This is a very important topic in my eyes, as so much of the enormous distress resulting from various drug withdrawals as well as tolerance development & loss of effects (most pronounced of course with opioids & GABAergics, but there is also a strong connection with dopamine / psychostimulants and through downstream mechanisms everything is interconnected in the brain) seems to be somewhat related to an imbalance in excitation and glutamate being crucial here.
If you search on PubMed for NMDA antagonism & opioid tolerance / benzodiazepine withdrawal / stimulant tolerance - there is so much exciting evidence. And it actually works, as many anecdotal reports confirm as well as my own experiences. Blocking NMDA at a reasonable degree (sub-dissociative) relieves so much distress, literally erases tolerance development to psychostimulants, lessens the rebound so much, gets one off opioids (low-dosed but enough still) without going through the terrible withdrawal and all this.
It even helps with those horrible brain zaps from SSRI withdrawal. Granted, I seem to have a natural, genetic prevalence for excess glutamate, and it is very possible that it won't work for every single person. But even if it does only work for 50%, or 25%, it would be a huge benefit. Every single person who can get around withdrawal, protracted PAWS with disabling depression, dysphoria, fatigue etc. is worth it.
And I highly guess there are many people with excess excitation, also being predisposed to PAWS, who because of this even begin to use sedatives / narcotics.
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A seriously interesting link I've just found through this thread is the NADPH oxidase. I don't understand the whole complexity yet,
but it seriously raised my interest to see that NADPH & oxaloacetate are interconnected.
Dextromethorphan is a
NADPH oxidase inhibitor. There are links to thyroid disorder, irritable bowel syndrome, and of course - excess glutamate, even ALS.
So DXM is not only a dissociative, but it directly helps in scavenging glutamate by inhibiting NADPH oxidase, eventually leading to more oxaloacetate ... and there is this nice little vanillin-related
Apocynin which acts as a selective NADPH oxidase inhibitor & an antioxidant.
The relieving effects of DXM without all the psychotomimesis? Would be too good to be true, I have to be misinterpreting somewhat ...
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And it even continues:
The NADPH oxidase NOX2 controls glutamate release: a novel mechanism involved in psychosis-like ketamine responses.
Interleukin-6 mediates the increase in NADPH-oxidase in the ketamine model of schizophrenia. (The link to inflammation & IL-6. Wow!)
It is just so confusing. Does now inhibiting the NOX2 help or activating it? Maybe even both is true, depending on the genetics?
IL-6 mediated degeneration of forebrain GABAergic interneurons and cognitive impairment in aged mice through activation of neuronal NADPH oxidase.
Does schizophrenia arise from oxidative dysregulation of parvalbumin-interneurons in the developing cortex?
Repetitive adult exposure to the NMDA-R antagonist ketamine increases the levels of the proinflammatory cytokine interleukin-6 in brain which, through activation of the superoxide-producing enzyme NADPH oxidase (Nox2), leads to the loss of the GABAergic phenotype of PV-interneurons and to decreased inhibitory activity in prefrontal cortex.
Oh fuck. But they say it's reversible in the adult brain - of course if everything is normal. With genetic predispositions this can be different. So ketamine would actually make things worse & DXM the opposite because it additionally inhibits NADPH oxidase to its dissociative effects...!? Well, would make some sense why memantine (purely lowering glutamate & showing some anti-inflammatory effects) is more a sedative & the arylcyclohexylamines are strong relievers, but also hypomania-inducing and have a somewhat excitatory rebound (because NADPH oxidase gets upregulated and after the NMDA blockade wears off, one has more glutamate than before... but also while under the influence, the overall glutamate rises, leading to a sum of less NMDA : more AMPA activity --> the pro-cognitive effects of racetams / AMPAkines. Makes perfect sense somewhat in why I'm processing information
so much faster whilst on arylcyclohexylamines when they should actually inhibit memory. Or, to be exact, after an initial adjustment phase of 1-2 days ... with initial dissociation from the pure NMDA blockade and then eventually the NADPH oxidase increases and AMPA activity rises.)
So in the end, we need to inhibit NOX2 & the Apocynin could actually be a miracle in relieving depression from glutamate excess??
Or memantine & unifiram

would be so incredibly nice to have this mood-lifting, depression- and anxiety-erasing nootropic-alike sobering effect chronic low-dosed MXE induces on a legal, sustainable and non-dangerous way..