gearjammer
Greenlighter
TL;DR in bold...
I have had embedded unipolar depression / adrenergic depression since 2001. I have been psychologically dependent on a mixture of cannabis and tobacco(roughly 50/50) since early 2009. My tolerance for the psychological and physical effeccts of cannabis and tobacco has grown to the point where I have been smoking between 1 and 1.5g of cannabis mixed with roughly the same amount of tobacco every day for close to two years. I no longer get any really discernable dissocative or psychedelic effects from cannabis, unless I abstain from smoking all day until before bed, and even then, it is a very minute, almost impercievable shift from my "baseline" state, which is nearly always one of complete "sobriety". I use "sobriety", because I don't use any other drugs for recreation, but I am prescribed pharmaceutical medications.
Basically, I am tired of the same routine of dependence; find bud, get bud, chop up bud, mix with 3 or 4 cigarettes emptied into chop bowl, stir and chop again, smoke. Repeat. Repeat. Repeat, repeat, repeat. After 6 years of almost constantly being stoned, being "not stoned" is starting to gain appeal. I initially never wanted to stop smoking pot, and had put off seeking psychiatric treatment solely because I knew that to gain authority to be prescribed the medication I know I need, I would be required to provide a urinalysis sample free of any cannabis metabolites.
I resisted this notion until August of last year, when I finally got to see a psychiatrist who was willing to listen to me and work with me. The way in which the idea of stopping smoking cannabis was presented was devoid of moral overtures; instead, my psy.doc stressed the importance of stopping smoking cannabis for diagnostic purposes and synergistic purposes.
My psy.doc diagnosed me with ADHD within 10 minutes. My reported subjective experiences would have played a part in this diagnoses, but I am confident that my anxious body language, inability to maintain eye contact and my darting from one non-sequitir to another would have given him all the evidence he needed, even if I had been dribbling an inarticulate stream of words. I was very honest about my own attempts to self medicate, which only extend as far as using diverted / illegally sourced pharmaceuticals that are already prescribed to those with ADHD here in Australia. Namely, the two most commonly prescribed stimulants, dexamphetamine (no trade name here as it is only available in generic form or from a compounding chemist) and methylphenidate (known here and as far as I am aware, all around the world, as Ritalin).
My experience with dexamphetamine began in 2013. I first took it when my partner was away for a week. Three days into this week, I became very irritable and depressed, ruminating on a succession of negative ideas. From recollection, at this point in my life, my idiotic, Bible-toting, guilt-leveraging parents were causing the majority of my inner tumult and turmoil. (I have, as of January 2015, not seen either of my parents for over a year, and it is foremost amongst the reasons I am a.) still alive and b.) dealing with my depression with some success).
The day I decided to take the little, white, scored pill with "D" above the line and "5" below it is still clear in my mind. I was on the cusp of tears all morning, telling myself that I was being childish for missing my partner, which in retrospect was a silly thing to think because my partner was the only person that had any idea just how depressed and anxious I was at that time.
Around lunch time, 1pm-ish, I swallowed the alabaster disc and hoped for a miracle. I carried on doing what I was trying to do, which in the throes of depression was usually something seemingly simple but ridiculously difficult to complete, like cleaning my room or sorting out old papers and receipts. Roughly 20 to 30 minutes after ingesting the dex tablet, I felt a sense of tranquility.
Having once been a problematic drinker and having obviously smoked my fair share of bongs, it is hard to subjectively compare the feeling to anything else, as I had never before used any stimulant or structurally or behaviorally similar substance. Having since been prescribed diazepam and clonidine, I would compare my first sensations and observations under the influence of dexamphetamine to be subjectively similar to the mental sedation and relaxation offered by both drugs. Clonidine takes away my anger, and diazepam takes away my worries. Dexamphetamine does both.
I remember feeling like I was in the eye of a cyclone. It felt like I had waited my entire life for this moment, as if I'd been in the outer reaches of the cyclone my entire life, watching the action but getting battered by strong winds and losing my footing every other second. The dexamphetamine seemed to make everything STOP. It was like I had time to gather my thoughts for the first time since I was 3 or 4 years old. To convey just how therapeutic this experience was, I would say that the anxiolytic effect of this first 5mg dexamp tablet was equipotent to 30mg of diazepam (without the sedation and loss of emotional self-regulation) and also equal to 200ug of clonidine, but again with no sedation.
Since that fateful day, LOL, a lot more upheaval occurred. My living arrangements abruptly changed at the end of 2013 / start of 2014, which has been one of the biggest stressors in the last year, as I now "temporarily" live with my partner and her parents. As much as it is stressful living in a house with people who are not familiar with your routine and needs, it is FAR less stressful than living with a loving and lovely but somewhat senile grandparent and opening yourself up to the possibility of an unannounced visit from fuckwit parents!
The irony here is that my partner's parents "know" we both smoke pot, but do not feel the need to discuss it, perhaps because they see it as a way of medicating ourselves rather than as a hideous adjunct to our personalities that hangs like a giant, flaccid, gangrenous, unwanted arm attached to the middle of one's chest, which is the only way I could interpret the weird, contorted face my silly old mother used to make whenever I'd candidly discuss my drug dependence, or whenever I politely suggested that there could be a remote possibility that God is a figment of her guilt-addled mind
SHIT, MOTHER ISSUES OR WHAT???!!!
Anyway, how good are all these tangents? Now you see what I am like sans stimulito!!! Had I ingested 10 to 15mg of dexamp, this post
would have been finished an hour ago, and would not be punctuated with largely irrelevant anecdotes about my parents who even I, with
my angry-at-the-world persecution complex, can see are basically just well-meaning, uninformed buffoons It would also not have been
punctuated with cups of tea and Oreos
Even I am getting bored writing this, so I cannot imagine anybody reading it, let alone without some stimulants.
So, the above shit is largely irrelevant unless you are my psychologist and, owing to cash flow, I currently do not have one!
Anyway, I will cut to the core of the issue. I know I have a good few years of consciously working through my "shit", "shit" mainly
referring to the afore-mentioned guilt my parents have tried to use as leverage, ahead of me. The longer I am not around bigoted, religious zealots, the easier it is to feel sorry for them. The anger towards my folks and the bullshit they indoctrinated me with is slowly fading. When I am on dexies and think of my parents (seldom, but it happens) and how they wronged me, I literally think "Their loss" and continue doing whatever it is that I am doing. It makes the angry thoughts that would usually derail me emotionally seem like a blip on the radar. I see things without all the elaborate, labyrinthine patterns and webs of intent that I seem to think underpin every social interaction.
So, here's the gist, the cut n thrust of my problem:
1.) I love smoking pot, to the point that it has become a part of my identity, almost subsuming my ego.
2.) Dexamphetamine is the only medication I have used that kills my anxiety-precipitated ADHD.
3.) I have not found anything besides clonazepam and alcohol that allow me to sleep soundly like I can after smoking pot.
4.) I am currently on 10mg of Selegiline (l-deprenyl) a day, which blunts some of the "euphoric" effects of the dexamp, but in my experience, evens out the "peaks and troughs" one can experience when redosing during the day, and extends the duration of dexamp, noticeable more at night when trying to sleep.
5.) My doctor has also prescribed me Clobemix (moclobemide), which is a reversible MAOI, at 600mg per day, as he thinks it will target dopamine better at this dosage and have a synergistic effect with the Selegiline, which at 10mg is selective only for MAO type B.
6.) Last time I was prescribed Selegiline and Clobemix together, albeit at a dosage of 300mg per day for Clobemix, it seemed to help for a few weeks, then just seemed to cause restlessness and useless rumination.
7.) My psy.doc is trying this novel combination as a last resort before we give tranylcypromine (Parnate) a go, as the Clobemix, owing to its reversible nature, means I do not have to observe dietary restrictions nearly as carefully, although I have almost no tyramine in my daily diet anyway.
Here are my questions:
1.) Will the concomitant use of Selegiline, Clobemix and dexamphetamine result in a dulling of the stimulant effects of dexamphetamine?
2.) Will Selegiline and Clobemix used together have similar efficacy to tranylcypromine?
3.) What is the usual starting dose for tranylcypromine in Australia?
4.) Is there anybody here who is prescribed any MAOI and also a stimulant? (Particularly Selegiline or Parnate)
5.) Is it worth trying carefully titrated doses of methylphenidate with Selegiline?
6.) Will a psy.doc in Australia prescribe amobarbital for pot / tobacco withdrawal?
7.) Will a chemist compound dexamphetamine without milk as an excipient and into an extended release formulation?
I am sorry for the rambling and disordered nature of this post. I am at the point now where, failing any worthwhile pharmaceutical intervention, I am considering going off my meds and using illicit stimulants to get myself out of this funk. I have managed to avoid ever using anything but dexamphetamine for the first 3 decades of my life and would ideally like it to stay that way, because I have an addictive personality and as much as I am dependent on smoking pot, I am far more dependent on the familiarity and comfort of the ritual than on any long-since-diminished effect that pot has on my brain
I figure if they're good enough for Paul Erdos and Johnny Cash, mother's little helpers are good enough for me
Oh, and yeah, concomitant use of ANY stimulants and ANY MAOI is contraindicated and potentially lethal. Do not try this unless you have read and re-read
every harm reduction FAQ you can find, and make sure you have something like clonidine on hand if you do. As much as having depression for the entire decade you are meant to be forging an adult identity does suck, I am sure a catastrophic hypertensive event or serotonin sickness would suck just as much. I only ever
take dexamphetamine with my MAOI/s when I have my blood pressure / heart rate monitor with me and my clonidine in my pocket.
gearjammer
I have had embedded unipolar depression / adrenergic depression since 2001. I have been psychologically dependent on a mixture of cannabis and tobacco(roughly 50/50) since early 2009. My tolerance for the psychological and physical effeccts of cannabis and tobacco has grown to the point where I have been smoking between 1 and 1.5g of cannabis mixed with roughly the same amount of tobacco every day for close to two years. I no longer get any really discernable dissocative or psychedelic effects from cannabis, unless I abstain from smoking all day until before bed, and even then, it is a very minute, almost impercievable shift from my "baseline" state, which is nearly always one of complete "sobriety". I use "sobriety", because I don't use any other drugs for recreation, but I am prescribed pharmaceutical medications.
Basically, I am tired of the same routine of dependence; find bud, get bud, chop up bud, mix with 3 or 4 cigarettes emptied into chop bowl, stir and chop again, smoke. Repeat. Repeat. Repeat, repeat, repeat. After 6 years of almost constantly being stoned, being "not stoned" is starting to gain appeal. I initially never wanted to stop smoking pot, and had put off seeking psychiatric treatment solely because I knew that to gain authority to be prescribed the medication I know I need, I would be required to provide a urinalysis sample free of any cannabis metabolites.
I resisted this notion until August of last year, when I finally got to see a psychiatrist who was willing to listen to me and work with me. The way in which the idea of stopping smoking cannabis was presented was devoid of moral overtures; instead, my psy.doc stressed the importance of stopping smoking cannabis for diagnostic purposes and synergistic purposes.
My psy.doc diagnosed me with ADHD within 10 minutes. My reported subjective experiences would have played a part in this diagnoses, but I am confident that my anxious body language, inability to maintain eye contact and my darting from one non-sequitir to another would have given him all the evidence he needed, even if I had been dribbling an inarticulate stream of words. I was very honest about my own attempts to self medicate, which only extend as far as using diverted / illegally sourced pharmaceuticals that are already prescribed to those with ADHD here in Australia. Namely, the two most commonly prescribed stimulants, dexamphetamine (no trade name here as it is only available in generic form or from a compounding chemist) and methylphenidate (known here and as far as I am aware, all around the world, as Ritalin).
My experience with dexamphetamine began in 2013. I first took it when my partner was away for a week. Three days into this week, I became very irritable and depressed, ruminating on a succession of negative ideas. From recollection, at this point in my life, my idiotic, Bible-toting, guilt-leveraging parents were causing the majority of my inner tumult and turmoil. (I have, as of January 2015, not seen either of my parents for over a year, and it is foremost amongst the reasons I am a.) still alive and b.) dealing with my depression with some success).
The day I decided to take the little, white, scored pill with "D" above the line and "5" below it is still clear in my mind. I was on the cusp of tears all morning, telling myself that I was being childish for missing my partner, which in retrospect was a silly thing to think because my partner was the only person that had any idea just how depressed and anxious I was at that time.
Around lunch time, 1pm-ish, I swallowed the alabaster disc and hoped for a miracle. I carried on doing what I was trying to do, which in the throes of depression was usually something seemingly simple but ridiculously difficult to complete, like cleaning my room or sorting out old papers and receipts. Roughly 20 to 30 minutes after ingesting the dex tablet, I felt a sense of tranquility.
Having once been a problematic drinker and having obviously smoked my fair share of bongs, it is hard to subjectively compare the feeling to anything else, as I had never before used any stimulant or structurally or behaviorally similar substance. Having since been prescribed diazepam and clonidine, I would compare my first sensations and observations under the influence of dexamphetamine to be subjectively similar to the mental sedation and relaxation offered by both drugs. Clonidine takes away my anger, and diazepam takes away my worries. Dexamphetamine does both.
I remember feeling like I was in the eye of a cyclone. It felt like I had waited my entire life for this moment, as if I'd been in the outer reaches of the cyclone my entire life, watching the action but getting battered by strong winds and losing my footing every other second. The dexamphetamine seemed to make everything STOP. It was like I had time to gather my thoughts for the first time since I was 3 or 4 years old. To convey just how therapeutic this experience was, I would say that the anxiolytic effect of this first 5mg dexamp tablet was equipotent to 30mg of diazepam (without the sedation and loss of emotional self-regulation) and also equal to 200ug of clonidine, but again with no sedation.
Since that fateful day, LOL, a lot more upheaval occurred. My living arrangements abruptly changed at the end of 2013 / start of 2014, which has been one of the biggest stressors in the last year, as I now "temporarily" live with my partner and her parents. As much as it is stressful living in a house with people who are not familiar with your routine and needs, it is FAR less stressful than living with a loving and lovely but somewhat senile grandparent and opening yourself up to the possibility of an unannounced visit from fuckwit parents!
The irony here is that my partner's parents "know" we both smoke pot, but do not feel the need to discuss it, perhaps because they see it as a way of medicating ourselves rather than as a hideous adjunct to our personalities that hangs like a giant, flaccid, gangrenous, unwanted arm attached to the middle of one's chest, which is the only way I could interpret the weird, contorted face my silly old mother used to make whenever I'd candidly discuss my drug dependence, or whenever I politely suggested that there could be a remote possibility that God is a figment of her guilt-addled mind
SHIT, MOTHER ISSUES OR WHAT???!!!
Anyway, how good are all these tangents? Now you see what I am like sans stimulito!!! Had I ingested 10 to 15mg of dexamp, this post
would have been finished an hour ago, and would not be punctuated with largely irrelevant anecdotes about my parents who even I, with
my angry-at-the-world persecution complex, can see are basically just well-meaning, uninformed buffoons
It would also not have beenpunctuated with cups of tea and Oreos
Even I am getting bored writing this, so I cannot imagine anybody reading it, let alone without some stimulants.
So, the above shit is largely irrelevant unless you are my psychologist and, owing to cash flow, I currently do not have one!
Anyway, I will cut to the core of the issue. I know I have a good few years of consciously working through my "shit", "shit" mainly
referring to the afore-mentioned guilt my parents have tried to use as leverage, ahead of me. The longer I am not around bigoted, religious zealots, the easier it is to feel sorry for them. The anger towards my folks and the bullshit they indoctrinated me with is slowly fading. When I am on dexies and think of my parents (seldom, but it happens) and how they wronged me, I literally think "Their loss" and continue doing whatever it is that I am doing. It makes the angry thoughts that would usually derail me emotionally seem like a blip on the radar. I see things without all the elaborate, labyrinthine patterns and webs of intent that I seem to think underpin every social interaction.
So, here's the gist, the cut n thrust of my problem:
1.) I love smoking pot, to the point that it has become a part of my identity, almost subsuming my ego.
2.) Dexamphetamine is the only medication I have used that kills my anxiety-precipitated ADHD.
3.) I have not found anything besides clonazepam and alcohol that allow me to sleep soundly like I can after smoking pot.
4.) I am currently on 10mg of Selegiline (l-deprenyl) a day, which blunts some of the "euphoric" effects of the dexamp, but in my experience, evens out the "peaks and troughs" one can experience when redosing during the day, and extends the duration of dexamp, noticeable more at night when trying to sleep.
5.) My doctor has also prescribed me Clobemix (moclobemide), which is a reversible MAOI, at 600mg per day, as he thinks it will target dopamine better at this dosage and have a synergistic effect with the Selegiline, which at 10mg is selective only for MAO type B.
6.) Last time I was prescribed Selegiline and Clobemix together, albeit at a dosage of 300mg per day for Clobemix, it seemed to help for a few weeks, then just seemed to cause restlessness and useless rumination.
7.) My psy.doc is trying this novel combination as a last resort before we give tranylcypromine (Parnate) a go, as the Clobemix, owing to its reversible nature, means I do not have to observe dietary restrictions nearly as carefully, although I have almost no tyramine in my daily diet anyway.
Here are my questions:
1.) Will the concomitant use of Selegiline, Clobemix and dexamphetamine result in a dulling of the stimulant effects of dexamphetamine?
2.) Will Selegiline and Clobemix used together have similar efficacy to tranylcypromine?
3.) What is the usual starting dose for tranylcypromine in Australia?
4.) Is there anybody here who is prescribed any MAOI and also a stimulant? (Particularly Selegiline or Parnate)
5.) Is it worth trying carefully titrated doses of methylphenidate with Selegiline?
6.) Will a psy.doc in Australia prescribe amobarbital for pot / tobacco withdrawal?
7.) Will a chemist compound dexamphetamine without milk as an excipient and into an extended release formulation?
I am sorry for the rambling and disordered nature of this post. I am at the point now where, failing any worthwhile pharmaceutical intervention, I am considering going off my meds and using illicit stimulants to get myself out of this funk. I have managed to avoid ever using anything but dexamphetamine for the first 3 decades of my life and would ideally like it to stay that way, because I have an addictive personality and as much as I am dependent on smoking pot, I am far more dependent on the familiarity and comfort of the ritual than on any long-since-diminished effect that pot has on my brain
I figure if they're good enough for Paul Erdos and Johnny Cash, mother's little helpers are good enough for me
Oh, and yeah, concomitant use of ANY stimulants and ANY MAOI is contraindicated and potentially lethal. Do not try this unless you have read and re-read
every harm reduction FAQ you can find, and make sure you have something like clonidine on hand if you do. As much as having depression for the entire decade you are meant to be forging an adult identity does suck, I am sure a catastrophic hypertensive event or serotonin sickness would suck just as much. I only ever
take dexamphetamine with my MAOI/s when I have my blood pressure / heart rate monitor with me and my clonidine in my pocket.
gearjammer
