Fluvoxamine and LSD

[stellarnaut]

Hey guys,
I am currently on prozac for what I would call moderate or severe OCD (i am way better now) and it mainly has to do with intrusive thoughts. I am going to be switching to fluvoxamine for OCD in about a month or less and I want to try lsd in the summer or late April or early May. I heard that it won't limit the effects that much or that it limits the effects severely. Does fluvoxamine dull the effects too much? And do you think that 100ug-150ug would it be enough for a first time or should I take more to counter act the fluvoxamine dulling? I am prepared to have an introspective-ish and fun trip with 2 to 3 friends.
Thanks!

 

[Hodor]

Hey guys,
I am currently on prozac for what I would call moderate or severe OCD (i am way better now) and it mainly has to do with intrusive thoughts. I am going to be switching to fluvoxamine for OCD in about a month or less and I want to try lsd in the summer or late April or early May. I heard that it won't limit the effects that much or that it limits the effects severely. Does fluvoxamine dull the effects too much? And do you think that 100ug-150ug would it be enough for a first time or should I take more to counter act the fluvoxamine dulling? I am prepared to have an introspective-ish and fun trip with 2 to 3 friends.
Thanks!

I think 100-125 micrograms would normally be a good dose for a first-timer. So even with the fluvoxamine, 150 should easily be enough.

That said, be aware that LSD can make thoughts feel much more significant, much more taboo, much more ...wrong. There is obviously the potential for great therapeutic benefits in people with OCD, but also for a decidedly unpleasant experience if it starts intensifying your intrusive thoughts.

I generally recommend that people experimenting with LSD have a fast-acting benzodiazepine on hand in case the trip goes bad; in your case I would go as far as to strongly advise against attempting a trip without having an emergency benzo at the ready. It's not like you necessarily have to completely kill the trip though - sometimes you only need to take, say, .25 or .5 mg of alprazolam (or an equivalent dose of a similar benzo) to turn an uncomfortable trip into an experience that is still highly introspective and possibly even fun.

Lastly, smoking weed while tripping often tends to intensify the psychedelic headspace and lead to difficult trips, so I would advise against that, especially on your first trip.

 

[Moxious]

I generally recommend 150ug for first-timers, I'd say at that dose even on an SSRI should get you to where you want to be without falling short. I wouldn't take less than 125, I find doses above threshold but below around 100ug to carry an awkward body load during the come up which can turn people off from future experiences if it's their first time.

Don't dive too deep, but make sure you dive haha. I also second having a benzo handy, just in case, but I doubt you'll need it.

 

[stellarnaut]

I think 100-125 micrograms would normally be a good dose for a first-timer. So even with the fluvoxamine, 150 should easily be enough.

What about shrooms? I heard fluvoxamine dulls shrooms worse than LSD does. Is it true and could I take shrooms and have effects? (sorry im brand new to the psychedelic scene)

 

[pofacedhoe]

if it was me i wouldn't take psychedelics while on lots of ssri's or in some transtioning withdrawal phase either

if your mental health is that bad that you need to be on ssris' and you are switching because one isn't effective enough isn't that a clue as to your mental state

 

[ivio]

Hi there,

I was in very similar circumstances (not to double-post please read my post here: http://www.bluelight.org/vb/threads/829928-LSD-and-the-Future-of-Psychiatry) in that I took LSD while I was on conventional psychiatric medications. It was a mistake! I would strongly discourage you to take LSD concomitantly with any other psychiatric medication since they act on several, and often the same, neuronal receptors at the same time, but often in opposing way (one may stimulate while the other inhibit the same receptor at the same time). Taking both LSD and SSRI (or any other psychiatric medication) is a sure recipe for unpredictable and compromised results! If I was in your position I would stop the antidepressant for several weeks (I know that could be painful) before taking LSD.

Good luck!

 

[Moxious]

ivio, looking at your other post doesn't really suggest this would be a mistake, you experienced no adverse consequences other than a dulled trip, which is if anything (psychologically speaking) safer than waiting until the medication is out of your system.

One caveat is that you are/were on antipsychotics, not just SSRIs. While SSRIs are known to decrease the effects of psychedelics, and while I don't believe there is much interaction between typical antipsychotics and psychedelics, there IS a well-known risk for schizophrenics to be taking psychedelics, as it is known to exacerbate symptoms or even trigger onset in predisposed people.

What I'm saying is that if you were to have experienced negative effects from your trips, the most likely cause would have been your schizophrenia, not SSRIs. You say it's a sure recipe for unpredictable and compromised results - compromised perhaps, but in a fairly predictable fashion for SSRIs!

 

[ivio]

Hi Moxious, as I said, combining LSD with any psychiatric medication is a recipe of unpredictable, and potentially dangerous, results!!! No studies exist for the various combinations, even for the legal medications never mind for LSD, so there is a big risk, believe me, this is a dangerous game! Much much safer is to stop the SSRI and after a pause to take LSD.

As for LSD supposedly exacerbating the symptoms, or even triggering, Schizophrenia this is big scaremongering myth! The LSD up to the 1970s was tested and used extensively precisely TO TREAT Schizophrenia! For references please check a couple of articles on the MAPS.org site; there is also a fairly recent publication on the treatment history of using LSD for Schizophrenia in the Netherlands, I read a review about it (in Dutch); if you search web you will find it.

 

[Moxious]

Excuse me but it is by no means a myth that LSD can trigger latent schizophrenia and making that claim without linking to any studies flies in the face of HR. Psychotic breaks HAVE occurred, triggered directly by psychedelics, which leave the user at the least presenting with symptoms of a schizophrenic disorder.

https://www.nature.com/articles/1300762

I don't have the time right now to do an extensive search but a quick look turned up this article suggesting synergy between SSRIs and 5-HT 2A antagonism. This suggests combined with an agonist such as LSD would have a decreasing effect (as we know it does). Yes there can always be idiosyncratic reactions but if that were a good reason to abstain nobody would ever use drugs!

I'm not saying it's not better to take a break first - it would save on material at the least. That said I don't think there is any evidence it would be (chemically) harmful to combine LSD with an SSRI.

 

[ivio]

Excuse me, but I will tell you this: if you cannot be bothered to do any search online - it takes only a fraction of a second(!) - you are not motivated to gain any understanding, never mind knowledge!

And please stop regurgitating this utter nonsense about LSD causing Schizophrenia because its embarrassing! You asked for "references"... are these enough for you?

https://www.maps.org/news-letters/v07n3/07318fis.html
https://www.maps.org/news-letters/v09n2/09211fis.html
https://www.maps.org/news-letters/v09n2/09203maa.html
https://drugs-forum.com/threads/recensie-lsd-therapie-in-nederland.74511/
https://www.theguardian.com/science/blog/2010/sep/01/psychedelic-drugs-mental-illness
https://www.theguardian.com/society/2014/oct/05/healing-trip-psychedelic-drugs-treat-depression


Thanks for the Nature link though for me its meaningless. Its the usual scientific babble that can't see the forest for the trees... I have no idea what are your qualifications, but if unaware you should strongly bear in mind the following: the whole "theory" of the receptors and the supposed brain neurochemical imbalance as a cause of the mental disturbances is a commercial concoction. There is still no plausible coherent explanation for the mental disturbances, and the theorising for their societal causes is long buried because of strong political and commercial pressures.

No one has measured yet what is the "proper" neurochemical balance so to apply a correcting medication when it deviates - true science works like that. Instead pharmaceuticals conduct hit-and-miss trials and if a compound happens to have some effect no matter how warped the "scientists" extrapolate backwards to invent some explanation. Pressure on health authorities and possibly bribes follow (psychiatry, with the possible exception of dentistry, is the most corrupt branch of medicine) so the newly patented medicine can get an approval. That's one of the reasons why LSD and cannabis will never get legalised, there is no profit there! That's was also the reason to suppress the investigations into the societal causes for the mental disturbances - societal causes will inevitably lead to popular pressures for political and social reforms; and societal causes cannot be milked for profits as the chemical imbalance "theory".

Currently on the market are medicines for every possible neurotransmitter and in various combinations; what's more significant, the different classes of medications work in opposing ways. So if one is based on sound science and supposedly effective the others shouldn't work, but they do (sometimes and to some degree). One can argue that the reasons for this is because the mental issues are so variable, but this is relative. As I said at the beginning of the post there is no plausible coherent explanation for the mental disturbances hence not even diagnostic tools to correctly identify the "illness" and then prescribe a medicine. If you open the US DSM manual of mental disorders, the psychiatric bible of the Western world, you will find practically all diagnostic criteria overlapping and applicable to almost every disorder. This fact is telling... it confirms that there is no true scientific understanding for the biological basis of the mental disorders.

Sorry for the long post, but serious issues cannot be discussed with one-liners.

 

[Hodor]

No one has measured yet what is the "proper" neurochemical balance so to apply a correcting medication when it deviates - true science works like that.

You're posting articles about case studies Bastiaans and Fisher did in the 1960's. True science(tm) usually involves double-blind studies with a large number of participants. Like the hundreds of studies confirming that 5HT2A antagonism (i.e. the exact opposite of what LSD does) is still the most "gentle" way of treating mania and psychosis.

Instead pharmaceuticals conduct hit-and-miss trials and if a compound happens to have some effect no matter how warped the "scientists" extrapolate backwards to invent some explanation.

Yes, because that is how true science(tm) works. Alexander Fleming didn't need to know what DD transpeptidase was to discover that penicillin kills bacteria. Nor did Albert Hofmann know what a 5HT2A receptor was when he discovered LSD. You observe a phenomenon, you make a hypothesis, you conduct experiments, you gain new data, you improve/discard your hypothesis, you conduct more experiments...

 

[ivio]

You're posting articles about case studies Bastiaans and Fisher did in the 1960's. True science(tm) usually involves double-blind studies with a large number of participants. Like the hundreds of studies confirming that 5HT2A antagonism (i.e. the exact opposite of what LSD does) is still the most "gentle" way of treating mania and psychosis.



Yes, because that is how true science(tm) works. Alexander Fleming didn't need to know what DD transpeptidase was to discover that penicillin kills bacteria. Nor did Albert Hofmann know what a 5HT2A receptor was when he discovered LSD. You observe a phenomenon, you make a hypothesis, you conduct experiments, you gain new data, you improve/discard your hypothesis, you conduct more experiments...

Hahaha... I loved the "True science(tm)" poppycock! However, I am afraid you may need to check and update your concept of science and what constitute "scientific". The true science on the basis of current knowledge can extrapolate and envision future phenomena, not only in terms of gradual evolution, but also in terms of qualitative revolutions; true science does NOT rely on direct observation of empirical reality. According to this paradigm the only true science is Mathematics and the derived from it Physics and Chemistry. The rest of human knowledge which heavily rely on direct observation of physical reality is not science even though many disciplines are grouped under the euphemistic umbrella of "natural sciences". Medicine is one of them: it heavily rely on Chemistry, a true science, and on a lot more empirical semi- or pseudo-sciences like biology and anatomy.

With the above conceptual frame in mind the work of Bastiaans, Fisher and the rest who used LSD for treatment of Schizophrenia is entirely within the bounds of the ethical medical practice at the time. They treated patients, many of them successfully; observed the results, and published detailed reports available for examination. That's what matters in medicine, not nonsensical non-consequential mumbo-jumbo articles like the one you linked from Nature, the type you apparently venerate.

Thankfully Bastiaans, Fisher and the rest worked in the 1960s when the social climate was more liberal, they could do their work and publish their findings. Today's climate in the Western countries is much more oppressive, and any findings that don't fit the current dogmas, or heavens forbid imply any controversy, are outrightly censured and simply not published. One is very likely to get sacked too and completely demonised in an orchestrated smear campaign as happened to an eminent British scientist who advised the British Government.

Btw, for your own information Albert Hofmann was a chemist, not a medical practitioner, and as such his work focus was in a completely different direction. It just happened that by accident one of his syntheses yielded a substance with unexpected physiological properties.

 

[Moxious]

You're appealing to a concept, the grand unified theory, that doesn't actually exist. Physics and chemistry cannot be constructed purely from mathematics, at least not with our current understanding of the subjects, so you're drawing a faulty distinction to begin with.

I apologize if case studies are insufficient for me or the rest of the scientific community. We're kind of sticklers about that sort of thing. I agree that there are problems affecting the community (e.g. pharmaceutical lobbying, 'publish or perish' culture), but what you are doing is not the solution. To be honest you come off more like a conspiracy theorist than a scientist.

 

[ivio]

We have a cultural problem here. You dismiss anything that goes beyond the narrow boundaries of contemporary pseudo-science or proposes a critical perspective. I from my side am extremely critical of perspectives like yours and Hodor's which for me exemplify everything that's wrong with our society in general and with corporate psychopharmacology in particular, namely vested interests, profound corruption and conformity. You call this "conspiracy theorist", I call it essential meta-narrative if one wants to gain any understanding of the world that surround us.

To return to our narrow subject. If you had a modicum of scientific spirit for which rigorous critical inquiry is essential you would've been deeply troubled by the disparity between the reported LSD effectiveness for Schizophrenia, Depression and Alcoholism and the current official dogma of neurotransmitter imbalance and the supposedly critical importance of the 5HT2A receptor antagonism. Evidently you have no problem with that and readily embrace the officially approved doctrine. Indeed you are not alone. There are thousands of people who earn a living from scientific jobs, but they themselves are antithesis of the scientific spirit of doubt and critical inquiry.

 

[Solipsis]

The 100-150 ug recommended for a first time probably isn't actual ugs but advertised ugs, otherwise I find it unnecessarily on the high side.

You should not compensate for the first time, because there always is a next time and you can always try more but you can't take back going in too fast.

True, SSRI's are really unpredictable when it comes to their ability to dull psychedelics. It apparently depends on both the person and the exact SSRI which together are pretty much unique most times. Dose as you would without any SSRI's just in case and if nothing much happens, try more next time carefully. You don't operate on the (especially a baseless) assumption that you won't get much interaction. Always err on the safe side and assume that there is.

---

Schizophrenics DO get in trouble more when they take drugs, especially ones that can contribute to their delusions ans especially if they are off their meds. That psychedelics can be used to treat them IN A SAFE, CONTROLLED AND CONFINED SETTING is no evidence that it is safe in all settings, because it is paramount what exactly happens when someone with schizophrenia trips and if the effects are used to help to reveal their delusions by proper guidance or not in which case they can really get confused.
Psychedelics are powerful tools not even remotely as reliable as antipsychotics. They are both ways of treating, one being repressive but generally effective and the other with great potential but also a complexity which is hard on an institution. Please don't overgeneralize and turn this into a very black and white thing.

There are threads more appropriate for this particular discussion, use the search engine and go look for them so that we don't have to disrupt this thread. With OCD there are different things to worry about, more related to anxiety. They don't really have much to do with being able to separate fantasy from reality or internal thought from speech.

Let's take a step back from schizophrenia etc and return to the last point ivio made related this which is relevant to this thread: the point of not combining psychiatric medications with LSD.

I agree that this would be best, to first withdraw from SSRI's entirely before you try LSD or if you absolutely must: try LSD while on a reasonable regimen of an SSRI but not while tapering. During tapering there is a particularly sensitive period even if you don't take any other drugs. Taking LSD on a stable regimen of an SSRI is not the best idea in the same sense that taking SSRI's to begin with is not the best idea: it changes your brain chemistry in ways more fundamental than other meds may do and it can be hard to revert this change. The interaction with LSD in this regard is unknown but I can't say I know of any evidence to suggest that it makes this matter worse apart from the outcome of the trip being unpredictable. Yet there may be some unknown interactions which go unnoticed so no it is definitely not ideal.

Something ivio should learn is that while we may convince stellar to wait, often people have made up their minds before creating a thread in a sense... so it is good to talk about realistic ways to go regardless of whether you are technically right.
Stellar is planning to switch from fluvoxetine to fluvoxamine within a month and from what it sounds about a month after the possibility of LSD. Of course, first make damn sure you are stabilized from switching to fluvoxamine... you should really have the feeling like you know what it is doing to you. While you still have the feeling like it is settling, wait off on the LSD and additionally wait some extra time after that just to be sure. I am talking weeks or months actually since this is more of a reasonable timescale for your psyche and brain chemistry overall.

My ex suffers from OCD and got relief only from a SSRI... So overall I doubt it would be responsible to go off SSRI's taken for OCD especially if only to trip on LSD. Going off and on SSRI's is taxing and you should absolutely not do it just to trip... it would only be justified in people who got on SSRI's on dubious reasons to begin with like a dope shrink's interpretation of depression from a much more complex story in which depression is a secondary side-effect. In such a case it is probably good to get off SSRI's asap but this actually has nothing to do with the LSD one might want to take.

 

[Moxious]

Solipsis you're a god. Excellent points, in particular about the change from fluoxetine to fluvoxamine needing time to settle. Totally agree that given the SSRI is prescribed for OCD, it would probably be best to stay on it.

You make a good point about advertised vs. actual dosage as well. My first time was with an advertised 150ug blotter but there's no way I could have known, it turned out to be a perfect dose for me. Years later I can say it was definitely in that range it was advertised as so that's the basis of my recommendation. 100ug is a solid trip though which I do semi-often, wouldn't be missing out on much at that dose either.

 

[stellarnaut]

Thanks guys for all the replies! I decided that I wasn't going to switch (Prozac worked for me but my doctor said it might be good to switch) Bluelight has a good community btw lel
Thanks everyone and God bless