DXM - Moderate - 90 mg of madness

[Trip Falling Up]

Reading the title of this, one may wonder "this guy is probably high off his ass right now, 90 mg of dxm is nothing?!"
Just you wait.

I've done lsd, shrooms, ecstasy, opiates, benzo's, and a variety of other homeopathic and herbal drugs. Lots of weed. Nothing has come close to the level of anxiety, panic and overall fear I had on my first experience with DXM. Before I start the report, I just want to begin by saying I've done extensive research on this drug. I know the basic pharmacology, proper dosing, plateau's, experiences and side effects. However, no matter how much research is conducted, it will never truly prepare you for the drug you are about to take, especially ones psychedelic and dissociative in nature. This being the first dissociative I've ever tried. After reading much up on the subject and learning that DXM is typically started at doses between 200 and 300 mg for first time users, and the first and second plateau consisting of music euphoria, slight stoned feelings, and an edgy weirdness / dissociativeness.

I decided to begin my experience by ingesting 6 15mg (90 mg lol) capsules of generic brand DXM. I poked holes in the capsules to allow them to digest easier, as I know sometimes they take a while to hit if not prepared properly. In addition, I normally take 1000 mg of fish oil and 50 mg of 5-htp before bed, but seeing as dxm is mildly sertonogenic I decided to skip the 5-htp for tonight and just take the fish oil.

T0: Capsules ingested, prepared for a good time. Excited for first plateau. I've read stories of people using 90 mg of dxm recreationally to help focus and to aid in studying. I'm relaxing alone in my room, had a good day with my family, a little emotional. My brothers graduation from highschool and my dad came by from out of town. Had worked that morning (I'm a pharmacy technician, still in college). I put on trailer park boys on my laptop, never watched the show before but I decided to give it a shot while I was coming up. For the first hours and a half or so, I didn't feel anything except a burning in my stomach accompanied by a mild nausea. This quickly subsided. I began feeling a little weird, but nothing interesting, novel or unique.

T1hr: Trailer park boys is starting to give off some bad vibes. I'm a bit pre-dispositioned for anxiety but I'm normally in control of it pretty strongly and usually never have any symptoms. Have had panic attacks in the past and my first trip on acid was pretty intense. It had it's ups and downs and I was fully prepared for an experience slightly similar to that? Oh boy, was I wrong.

T1.5hr: I switched on that 70's show, which is something I love to get stoned/tripped up on. Great vibes. Really enjoying it. It starts to hit me and I get a very mellow stoned feeling. I remember there was a part where Foreman wakes up and stares straight to the camera and says "whoa, where am I", and at the point I definitely felt the trip tell me I was at the first plateau and I was thinking it wasn't so bad. The mellow stoned feeling is exactly what I imagined being high would feel like, before I ever got high on marijuana.

T2hr: The mellow stoned high begins to amp up then disappear entirely. I'm under the blankets nice and cozy. Excited for some potentially closed eye visuals, musical euphoria. I've watched a few episodes of that 70's show, and feel it creeping up more and more on me. Definitely starting to feel it.

T2.5hr: Turn on hipster bbq on pandora and start to jam out. As I often do when I'm high on mary jane, it's kinda hard to explain but I close my eyes and feel the music and my body normally explodes in sensations of euphoria. It helps focus my highs and has an interesting spiritual/introvertive spin. However, I made the mistake of turning on the music and closing my eyes to the music at the same moment the DXM fully began peaking.

I close my eyes, listen to the music, and things start to slow down. I start getting dizzy. I feel like I'm falling. The music is swirling around me. I see a triangular geometric symbol in front of my eyes, the first time I've ever seen anything geometric throughout my tripping experiences. For some reason, geometry is oddly absent from the visual aspect of my trips. Although I feel my mind start racing forward through the triangle and it begins going deeper and deeper and deeper.

I start getting scared. It's completely uncontrollable at this point. The DXM is fully taking over my being. My heart begins racing, my eyes shuddering underneath my lids.

It's taking me deeper. Deeper deeper deeper. Too deep.

The music is haunting me. What did I get myself into.

My entire body feels like fire. It burns. I touch my forehead, I'm sweating profusely. I think I should go to the room across the hallway to wake my dad and tell him to take me to the hospital because I think I'm having a serious allergic reaction. I think I'm going to die.

Times ceases to have meaning, and I'm curling in my bed just waiting for it to go forward, finish and end. At this point, I'm listening to a song by BXRNS called Dopamine, which ironically I was feeling the exact opposite of.. I remove the covers from me and the painful burning begins to subside. The music is way too intense. It's much too dark in my room. Everything is dark and at that moment I remember thinking I've made a grave mistake. My mind was there, as it always is, but my thoughts were distant. I was balls deep.

T3.5hr: My panic attack seems to last for hours. I think I'm drifting between REM sleep and trippiness. My mind seemed distant, and I remember I was very very afraid of loosing sense with the rest of my body (since with high amounts of dissociatives, your consciousness essentially separates from your body and you lose sense of your corporeal self. I remember feeling as if I was dangerously close to this edge. In a desperate attempt to regain control, which was one of the most horrifying parts, I turned on the sounds of the jungle.

Fuck that shit.

Turned on the sounds of "north american crickets and frogs nighttime" to help me relax. It was eerily creepy, and was very weird, but I drifted to sleep (I think?) and had extremely lucid and vivid dreams of me in my pharmacy working. While experiencing this, I also recall reading that the events you did during that day have a large impact on your dxm trip). I remember opening vials to count pills, not realizing it was an actual vial for a prescription med or anything, and then coming to the realization I was actually in my pharmacy. It sounds weird, but while opening the vials I didn't actually realize what the fuck was going on, only until after opening them did I realize that it was some kind of connection to my pharmacy. Very odd.

T???: I awake at a time that I do not know. I suspect it's around 5 to 6 hours after ingestion, if not longer. I hear my mom getting up and getting my younger siblings ready for school. Morning birds are chirping outside. I'm somewhat relieved to have slept/meditated/lucid dreamed through a potentially harsh comedown. I turn off the cricket frog video ( it was like 10 hours long lol) and try to go back to sleeping. Turning off the sounds instantly initiate further anxiety, and falling back to sleep is very difficult.

I awake 10 hours after initial ingestion. Very groggy. My legs feel weird. Slightly robo walk to the bathroom to take a piss. Definitely feeling a really weird afterglow. I had a bunch of stuff to do that day. There were points where I felt slight euphoria from music. I was very tired. In the morning I dosed 260 g Gingko Biloba, 1000 mg fish oil, and 200 mg Ginseng as I normally do in the morning. Things start to pick up during the day and I try to forget about the events of the previous night. I can't help but feel a slight buzz throughout my body. Halfway through the morning I take .25 mg of xanax to calm me down a bit. Helps a bunch, but after it wears off I feel it coming back. Don't really wanna redose so I just tough it out, it's not too bad.

The night after the robo trip I return to my normal evening dosing of 1000 mg fish oil, 50 mg htp, and to help me get to sleep I take 5 mg melatonin, 900 mg valerian root, and 500 mg vitamin c. That night before I went to bed, I experienced extreme anxiety before falling asleep, and I was very very afraid of the darkness. Whenever I closed my eyes, I felt those same feelings of paranoia coupled with dizziness and falling. I opened my blinds and turned on my fan for background noise. I slept 10 hours that night.

Something odd happened halfway through the night. Around 3am, I woke up, and experience an intense but puzzling feeling in my head and throughout my body. It felt a bit euphoric, and a bit neurotoxic if that feeling can even be described. I have no idea what's happening. My mind literally hurts and my whole body is coursing with energy, what I think is serotonergic in origin? That would make sense to me anyways. I was very confused and I don't know how long I laid there before returning to my slumber.

The following day I woke up and felt relatively normal. Still a bit unsettled and weirded out by what happened but since then I've been totally fine (3 nights prior to this point).

IN CONCLUSION, never overestimate your tripping abilities. Ever. You have no idea what kind of ride you're in for or where you're going. I'm very glad I didn't mix anything with it. Pharmacologically speaking, I'm confused. 90 mg is nothing. I don't know what happened. I haven't read anything describing what I went through. I'm disappointed I experienced none of the novel and interesting effects of 1st/2nd plateau. When the trip climaxed, I really have no clue what plateau I was at or where I was in relation to other people dosing. I guess it effects everyone differently. I definitely am pissed I didn't have any euphoria, in contrast it was mostly dysphoric. LSD is way cooler, although I often here dissociatives and psychedelics compared as yin and yang. Introspectively deep and universally connected respectively. This experience was in no way spiritual, meaningful or insightful in any way shape or form. I doubt I'll ever experiment with DXM again.

My only hypothesis for what could have happened are the following:

1: I am enzyme deficient in CYP-2D6, the enzyme responsible in processing DXM. Curiously though, it is the same enzyme involved in the process of MDMA, which I was able to successfully have an AMAZING time on. One of my favorite drugs. Absolutely incredible. If I were enzyme deficient, I would understand why I experienced the high body load and the inability of my body to turn DXM into DXO, allowing the drug to manifest itself strongly in my blood glucose levels. However, MDMA was processed successfully and I had no ill effects whatsoever. Comedown was pretty easy too.

2: Seeing as I ingested fish oil as well, IF DXM is lipid soluble this would lend credence to another way it would have high blood glucose amounts, and be able to cross the blood brain barrier easier / make it a more effective NMDA antagonist? I'm not entirely sure though. Has anyone experimented with fish oil potentiation with DXM? If so, what were your results?

Hope you guys enjoyed the report, sorry it was long. Do your research kids, and make sure to start any new and novel substance by dosing low. Happy tripping

Tagged by Xorkoth
substancecode_dxm
substancecode_dissociatives
explevel_experienced
exptype_neutral
exptype_difficult
roacode_oral

 

[Jackplays]

What the hell? I know a few people are hyper sensitive to dxm (like where a normal dose for cough is a high 1st plateau), so that could be you. I say do it one more time, same dose or less, and see. For science sake, I would skip the fish oil for that time, and if you have no trip, do it a third time, same dose, plus fish oil. I think that that would prove fish oil potentiates it (which I would love to know)

 

[N0 W4RN1NG]

Fish oil is highly unlikely to potentiate DXM.

DXM HBr is sparingly water soluble but enough that you don't need to take fats alongside it for absorption.

There is really only one explanation for your experience, and you mentioned it yourself: You are deficient in CYP2D6.

DXM is not a recreational drug, it is a pro-drug for a recreational drug. DXO is the recreational drug.

Your analogy about MDMA is non-analogous, MDMA is INACTIVATED by 2D6, whereas DXM is ACTIVATED by 2D6.

You should not take DXM again in the future, and you should really know better as a pharmacy tech.

EDIT: I just re read this post and realized it probably came across as harsh, especially the last part. I did not intend to sound punitive. But, with knowledge comes responsibility - if you knew you were 2D6-deficient, you should have looked into whether that would affect DXM negatively. Oh well. Glad you are OK. Steer clear from recreational DXM in the future though, for real.

 

[Xorkoth]

While I was reading this, I was thinking I was going to suggest that you're CYP-2D6 deficient, but I see that's your first guess. It sounds that way though.

Good report, well-written. Thanks for sharing.

 

[Trip Falling Up]

I had no idea I was enzyme deficient prior to my DXM trip. I understand that both DXM and DXO have certain affects on the physiology, but from what I've researched I can't find any clear cut differences as there hasn't been any legitimate studies. As a pharmacy tech we're not really responsible for pathways, etc, as that's the responsibility of the on-duty pharmacist, but I'm happy I started out at 90 mg as opposed to 200-300 at least! In the future I will most definitely steer away from recreationally using DXM, I found none of the effects pleasant whatsoever, and experienced no euphoria or trippiness; just intense dissociation, spaciness and fear.

Perhaps DXO is the compound that has serotonin affinity, resulting in the pleasure of most 1st and 2nd plateau experiences, when the levels of DXM are so low as compared to the processed DXO. However as your dosages of DXM begin to rise, and the CYP-2D6 enzyme becomes more fully saturated resulting in an increase of DXM in the body (as it can't get processed), you get more of the dissociation, tussin space and general 3rd-4th plateau attributes? Just a hypothesis though.

I am curious though whether I should be wary with using MDMA in the future. Some literature I found at Erowidhttps://www.erowid.org/chemicals/mdma/mdma_pharmacology1.shtml)
- suggests that CYP-2D6 isn't the only enzyme responsible in the processing of MDMA, however I also don't want to experience acute neuro-toxicity haha. My first (and only) experience was pretty great though, and my girlfriend who was with me at the time took the same amount as me and had an even more intense experience than I did. I know this is straying into discussion for another forum though so I could always repost in Pharmacology.

 

[N0 W4RN1NG]

^^^There have been MANY studies, very clear cut.

DXO is not serotonergic at all. DXM is highly serotonergic, binding to SERT with a ki value of ~26nM.

I can understand why you might have thought that way though.



You did not mention in your original thread (unless I am misreading? I have a habit of doing that sometimes, it's almost like a minor dyslexia, so forgive me if I am wrong) that you were simply ASSUMING yourself to be a poor metabolizer of CYP2D6 substrates. I admit, it is likely given your response, but for all I know you have a tumor in your temporal lobe or something, and your liver has nothing to do with this...you might want to get a check up, complete with a cat scan and blood work. Mention to your doctor what happened - say you took 60mg and not 90mg though, and tell him it was for a cough.

If the issue is indeed, that you are weak in CYP2D6 functionality, than MDMA should be stronger for you than a normal person, and I would recommend a 20-30% dose reduction for you.

In my experience, females tend to respond more strongly than males to the same dose of MDMA, even accounting for body weight. Does your Girlfriend take birth control?

 

[theGirlWithBlueHair]

I had no idea I was enzyme deficient prior to my DXM trip. I understand that both DXM and DXO have certain affects on the physiology, but from what I've researched I can't find any clear cut differences as there hasn't been any legitimate studies. As a pharmacy tech we're not really responsible for pathways, etc, as that's the responsibility of the on-duty pharmacist, but I'm happy I started out at 90 mg as opposed to 200-300 at least! In the future I will most definitely steer away from recreationally using DXM, I found none of the effects pleasant whatsoever, and experienced no euphoria or trippiness; just intense dissociation, spaciness and fear.

Perhaps DXO is the compound that has serotonin affinity, resulting in the pleasure of most 1st and 2nd plateau experiences, when the levels of DXM are so low as compared to the processed DXO. However as your dosages of DXM begin to rise, and the CYP-2D6 enzyme becomes more fully saturated resulting in an increase of DXM in the body (as it can't get processed), you get more of the dissociation, tussin space and general 3rd-4th plateau attributes? Just a hypothesis though.

I am curious though whether I should be wary with using MDMA in the future. Some literature I found at Erowidhttps://www.erowid.org/chemicals/mdma/mdma_pharmacology1.shtml)
- suggests that CYP-2D6 isn't the only enzyme responsible in the processing of MDMA, however I also don't want to experience acute neuro-toxicity haha. My first (and only) experience was pretty great though, and my girlfriend who was with me at the time took the same amount as me and had an even more intense experience than I did. I know this is straying into discussion for another forum though so I could always repost in Pharmacology.

Serotonergic affinity at SERT, resulting in transporter blockade wouldn't produce any pleasurable experience. SSRIs are known for being dysphoric, anxiogenic during the therapeutic delay. (some people get manic from them, though, due to excitatory serotonin receptors being activated.) That's because of the inhibition caused by activation of 5-HT1a autoreceptors, which decrease serotonin release. Now it's different for releasing agents like MDMA, which are able to completely bypass the feedback mechanism and cause massive activation of postsynaptic 5-HT1a receptors.

The pleasure people feel from dxm is the interaction the NMDA receptors have with dopamine receptors, as euphoria remains even after most dxm is converted or eliminated. NMDA antagonists caused increases in the extracellular release of dopamine. the way it works is a bit complicated with interneurons and other transmitters and whatnot. But here's this:

One theory postulated regarding the underlying pathophysiology of schizophrenia is that under normal circumstances, tonic inhibition occurs in the NMDA receptor regulation of the mesolimbic dopamine pathway. The glutamate neuron connects to a GABA interneuron, which then connects to a dopamine neuron, resulting in inhibition of dopamine release. In the presence of NMDA receptor hypofunction in cortical brainstem projections of patients with schizophrenia, hyperactivity of the mesolimbic dopamine pathway would take place. In other words, in the normal state, glutamate acts as an indirect brake. With hypoactive glutamate neurons, the result is insufficient activity at the GABA interneuron, the brake is released, and excessive dopamine is released in the mesolimbic system, producing the positive symptoms of schizophrenia.1,5
Cognitive, negative, and mood symptoms are explained by the possibility that glutamate neurons project directly on dopamine neurons, rather than through a GABA interneuron. Under normal conditions, NMDA receptor regulation of mesocortical dopamine pathways is that of tonic excitation. In the normal state, the dopamine neuron is tonically excited, resulting in the release of sufficient dopamine in the DLPFC and VMPFC to allow successful regulation of cognition and mood, as well as avoiding so-called negative symptoms. With NMDA receptor hypofunction, the direct result would be hypoactivity of mesocortical dopamine pathways, with insufficient dopamine release in the DLPFC and VMPFC, resulting in the cognitive, negative, and affective symptoms of schizophrenia

Your response to the dxm was pretty extreme. It could be due to enzymatic issues. Or a central issue with your glutamatergic neurons. Is NO W4RNING said below, it's not safe to assume. But even for poor metabolizers, that's quite a reaction to 90mg, just three times the normal dosage. I'm deficient in CYP3A4 and have poor metabolism of substrates for it, but I"ve never had any bad reaction to anything that is metabolized it.

The thing most people don't ask is: do you take any meds or anything that would interact? I know topamax and dxm can precipitate extreme reactions. The same for lamotrigine. Do you take anything CNS active?

 

[Trip Falling Up]

Mention to your doctor what happened - say you took 60mg and not 90mg though, and tell him it was for a cough.

If the issue is indeed, that you are weak in CYP2D6 functionality, than MDMA should be stronger for you than a normal person, and I would recommend a 20-30% dose reduction for you.

In my experience, females tend to respond more strongly than males to the same dose of MDMA, even accounting for body weight. Does your Girlfriend take birth control?

I think I definitely will mention to my doctor this experience. Prior to anyone replying to the original post, I attempted to try the experiment again on a lower dose, perhaps it was just a fluke. This time with 30 mg of the same capsule. My experience was nearly identical to my first, with the exception of the panic and anxiety, and much lowered histamine response (I think). However this time I was in a well lighted environment and I notice tracers, and when focusing on a certain point, things began to move all around me in like a sinking dizzy fashion. I went to bed shortly after these symptoms began just fine, but awoke an hour and a half later in the same state that I had trouble falling asleep previously during the first time I it. I was restless in bed and experiencing intense dissociation, but about a 1/3 as powerful and anxiety striking as my first. It was essentially the same, and yet again dysphoric and relatively boring. No enjoyment whatsoever from it, as opposed to any other recreational substance. It was novel. This was just to confirm my initial thoughts about the deficiency in the enzyme.

I'm aware that there are a few medications that use that specific enzymatic pathway, so it's definitely worth bringing up to my doctor haha. I don't know whether I should make an appointment or just call in my concerns. I hope I don't have a tumor or anything. Although the apparent lack of NMDA antagonism is a bit concerning, at least to my observation (in relation to positive affects).

My girlfriend does take birth control and she's around 120-130 lbs I believe. I'll definitely watch my mdma doses from now on. As for other medications / dosing patterns, this is usually what I supplement:

Morning: 260 mg ginko biloba, 2 capsules of ginseng (variety of different roots and mg's within), 500 mg vitamin c occasionally, 1200 mg fish oil, once daily multivitamin

Evening: 50 mg 5-HTP, 1200 mg fish oil, occasionally 450-900 mg valerian root and/or melatonin for trouble falling asleep.

I don't dose the 5-HTP the night of use of serotonergic drugs. And a good portion of the reason why I take the supplements I do are for some of the neuroprotective attributes, vitamin replenishment (due to some drug use, such as with DXM), help with energy in the morning, as I don't drink caffeine and an overall state of well being.

I'm not on any psych or maintenance meds. I've experimented with tramadol which has both ssri and sra qualities, and have completely enjoyed those experiences aside from temporary nausea. Wonderful afterglow the flowing day and high reduction in pain; little to no anxiety.

I actually was unaware ssri's could have anxiogenic qualities, but after reviewing some additional literature on DXM, they could potentially cause or exacerbate those symptoms. And I am a bit prone to anxiety. I am only ASSUMING I have the enzyme deficiency and I do not know for sure. But after reading your guys very helpful responses, I will definitely double check with my family doctor!

Thanks for all your guys input, the pharmacology is extremely helpful for bettering my understanding of not only DXM but serotonergic drugs in general, which is about the extent of my drug use.

Also, where do you guys find your sources? I've tried looking everywhere and can't really find anything academic in origin about DXM/DXO processing and enzyme deficiency.