What to do in the case of NMDA damage due to DXM

[Doctor Roberts]

A very close friend of mine was addicted to over the counter cough medicine (primarily Coricidin Cough and Cold) for the last couple of years. He would use it at least 3 times a week if not more. He hasnt done it in 4 months but is still experiencing reprecusions from his drug use. From what I understand DXM blocks the NMDA receptors and if done enough the brain would no longer think it needs to produce the glutamate levels it did at one time (sort of like opiate addiction except not the endorphans but the glutamate) Ive read a lot on the subject trying to find something to help him. The symptoms he is experiencing are a lack of confidence, anxiety, depression, and a general feeling of emptiness.
I suggested that he try taking 5htp, but when took 50 mg he became sick to the stomach and vomited twice. He also described a more than normal brightness in color and sound. This makes me think he has done some damage to his serotonin receptors as well. The way he described it makes me think he doesnt have a lot of serotonin to work with and when he gets it his system overloads and cant handle it. Since then he has been taking St. Johns Wort with a little better results.
He has a heightened sensitivity to stimulants as well. Amphetamines and cocaine make him experience lots of anxiety and even bring on signs of schitzophenia. My guess is that his brain has stopped producing lots of dopamine as well. His sensitivity to opiates has been unaffected though. He only uses oxycottin or heroin once or twice a month and has to do around 60 mg of oxycottin or 1/4 gram of heroin (which doesnt really tell anything due to varying potence) to get high. His reaction to Tryptamines though is interesting, he says he recovers some of what he lost when he uses LSD or related chemicals. His reaction to xanax is that he loses his anxiety (of course) and he is able to think clearer (I'm talking about using .5 mg not abusing it) I have read that using xanax while using DXM will help prevent damage, but Its unclear whether its helping the problem he has or just treating the symptoms.
My question to bluelight though is if anyone has any suggestions on what he could do/take to help his problem. There is plenty of information on how to prevent the damage from DXM but none out there on what to do once the damage is already done. I was thinking about having him try glutamic acid but ive also read about the dangers of having to much glutamate in your system and my fear is that he will have hypersensitivity to it and have adverse effects. Has anyone heard of a case like this before and what they did to treat it? Perhaps it is the same type damage that would happen if one were to abuse PCP or Ketamine for long periods of time. In this case what did they do for those cases? Your comments and suggestions would be greatly appreciated.

 

[5-HT2]

having observed quite a few friends who were addicted to dissociative NMDA antagonists, I can say with some confidence that extended abstinence from all "psychotomimetic" drugs is the surest bet to recovery from his cognitive impairment.

 

[MattPsy]

Overuse of DXM *may* cause actual physical damage through excitotoxicity - which is the same possible mode of toxicity for PCP & Ketamine, as you mention.
All I can really recommend is abstinence from dopaminergic stimulants and NMDA antagonists.
As for improving his cognitive performance, given the nature of the damage involved, ampakines could be of use.

 

[Doctor Roberts]

Thank you so much on the reply about ampakines. I'de never heard of them till you just said that so i did a quick search and they sound like thats exactly what he needs. I did forget to mention one pretty important bit of information in my post. He claims to have a sharp pain in his left lower abdomen below his rib cage when he takes things that raise his dopamine levels. Any ideas on what this could be? Some type of organ damage?

 

[UnfortunateSquid]

You say your friend was abusing OTC DXM preparations, primarily Coricidin Cold & Cough. Was he simply eating the CCC tablets whole?

CCC tablets contain Chlorpheniramine Maleate, which is a mild serotonin reuptake inhibitor. Combined with DXM, another mild serotonin reuptake inhibitor, in repeated recreational (i.e. very large) doses is going to induce serotonin system.

If this is the case, the LAST thing in the world he wants to be doing is taking 5-HTP or St. John's Wort, as these will make his symptoms worse!

 

[MattPsy]

^ He's no longer taking DXM or DXM-containing products, so this is irrelevant.