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RCs Ketamine + Abilify + Lithium

leanbo

Greenlighter
Joined
Jan 9, 2019
Messages
8
I would like to know if it would be possible to use ketamine recreationally even taking these medications ( Abilify = 10mg Lithium = 450mg). I researched and I know I will need to use more, but I wanted to know if it will work and it will not have any side effects.
 
Both the abilify and lithium dosages are pretty low, never assume you'll need more, go light and redose if needed. I would in fact recomend you to do not take your usual meds a day prior, you're going to counter their effect by tripping anyway. On that note, because of your meds I'm guessing you have bipolar and from personal experience, ketamine is not a good drug for bipolar people. You're more likely to fall in the hole and it's possible it triggers a manic episode. Even if you have other mental condition, if you're taking medication right now to treat something, tripping on K is a really bad idea.
 
Both the abilify and lithium dosages are pretty low, never assume you'll need more, go light and redose if needed. I would in fact recomend you to do not take your usual meds a day prior, you're going to counter their effect by tripping anyway.
Bad idea, especially as lithium has only a small therapeutic index and taking it regularly is really important

On that note, because of your meds I'm guessing you have bipolar and from personal experience, ketamine is not a good drug for bipolar people. You're more likely to fall in the hole and it's possible it triggers a manic episode. Even if you have other mental condition, if you're taking medication right now to treat something, tripping on K is a really bad idea.
Exactly this, sorry OP, but with this medication it's best to not take any drugs.
 
So the situation is that I do not really have a crisis for months, and I've never had manic episodes, so my biggest question is whether I can feel the effects of ketamine without having side effects
 
So the situation is that I do not really have a crisis for months, and I've never had manic episodes, so my biggest question is whether I can feel the effects of ketamine without having side effects /2
 
Why are you on lithium if you've never been manic? And your dose of 450mg is barely past the therapeutic threshold.

But to answer your question, you'll undoubtedly have side effects. Sure, you'll feel the ketamine of course, but at the risk of mental health problems.
 
Why are you on lithium if you've never been manic? And your dose of 450mg is barely past the therapeutic threshold.

But to answer your question, you'll undoubtedly have side effects. Sure, you'll feel the ketamine of course, but at the risk of mental health problems.

use it as a mood stabilizer
 
It's notorious for killing mania. Doesn't do much for depression unless it is used in conjunction with another AD, says my psychiatrist.

But i'm no doctor and i'm sure there was a good reason for it being prescribed. Definitely a mood stabilizer.
 
It's notorious for killing mania. Doesn't do much for depression unless it is used in conjunction with another AD, says my psychiatrist.

But i'm no doctor and i'm sure there was a good reason for it being prescribed. Definitely a mood stabilizer.


My only fear is to have some reaction that could kill me or send me to the hospital, do you think this can happen?
 
Taking ketamine and lithium might increase the risk of serotonin toxicity, so imo better not take it
 
Taking ketamine and lithium might increase the risk of serotonin toxicity, so imo better not take it



I researched in some places and none talked about this interaction, would it? Could it be that even with the low dose that I take, is it possible?
 
Look, I'm bipolar and a recovering addict. Any drug can make you cycle, yes, ketamine has been used experimentally in bipolar depression, but with much lower dosages. Ketamine has a complex pharmacology, it's an NMDA antagonist, a dopamine reuptake inhibitor, a mild 5-HT2A agonist (like LSD and mescaline), you simply cannot know what effect it will have on you. I have bipolar disorder type II, but I've had manic episodes during drug use. You could go full psychotic like it happened to me with uppers, or have a terrible comedown that translates into depression, or most likely and worst case scenario, mixed episodes. You're taking a mood stabilizer and an antipsychotic, just out of common sense, do you think it's a good idea to take something that can give even a healthy person a psychotic episode? Some people can drink, some can smoke weed, some can't take even caffeine, but I don't think you can effectively manage your bipolar disorder and trip on dissociatives or psychodelics, put your mental health first.
 
Bad idea, especially as lithium has only a small therapeutic index and taking it regularly is really important

I said that in case OP decides to do it, it's better to not have lithium on the body, skipping one day is fine, I take 1200mg, I've skipped a day a few times, it's not enough to drop your levels. It tends to get stored in the brain, because of that, you usually have 3 days, and sometimes you need to stop, for example one time I had to stop for 2 days was because I had terrible lower back pain and I couldn't take an NSAID with lithium.
 
Look, I'm bipolar and a recovering addict. Any drug can make you cycle, yes, ketamine has been used experimentally in bipolar depression, but with much lower dosages. Ketamine has a complex pharmacology, it's an NMDA antagonist, a dopamine reuptake inhibitor, a mild 5-HT2A agonist (like LSD and mescaline), you simply cannot know what effect it will have on you. I have bipolar disorder type II, but I've had manic episodes during drug use. You could go full psychotic like it happened to me with uppers, or have a terrible comedown that translates into depression, or most likely and worst case scenario, mixed episodes. You're taking a mood stabilizer and an antipsychotic, just out of common sense, do you think it's a good idea to take something that can give even a healthy person a psychotic episode? Some people can drink, some can smoke weed, some can't take even caffeine, but I don't think you can effectively manage your bipolar disorder and trip on dissociatives or psychodelics, put your mental health first.


Thank you very much for the concern, it's very good to see that you're worrying about me but I do not think I'm going to have problems, I'm just afraid and I want to know if I can use it without worrying about going to the hospital or dying?
 
The pharmacology of lithium is still not exactly well-understood; apparently, it can cause dangerous interactions (seizures, fugue states) when combined with LSD.

While ketamine's mechanism of action is different from that of classical psychedelics, we can't really rule out the potential for dangerous side-effects when combined with lithium.
 
Thank you very much for the concern, it's very good to see that you're worrying about me but I do not think I'm going to have problems, I'm just afraid and I want to know if I can use it without worrying about going to the hospital or dying?
In all honesty, I don't think you can take a recreational dose of ketamine without risking your mental health enough for it not to be worth it. I used different drugs, but I'm using myself as a light example. I was psychotic for 5 months, that's how I ended in rehab, I became so erratic my family found out I was using drugs. Then it was at least 6 months on high dosage antipsychotics. That's about a year of my life gone. I barely remember any of it. Now, I didn't know I was bipolar, you do. I'm not your partner or your parent, you can go ahead and do it, but just think why you're taking the medications you're taking. Ketamine does pretty much the opposite.
Is it possible you go k-tripping and everything's fine? Sure. It's also possible you need you will need higher dosages or even new medications to treat your bipolar. 10 mg of Abilify and 450 mg of lithium, that's milder than any instance of my life since I was diagnosed. I was put on 400+ mg seroquel, I was on risperidone, olanzapine, valproic acid, lamotrigine, right now I'm on 1200 mg of lithium and 10 mg of vortioxetine (plus a few other things for anxiety and ADHD I don't mind) and I'm doing well. I was diagnosed 9 years ago. I've been good for 3-4 years and boom, start over. You're doing well with very small dosages. Imagine you drop K and 2 days later, you're taking 900mg of lithium, and instead of nice abilify, you go into risperidal hell, all because of a trip. I made that mistake, more than a few times. And I swear it wasn't worth it. Being suicidal for years, taking more medications I can recall because I made my disorder resistant to milder drugs, no sleep, my eyes are sensitive to light because of lamotrigine, gained a fuckton of weight on seroquel which took me years to drop, I had extrapyramidal symptoms, which is like having mild parkinson with no way to know when it's going to end, there are things to worry about other than death. Please consider it, I wasn't diagnosed when I binged on drugs out of highschool and I payed for that shit. You're aware of what you're risking, believe it or not, that's a lucky position, but it only matters if you choose not to risk everything for a trip...
 
Neither drug is serotoninergic enough, lithium barely affects serotonin

You're right that neither drug seems to affect serotonin to a large extend, but looking at interactions I did get Lithium + DXM (I'm aware that the MoA of DXM and ketamine is different and DXM affects serotonin much more than ketamine)
dextromethorphan hbr oral and lithium carbonate oral both increase affecting serotonin levels in the blood. Too much serotonin is a potentially life-threatening situation. Severe signs and symptoms include high blood pressure and increased heart rate that lead to shock.
https://www.rxlist.com/drug-interac...al-and-lithium-carbonate-oral-interaction.htm
While the risk of serotonin toxicity seems to be extremely low and I agree with what you've said we can't rule it out completely (especially as Hodor said, because we don't really know a lot about the MoA of lithium) so imo better be safe than sorry

Another possible interaction is CYP3A4 as both ketamine and Aripiprazole (Abilify) are metabolized via this isozyme. This can result in competetive inhibition, leading to increased plasma levels.
 
You're right that neither drug seems to affect serotonin to a large extend, but looking at interactions I did get Lithium + DXM (I'm aware that the MoA of DXM and ketamine is different and DXM affects serotonin much more than ketamine)
https://www.rxlist.com/drug-interac...al-and-lithium-carbonate-oral-interaction.htm
While the risk of serotonin toxicity seems to be extremely low and I agree with what you've said we can't rule it out completely (especially as Hodor said, because we don't really know a lot about the MoA of lithium) so imo better be safe than sorry

To be clear, I'm not aproving of someone with bipolar disorder taking K, just arguing regarding lithium.
Lithium is interesting when it comes to interactions. It doesn't increase any major neurotransmitter, doesn't interact with any enzyme responsable of xenobiotic metabolism, the only major way you can have an interaction is when certrain drugs (NSAIDs, ACE inhibitors and some diuretics) prevent the excretion, that can kill you or leave you brain damaged easily. The big reason I'm saying all these is I take 1200 mg of lithium, have been for years. I have taken sertraline, lisdexamphetamine, vortioxetine, and abused tramadol, tapentadol, morphine, codeine, methylphenidate, amphetamine, all the benzos, all in high dosages and while taking my normal meds. That led to fucking up my life for a year, but it wasn't an interaction, it's what happens when bipolar people abuse drugs. OP is asking if the interaction will harm him, and the answer is no, but the drug may, and because of personal experience it takes so much more to fix it than whatever fun you had. Ketamine increases dopamine levels by reuptake inhibition and indirectly as an NMDA antagonist. For a bipolar person, that can lead to hypomania or mania, which then makes you cycle. And once you're cycling (going up and down basically) it can take months to stabilize it.
 
To be clear, I'm not aproving of someone with bipolar disorder taking K, just arguing regarding lithium.
Lithium is interesting when it comes to interactions. It doesn't increase any major neurotransmitter, doesn't interact with any enzyme responsable of xenobiotic metabolism, the only major way you can have an interaction is when certrain drugs (NSAIDs, ACE inhibitors and some diuretics) prevent the excretion, that can kill you or leave you brain damaged easily. The big reason I'm saying all these is I take 1200 mg of lithium, have been for years. I have taken sertraline, lisdexamphetamine, vortioxetine, and abused tramadol, tapentadol, morphine, codeine, methylphenidate, amphetamine, all the benzos, all in high dosages and while taking my normal meds. That led to fucking up my life for a year, but it wasn't an interaction, it's what happens when bipolar people abuse drugs. OP is asking if the interaction will harm him, and the answer is no, but the drug may, and because of personal experience it takes so much more to fix it than whatever fun you had. Ketamine increases dopamine levels by reuptake inhibition and indirectly as an NMDA antagonist. For a bipolar person, that can lead to hypomania or mania, which then makes you cycle. And once you're cycling (going up and down basically) it can take months to stabilize it.

I understand, what about this middle ground: "OP is asking if the interaction will harm him, and the answer is most likely no"?
 
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