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Misc Questions about Pharmacology

pharm-boy

Greenlighter
Joined
Jul 15, 2012
Messages
18
Location
UK
Hey all, this is my first post so apologies if this is the wrong forum. I've been lurking here for a while and this seems to be one of the most intelligent, down-to-earth forums around so I thought I'd post my question here. Although it's sort-of a medical issue, I am a frequent user of various drugs and have a serious interest in drug reduction, and I'll contribute as best I can to other discussions whilst I'm here :) So, here goes:

I have had some psychopharmacological difficulties for a while, which seem to get various diagnoses depending on the doctor I speak to, these include anxiety/depression, ADHD, and emotional-affective personality disorder (ie. they aren't consistent in the slightest. None of the treatments I have tried over several years have alleviated my symptoms. I have a few ideas, but I have a few pharmacology-related gaps in my understanding that I was hoping some anons would be able to help with.

My three main problems are 1) energy levels, 2) ability to concentrate, and 3) on-and-off social anxiety. These do not seem to coincide necessarily with any other symptoms, and from my limited understanding of pharmacology it may be possible to target these symptoms specifically and individually, instead of going with the medical view of "diagosis of specific disorder according to combination of symptoms ---> treatment according to specific disorder".



My idea is this: energy levels and ability to concentrate both seem to respond well to methylphenidate, which I can be prescribed easily due to my ADHD diagnosis. So 1) and 2) can be dealt with.

The social anxiety, however, is different - the only thing I have ever done, including non-drug based therapy (and I have tried various treatments for years), which alleviated this was MDMA. My hypothesis, based on subjective experience and reading, is that this effect is due to MDMA's effects on 5-HT1A receptors *specifically*, that is, the other effects of MDMA are undesirable and a 5-HT1A agonist may be the best way forward. Buspirone seems to be the only candidate for this, as it is the only selective 5-HT1A agonist I can find that is widely available, clinically tested and of guaranteed quality (I can get it prescribed as an anxiolytic). However Buspirone is also a moderate D2 antagonist which may cause problems with the dopamine-related effects of the methylphenidate.

So, after that possibly-TMI background info, here are my questions. General thoughts would also be greatly appreciated.

1) Do you think specifically targeting symptoms one-by-one is better, in some cases, than attempting a generalised diagnosis?

2) What can I expect, in terms of effects, from the D2 antagonism caused by buspirone, in relation to the action of methylphenidate?

3) Is this combination of drugs a good way to try and alleviate the 3 symptoms described, and can anybody think of any other options?

4) What harm reduction-related issues might come up with this combination, or even the use of either of the two drugs independently, and what recreational drugs if any should be avoided, if they could cause harm, or a reduction in effects?

5) What other neurological processes and neurotransmitters relate to those symptoms, besides the "big three" of dopamine, serotonin, and norepinephrine?

6) Is it possible to have any idea what I'm doing with this without literally studying pharmacology from the ground upwards? I have no background in Biology whatsoever, not even at highschool level, let alone pharmacology. All I've learned is basically through reading shit on the internet related to drugs.
 
1. i think targeting specific symptoms is the way to go in your case, considering doctors have been trying the other approach without much success.

2. no one can really answer this question. everyone's body reacts differently to different medications. you're just going to have to try. i am also on buspirone for GAD and social anxiety and at first I thought it didn't work. However, after waiting 3-4 weeks since beginning treatment I believe it actually is helping me. The only thing I need is possibly a dose increase.

3. your reasoning is pretty solid in my opinion. i would give the two med a try and see how you feel after 3-4 weeks. give the buspirone time.

4. not really sure what recreational drugs should be avoided, but I don't see any harm in taking both these meds at once. Buspirone is completely non recreational and methylpenidate should help you considering your lack of concentration.

5. not really sure, sorry.

6. you actually do sound like you know what you're doing already. give yourself some credit.

good luck (:
 
Welcome to BL friend, and fuckin yeah, THIS is a really, really good first post!
Well, you didn't mention anything about benzos, and i think Dr's prescribe benzos usually to help with the anxiety, smth like 0,5mg klonopins...BUT benzos are drugs that create addiction, and of course there's an issue, as to mix them with the methylphenidate, i'm not sure if this can be done in a safe way, your Dr will tell you..But I wouldn't suggest benzos to anyone, most times, they rather take more than they give, if you got me.. It seems that you've done a good research, (I'm sure you've done all of your homework, heh?;)), and maybe the mods could move this to ADD, i don't know, but i'm sure the answer you're searching, has a lot of parameters that should've been considered...Anyway, welcome to BL, and again congrats about your post, man..


MartinFn%)
 
This is not ADD material, works fine in OD. If you're not recommending benzodiazepines then why mention them? They aren't often prescribed to kids, and for good reason too.

I agree this is a good first post though, compared to most people's.
 
Many thanks for the replies everyone :) I'm probably going to start on the methylphenidate for a few weeks to reaquiant myself with the effects, then take the buspirone, this way I'll have a better idea of which drug is responsible for which effect (subjectivity and placebo aside ofc). And yeah, I do take benzos occasionally, I generally use them recreationally or when I have random bouts of extreme insomnia, but strangely I never found them effective for relief of social anxiety in everyday situations. I have to take a very large dose to feel any relief of social anxiety, and there's no point in being chilled out if I'm slurring my speech, falling around everywhere and generally looking/acting like an idiot ;)

Even if I did find effective relief of social anxiety from benzos, daily use in my view is a big no-no due to addiction/withdrawals, plus I find I have slowed reaction times, cognitive impairment and slight loss of co-ordination even at low doses. Anyway, where I live, it's extremely difficult to get a long-term benzo script. Sometimes I can get a script for a very small amount of temazepam for short-term insomnia (7*10mg for 7 days) but that's about as far as it gets. So, I end up getting them through other means, which raises the issues of purity, consistency of dose, threat of supply being randomly cut off, trouble with the law etc. Just not worth it IMO.

*Edit - I realise now question 5 is probably more suitable for ADD, should I ask there?
 
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