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Misc Why do recreational doses of DXM cause nausea and why do SSRI's prevent this?

the_integerian

the_integerian

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Joined
Apr 15, 2010
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112
I have been an on again off again recreational dextromethorphan user for years. DXM often causes nausea to varying degrees and this is regardless of whether you use the syrup or the geltabs. However, when I have been on SSRI antidepressants (which was most of my life) I had no nausea from the dextromethorphan at all. Now I am off of SSRI's and take St John's Wort which also seems to alleviate the dxm nausea. My guess is that the serotonin-releasing quality of the DXM causes the nausea though I could be wrong. And perhaps the SSRI's block the excess serotonin flow?? So why do SSRI's block nausea associated with DXM and why does DXM cause nausea in the first place?
 
is it true that if you on ssri's you shouldn't take dxm because it can cause serotonin syndrome or something? i heard this somewhere and im not so sure about that
 
It is true about the risk of serotonin syndrom. Of course, MAOIs are far more dangerous than SSRIs but you shouldn't risk it nonetheless
 
Taking DXM while on SSRIs is a terrible idea, a friend of mine had an awful reaction to this that caused him to become blind temporarily and feel other symptoms that indicated serotonin syndrome.
 
Yes but that doesn't answer my questions
Click to expand...

No, it makes your question redundant. No sensible person will have done what you describe because it's unnecessarily dangerous :\
 
the_integerian said:
I have been an on again off again recreational dextromethorphan user for years. DXM often causes nausea to varying degrees and this is regardless of whether you use the syrup or the geltabs. However, when I have been on SSRI antidepressants (which was most of my life) I had no nausea from the dextromethorphan at all. Now I am off of SSRI's and take St John's Wort which also seems to alleviate the dxm nausea. My guess is that the serotonin-releasing quality of the DXM causes the nausea though I could be wrong. And perhaps the SSRI's block the excess serotonin flow?? So why do SSRI's block nausea associated with DXM and why does DXM cause nausea in the first place?
Click to expand...

The serotonin aspect of the drug could certainly be related to the nausea and it's interesting that in your experience SSRIs and now St. John's Wort prevent this. As you probably know, when first starting SSRIs nausea can be a side effect and other serotoninergic drugs certainly cause nausea.

It's quite possible that your downgraded serotonin receptors led to less of a serotonin related nausea reaction, perhaps the fact you had been on SSRIs for so long also had something to do with the fact you tolerated the DXM + SSRI reaction better then others have.

Also, I understand your frustration that people are bringing up serotonin syndrome risks instead of discussing your topic, but understand this is a harm reduction forum and the risk of serotonin syndrome here is real and potentially fatal.

For what it's worth, I used DXM for the first 'real' time a week ago, third plateau dose, experienced little to no nausea.
 
Most people assume it is the DXM that causes the nausea. This is a misconception.

Even in gels there is a large amount of additives which, in themselves, weigh far more than the DXM and likely contribute heavily to the subjective experience of nausea.

I've done DXM well over 300 times (although I no longer do and haven't for a couple years). I've tried all sorts of preparations, including extracts and purified crystalline powder. There is DEFINATELY a difference in store-bought products and pure DXM. The pure tastes vile, but I most certainly do notice a reduction in nausea. Also, cannabis is a MUST with DXM, both for nausea and potentiation of desirable effects. One thing that many people are unaware of is that nitrous oxide is an excellent addition to DXM as well. Not as good as cannabis, but still great. It lasts much longer than normal, and its effects are much more euphoric.

There are a number of tricks to reduce nausea beyond these. One is to lay down with your torso slightly elevated, then do something like watch a movie so time passes with you less aware of your physical body. It`s also helpful to eat high carbohydrate foods. Not a lot, but maybe 8-12 crackers or so, maybe some bread. Not only does it help absorb some of the DXM so that your stomach isn`t assaulted as much, but carbohydrates naturally cause a reduction in nausea. Stay away from carbonation and avoid alcohol like vampires do the sun (its a recipe for projectile vomiting). Soft music is often helpful. Some people like to take anti-cholinergics to help, but you have to be very careful with this combination. Triple-Cs, a preparation of DXM already containing chlorpheniramine maleate, an anti-cholinergic, have caused blindness, liver damage, and even death. So keep the dose low, and use a weak one like gravol.

It is definately important to note that, as mentioned, SSRIs should NOT be taken in conjunction with DXM, there is a real risk of seratonin syndrome. I have seen it. It`s not pretty, it`s horrible to both see and experience. Certainly it`s not worth the risk for simple nausea reduction.
 
Forgot to add a couple commonly forgotten nausea methods.

You can use minty flavoured candies or minty gum. It has a good antinauseant action much like the chewing itself brings. Make sure you drink a lot of water. Diluting that mess seems to help. But drink it slowly, no chugging, please, for you sake.

If all else fails, just try to make it to (~60) to (~90) minutes. If after that point, and it still won`t go away, feel free to puke. But go for at least an hour so itcan absorb. You WILL feel better afterward.
 
Druidus, when do you recommend eating, before dosing? Do you think this affects potency or onset in any way?

Also ginger is good for nausea in my opinion, I take it if I know I'm going to have nausea or before I have to go on boat.
 
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