serotonin2A]

2. Compulsive sexual behavior is an addiction because it involves all the pathophysiological hallmarks of an addiction (i.e., amplified incentive salience [cravings] for sexual activity, impaired inhibitory control [inability to stop sexual behavior], conditioned reinforcement of sexual behavior [cue-triggered wanting/craving], and the induction of ΔFosB in D1-type medium spiny neurons in the nucleus accumbens). It really doesn't fucking matter if there's diagnostic criteria for "sexual addiction" because diagnostic criteria for mental health disorders are not based upon pathophysiological research; they're based upon clinical observations of people with a given disorder phenotype. Consequently, the diagnostic classification of mental health disorders in general lack validity.

I guess one problem for me it that one of the most important hallmarks of addiction is tolerance and withdrawal. Individuals with sexual compulsions typically do not show evidence of tolerance or withdrawal.

The argument you seem to be making is that induction of ΔFosB is somehow specifically linked to addiction. But ΔFosB is also induced in accumbens by stress (https://www.ncbi.nlm.nih.gov/pubmed/15564575), by natural rewards like exercise (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021978/), by environmental enrichment (https://www.ncbi.nlm.nih.gov/pubmed/24686135), and by sucrose drinking and normal sexual behavior (https://www.ncbi.nlm.nih.gov/pubmed/18842886). In fact, chronic exposure to most stimuli seems to induce ΔFosB expression (https://www.ncbi.nlm.nih.gov/pubmed/24259563). So ΔFosB expression probably merely reflects striatal plasticity, which occurs in many behavioral states other than addiction.

I don't really get your argument about diagnostic criteria; if you think that diagnostic criteria based on clinical observations are worthless, then what is the rationale for classifying the disorder as a sex addiction? You could just as easily make the argument that we shouldn't classify this disorder at all until we understand the psychopathology of the illness. The reason why diagnosis based on clinical observations is useful is because it allows you to differentiate patients in a way that predicts treatment response. So we can make the prediction that patient A should be treated with an antidepressant whereas patient B should be treated with an antidepressant, even though we know nothing about the underlying psychopathology. The is basically a fundamental tenet of modern Western medicine.

The other problem in my mind is that the concept of sex addiction isn't based on some objective study of patients. It started in the early 1980s as an outgrowth of 12 step programs for other disorders. Patients suffering from this illness have never really been studied, so it seems premature to classify the illness as an addiction until there is actually evidence one way or the other. You may be convinced that is an addiction, but I, and most other people, want actual, conclusive evidence showing that is the best way to classify this disorder.

 

[Overcoming]

Problem is, who is going to study this patient group and when? It will probably take a long time until that happens.

I don't want to be on any anti-androgens but let's see. TBH, now, I couldn't give a fuck about dating a transexual.

My problems are much deeper than that. Like I said, I need something to help with this compulsive behaviour (whether that's porn, escorts, whatever), and two, to help my dp-dr. I can barely follow the discussion between you two, even though I have a degree in this stuff and am (generally) a clever person. That's how impaired my cognitive abilities are.