Dextromethorphan 3rd Plateau Safety while on Methadone Maintenance.

[Thomas29]

I Am on 90MG of Methadone Daily And I Am Prescribed 1MG of Clonazepam And 10MG Nitrazepam Daily but I try to stick to 1MG for most Days I use various other Benzos And varying Doses occasionally at different times.


I have PLENTY of Experience with the 2nd Plateau at Doses of 450MG since I have A Body Weight of roughly 150-155 Pounds with the Dextromethorphan Recommended Dose Calculator saying if weighing 150 Pounds 600MG to 1000mg is the Dosage Range for the 3rd Plateau And I plan on using 900MG I Am just A bit worried that taking that much Dextromethorphan could have unpredictable Effects on My Methadone potentially causing A Fatal interaction Or Am I Safe considering I have Not had any Fatal Experiences just the expected Side-Effects from using 450MG for A Strong end of the 2nd Plateau?


I Am A bit worried about My Long Acting Clonazepam that has built up in My System having Effect lingering into the next when I plan on using Lorazepam very first thing when I wake up And waiting 4-6 Hours after using it for most of the Effects to wear off unless I should be using Xanax I think that would be just A little bit too short-acting. I want most of the Effects to wear off from the Lorazepam before I use the Dextromethorphan But I don't want Rebound Anxiety Or some during My trip from the Xanax wearing off But I know the Clonazepam from the Day before will still be helping to prevent any Withdrawal Symptoms just not any potential Anxiety etc.

 

[kleinerkiffer]

1.

Dextromethorphan is a commonly used antitussive agent that can be purchased over the counter. It is metabolized primarily by the cytochrome P450 (CYP) 2D6 isozyme. Methadone has been found to inhibit CYP2D6, indicating a potential for interaction with dextromethorphan.

https://www.ncbi.nlm.nih.gov/pubmed/16089243
2.

Some drugs that increase serotonin release are dextromethorphan (..) methadone

https://www.medscape.com/viewarticle/733706_2
3.

This case demonstrates a potential correlation between DXM ingestion in large quantities and prolonged QTc interval. QTc interval prolongation has never been associated with DXM ingestion, although, tachycardia and nonspecific electrocardiographic findings have been associated with ingestions

http://accurateclinic.com/wp-content/uploads/2016/05/QTc-Prolongation-Due-to-Dextromethorphan.pdf (while the guy in the case report combined the DXM with ethanol you're on methadone, which causes QT-prolongation)
So all in all a bad idea as there's the potential for serotonin toxicity, QT-prolongation (can cause Sudden Death in the worth case), potentially higher concentrations due to the inhibition of metabolism and the risks of respiratory depression

 

[Thomas29]

Are u saying I have been IGNORANTLY RISKING MY FUCKING LIFE with the Strong Dextromethorphan during My 450MG Second Plateau Trips And is it IMPOSSIBLE FOR ME TO FUCKING USE THIS DRUG ON METHADONE Like really? OMFG!


I LOVE DXM And I have NEVER EVER TRIED A 3RD Plateau which I have ALWAYS wanted to try with some Nitrous alongside And Weed.


Is there alternative's Like Memantine I can maybe use instead of Dextromethorphan And again. Have I been risking possible Death by consuming fucking Strong 2nd Plateau trips is impossible for Me to consume Dextromethorphan Safely God Damnit My Methadone for Pain Management HAS RUINED my fucking life in sooo many unforeseen ways such as Lowering Testosterone just one of many things.


Is it possible to skip My Methadone And replace it with A different Opioid for the Day when I use the DXM Or will the Methadone still in My System continue to cause problems. Or can I possibly wean down to A Low enough Dose of Methadone to fucking be able to use Dextromethorphan Like I wish I stayed on My Prescription pain Meds instead of trying out Methadone. It worked great at first for My Pain but it's literally BARLEY working now after 5 Years on it.

 

[Thomas29]

Should I maybe move this to another Thread for more Responses?

 

[Speed King]

We are telling you how it is. You asked. If was fine, we would have said so. If you really think we're bullshiting you, try N&PH.

DXM is strong shit, when used with other substances.

 

[kleinerkiffer]

Are u saying I have been IGNORANTLY RISKING MY FUCKING LIFE with the Strong Dextromethorphan during My 450MG Second Plateau Trips And is it IMPOSSIBLE FOR ME TO FUCKING USE THIS DRUG ON METHADONE Like really? OMFG!


I LOVE DXM And I have NEVER EVER TRIED A 3RD Plateau which I have ALWAYS wanted to try with some Nitrous alongside And Weed.


Is there alternative's Like Memantine I can maybe use instead of Dextromethorphan And again. Have I been risking possible Death by consuming fucking Strong 2nd Plateau trips is impossible for Me to consume Dextromethorphan Safely God Damnit My Methadone for Pain Management HAS RUINED my fucking life in sooo many unforeseen ways such as Lowering Testosterone just one of many things.


Is it possible to skip My Methadone And replace it with A different Opioid for the Day when I use the DXM Or will the Methadone still in My System continue to cause problems. Or can I possibly wean down to A Low enough Dose of Methadone to fucking be able to use Dextromethorphan Like I wish I stayed on My Prescription pain Meds instead of trying out Methadone. It worked great at first for My Pain but it's literally BARLEY working now after 5 Years on it.

Don't forget that I'm not a doctor and there haven't been any studies on the combo of methadone, benzos and DXM afaik, so what I posted is just speculation.
Imo it's a potentially lethal combo, but I can't tell you any safe/unsafe dosages.

Skipping methadone won't help much due to the long half life and other opioids can cause respiratory depression as well.
Memantine has some nasty side effects especially in high doses iirc and the trip lasts quite a while

I can move the thread to Neuroscience and Pharmacology Discussion if you want me to.

 

[kleinerkiffer]

Od - > n&pd

 

[clubcard]

BNF silent, Merck Index doesn't give a warning. I would presume that no medical situation would need concomitant DXM and juice. Benzos and juice is a classic way to pull a blue and I don't know how people's judgement on the cocktail would be. We host an array of NDMA & benzo blackout/huge unremembered redosing stories for you. We also offer a seriously unrivalled number of dead members. The refs are good and your doctor may offer genetic testing and/or an electroencephalogram to detect long QT but you know you best. How lucky do you feel? Sorry to be blunt but there are so many hazards and this site is about HR. Feel free to do what you want to do and DO send in an experience report if the circumstances allow it... we don't get a LOT of the negative outcomes, first-hand at least.

 

[Thomas29]

We are telling you how it is. You asked. If was fine, we would have said so. If you really think we're bullshiting you, try N&PH.

DXM is strong shit, when used with other substances.

I got NO IDEA where that came from Speed? Did you even Read My Post thoroughly?
I know Dextromethorphan "is strong shit" hence I always wanted to try the 3rd Plateau with some Nitrous Oxide And more IMPORTANTLY! Why I Am freaked out! When I learned it is potentially fatal after I have ignorantly had plenty of Second Plateau Trips on it when everyday I was using 90MG of Liquid Methadone not knowing that it Releases Serotonin. I figured/assumed the Tolerance from using the exact same Dose everyday would make the Respiratory Depression Effects not as severe compared to the same Dose of Daily use of any different Opioid/Opiate. But that is just My own personal SPECULATION AND EDUCATED GUESS! WHICH IS ALL I AM LOOKING for from all of you And any Facts Or Experiences identical to My own does not have to on Methadone. It can anything at all useful Like any Studies Or what ever you feel might be Helpful And Or Life Saving Information about using the SAME DOSE OF ANY DIFFERENT OPIOID/OPIATE then Methadone DAILY while using A 3rd Plateau Dextromethorphan if you want to get all complicated about it.


If there is anything else at all I can clear up then that would be great since I REALLY need to get to the bottom of whether this is RISKY But Not RECKLESS RISKY! Kind of small dose of benzos with 1 beer being risky and reckless risky being huge dose of benzos with 6 beers without any Tolerance either substance for an IDEA of what I mean By RISK And RECKLESS RISKY! Understand I hope, everyone? Lol.

 

[clubcard]

It's reckless. Other people have gone to time and effort to provide you with the data but I think you have already decided what you want to do and just want someone else to wave it through. We aren't going to. Your life, your choice.

 

[Speed King]

I read the fine print and that's the answer you received. I now willlook into this further, since it has now spiked my interest as well. apologies if you were pissed off, but it comes with the territory.

Clubcard hit it on the nose. you are fucking with a lot oof sstuff mixing all that "crap" together. I will still look into it for some benefit.
.
Whatever you do, be safe! The shrine has too many people in it.

 

[dopamimetic]

You shouldn't be using that DXM calculator, IMHO nobody should. Leads to false security, it blessed me with severe panic attacks when I've tried to reach the third plateau and under-estimated how strong of a norepinephrine agent DXM is. I was 'fine' mixing it with SSRIs though. So, you see, it's different for everybody but I would not want to play with something like QT prolongation either... if you're desperate to try it out, maybe skip the methadone at least and wait until you start to feel withdrawal, as DXM does work against it like other dissos do ...

 

[Thomas29]

It's reckless. Other people have gone to time and effort to provide you with the data but I think you have already decided what you want to do and just want someone else to wave it through. We aren't going to. Your life, your choice.

WTF! Did you not read and comprehend when I stated! "I AM FREAKED OUT I IGNORANTLY USED IT ON 90MG METHADONE DAILY NOT KNOWING IT RELEASES SEROTONIN!"


FRANKLY i dont got the patience or the time for USELESS POSTS that are just cluttering up this thread and PROVIDE NO VALUE TO MY questions.


Now along with Methadone increasing Serotonin I Am on Clonazepam daily which I have Read increases Serotonin but I have no idea how MUCH SEROTONIN both of these drugs cause an increase of and THANKFULLY I AM NOT DEAD SO I assume maybe I just got lucky like russian roulette or maybe I Am right And the cns depression with tolerance to 90MG methadone same dose daily is not anymore life threatening then when I take my daily DOSE of BACLOFEN CLONAZEPAM AND GABAPENTIN ALL acting as CNS DEPRESSANTS at the same time as My methadone is working yet I Am still alive.

FYI I only use 60MG Baclofen and the GABAPentin at night before going to bed to help Me sleep not throughout the day And I experience no withdrawal symptoms from cold turkey stopping both those substances. So they would not be an issue Or used during any of My Dextromethorphan Trips.


I KNOW THIS IS NOT SAFE BUT I NEED TO NOT HOW NOT SAFE IT IS!

Now I just want to know if I can USE DEXTROMETHORPHAN SAFELY AGAIN IF NOT I WILL NEVER EVER EVEN TOUCH THE STUFF BEYOND the Recommended 30MG Dose for the NMDAR Effect for Preventing tolerance And I will simply JUST WAIT UNTIL I AM COMPLETELY 100% OFF THE METHADONE BEFORE I use A 3rd Plateau Dextromethorphan trip.


The problem is it will be well over a decade if I even EVER get off the Methadone completely I might be on it for life so I Am asking if possibly being at only like 20MG of Methadone daily or even 1MG since I got on Methadone to prevent Post Acute Withdrawal problems.


But I understand that when you make A thread certain people are going to post certain things that like speed king said it comes with the territory nuff said.


I UNDERSTAND that THERE IS NO CONCRETE INFORMATION AVAILABLE ABOUT MY SPECIFIC SITUATION HENCE THIS THREAD BEING CREATED Or I would of SIMPLY done the Research all on My own And not be asking for all of your Help in finding out AS MUCH relevant Data as possible.

That's all I Am asking is for someone to find out non-specific things such as how STRONG the Serotonin release from methadone and clonazepam is And any reported QT Prolongation Effects from Dextromethorphan or Idk ANYTHING useful And Speedking if you find out anything useful I would very grateful for your help as I want to stay Safe And more importantly BE TOTALLY 100% INFORMED!

 

[Thomas29]

People seem to mix Shrooms And DXM all the time despite the Serotonergic Activity Shrooms have. I can't imagine Methadone having much very Strong Serotonin Releasing Effects.


I

 

[dopamimetic]

Shrooms aren't SSRIs, serotonin syndrome is about mixing SSRI chemicals afaik. But yeah it's a rare condition (yet a life threatening one), and methadone isn't really a strong serotonergic, but it's about QT prolongation. A heart condition I don't know much about but it's able to kill you.

 

[clubcard]

WE don't know the risks since we don't have your medical records! AFAIK psilocin is a 5HT2a ligand, not a serotonin releaser/reuptake inhibitor but the chances of interaction with DXM appearing on the death certificate are remote to say the least. THAT is the point. We have enough cases of clonazepam/methadone toxicity reported simply because both drugs will be spotted by a simple ICD-10 test but the tests are designed to exclude DXM so we have literally no way of knowing the number of fatalities. Likewise, mushrooms likely won't be even considered if toxic doses of DXM are present. Given the pretty conclusive list of methadone interactions, staying well away from anything else that's hard on the system is common sense.

We would LIKE to know so as I said - just write down what you are doing beforehand and ask someone to post for you if you are unable to... someone has to be first.

 

[Thomas29]

I am truly puzzled if people will read this post or just skim through it then reply please don't do that just read the whole thing or skip for all I care.


My medical records hell I will email them to you if you want lol I don't see how that will help you solve this pickle but okay PM and I will give you the info you need to help me out. Second of all why are you speaking of death certificates of a dead person on a myriad of drugs your post is very confusing fyi.... seriously what the flippin flop are you talking about lol?

I have got the information I needed SIMPLY by using UTFSE and google and typing in these "interactions" that you can't answer separately then doing the math about interactions all combined and the only reason among some other few reason I will get to later in the thread. Is I am not using it is as I want don't want to fuck up my Tolerance to Dissociatives in general with DXM fucking up tolerance in general for them really being really bad for that. But I don't use Dextromethorphan when I am lowering my Dose of benzos right now and want to be in a good frame of mind and plan to wean off of Methadone anyways so maybe I will wait.


Methadone is literally the most researched drug on to Date or the top list of them and based on my research of these drugs by themselves QT Heart Prolongation has already been stated in this thread to not have been proven just suspected to be something Dextromethorphan causes with literally a scarce 2 cited sources of "tachycardia" being the only real very very assuming degree for someone to suspect QT Heart Prolongation based off of a symptom in which that a lot of different things could of caused this?

On top of that the Orphenadrine plus the Clarithromycin I was prescribed at the exact same time as a prescription for Koffex Brand Cough Syrup from my Dr. which I asked for so I don't have to pay for it but I saw a heart Dr. recently for something unrelated to this issue but I forgot to ask him about QT Heart Prolongation and I am kind of pissed nobody did a EKG on me before and after getting on Methadone But being on all these drugs are are confirmed to cause QT Prolongation unlike the suspected effect DXM can cause. Yes QT Heart Prolongation can and will kill you yes that is a fact and a very real one so that is a danger but is it a one time use type of danger of medication like the acne anti-bitoic clarithromycin I was prescribed for years with methadone and same with the Orphenadrine except both these drugs I took on and off thank god in hindsight.


Another good question is this a type of some kind of a cumulative type of effect that happens when you take a drug such as these ones I was using confirmed to caused QT Prolongation for too long causing disruptions in the heart or can it happen from taking a large dose of a drug we don't even know for a fact effects QT so that's a possible but far from a given fact or even in the same time zone as being close to certain.


What about the sun increasing Serotonin is there anything else besides Methadone increasing Serotonin I should be in fear of my life for?


That being said and scares me that it needed to be I suspect respiratory is a very possible reality being on so many different downers so I will probably play it on the safe side of caution but you are really making the dangers seem like inevitable death or russian roulette at best rofl wtf?




^ Like you said you don't know the dangers so why are you all making it seem like you know its a fact I don't understand.... has there been a death from the type of use I am speaking of because if someone has died from these very "specific circumstances we can not provide information for" then I will be very humble in thanking you all for your advice which I am thanking you for anyways but it is not so much "advice" as "statements of personal and only personal opinions slightly more or less."


I hope this does not come off as to hostile as I haven't eaten and I believe someone just tried to rob my house when I went to the bank but luckily told my neighbour to watch my place so I don't get robbed thank god for that. So I trying to type this quickly so I can vape some weed which I haven't yet today and get grumpy without it and plus I AM PISSED someone claimed to be my friend and I was doing a drug deal when the person I believe I sold some to tried to set me up for being fucking robbed.


So I apologize in right now for any "Bad vibes" I am giving you all truly I am not trying to be a dick or think "I know what I'm doing" since I wouldn't of created this thread if I did but neither do any of you so why can't we just work together to find a solution even if it's wait until you wean off Methadone.


But the problem is with weaning off Methadone I only just found a Brand Named Koffex that causes ME ZERO NAUSEA even at 450MG gulped down not even a slight bit of it so I am worried if I return these unusedbottles to the Pharmacy they will discontinue the Brand before I can detox from the Methadone in like 5 Years I hope to be able to start to do that.


But even if I do wean off the Methadone how dangerous is it to take my Prescribed Daily Dose of Benzodiazepines during A 3rd Plateau Trip since if I am not mistaken the risk of Respiratory Depression increases as you increase the dose of Dextromethorphan or correct? But I assume especially using say 1MG of Clonazepam daily and only that same Dose daily will build up enough tolerance to not cause as severe respiratory depression but idk since doesn't NDMAr Antagonist effect Benzodiazepine and Opioid Tolerance while under the influence of the drug but wears off as soon as the Dextromethorphan does and then your Tolerance goes right back to what it used to be hence the confusion about NMDAr Antagonists Lowering Opioid withdrawal which it does just not permanently from what I understand it either increases the effects of the Opioids which is very likely since DXM Effects certain Opioid Receptors which is why I assume it would cause stronger respiratory depression than with Benzos.


How long will the Cough Syrup And Dextromethorphan stay good for and not make me vomit from it being Expired or have loss of Potency of the DXM from being expired which is literally this May in as little as a few months I will Post the Ingredients when I got time and get a reply about it.


Oh and I can wait to quit Methadone but I don't think I can quit both the methadone and than the Benzos to do the Dextromethorphan Safely and not many drugs are 100% safer when it's Polydrug use or just one Drug and whether it's mentally scarring experience which is just as devastating an E.R. Drug Experience.

 

[Thomas29]

Wow no reply? I'm shocked!! NOT ROFL.... anyways.


I just found out the fucking Inspiolto Respimat Inhaler which increases chances of seizures which I was reading about since I am lowering my dose of Benzos right now and was worried about it. Which it's a canadian Inhaler maintenance one I am prescribed which CAUSES QT HEART PROLONGATION so basically I am a dead man walking since I have LITERALLY been using a myriad of drugs that cause QT Heart Prolongation not knowing about the effects it has or that methadone or any of these drugs caused it which says a lot about how irresponsible our fucking health care system is the pharmacy and Doctors are gonna get an ear full from me when I got fucking energy to talk to them about it.


I never got to talk to my heart doctor about it now I gotta make a new appointment so you all really are just sticking your heads in the sand... You think I wanna get high or some is that the idea because its not the reason I want to use a 3rd plateau trip and I am not explaining my reasons to a bunch of judgmental people hiding behind "harm reduction" to cover the websites ass same way RC Vendors say "Not For Consumption" so the website is not shut down.


**Face Palms** I don't know why I expected anything ignorance arrogance and talking to me LIKE I DON'T ANYTHING ESPECIALLY ABOUT DEXTROMETHORPHAN AND I QOUTE "Dextromethorphan is some strong shit!" Oh and my favourite "you don't like the answer were giving you" or some like that when the problem your not giving me answer your giving me literally 2 second google search results your not even using those results to use your known information about these interactions to give an educated answer rofl like wtf to say the least? Why on planet earth would I have created this thread because I know nothing if I did not know a lot about DXM I would of not made this thread ffs people and somehow you all know me and my life and my living situation and my desires to use this drug and what the desires to use for are


Since know one is worried about qt heart prolongation from drugs that are confirmed to cause. I am prescribed literally probably every drug that can cause it except dextromethorphan which POSSIBLY can cause qt heart prolongation rofl talk about like overkill precaution **Face Palms**


Just wow people wow... I really would like to know what's going through your minds? I'll show you mine if you show me yours?


I would make a thread about qt heart prolongation and all the drugs confirmed to cause QT Heart Prolongation which I am extremely scared and worried and anxious about being in benzo withdrawal being on all these confirmed QT H/P at once but considering the way you all reacted in this thread I am better off asking a fortune teller or some shit.


I am not fixing any typos or parts of this post that make no sense since it's a waste of time I don't have right now or I would happily make a fool of myself here some more by asking people that don't want to know the answer maybe you don't see the bigger picture you don't need to research all the drugs I am taking you can research them individually like i said and do 1+1 equals dangerous or not dangerous but that should keyword being common sense but it's not.


/Thread Closed.

 

[sekio]

Qt prolongation is mostly an issue with higher doses of methadone, from what i recall. And unfortunately it's not an effect that is easy to predict based upon dosages of specific drugs, some people will be more predisposed to it than others. The only way to tell for sure is if you get an EKG while on the drugs you're concerned about.

You think I wanna get high or some is that the idea because its not the reason I want to use a 3rd plateau trip

Well, it seems to me anyone who's using DXM at doses any higher than maybe 100-150mg/day is undoubtedly going to get high whether they want to or not.

DXM itself is a quite potent serotonin/norepinephrine reuptake inhibitor. As stated before in this thread shrooms/psilocin is a 5ht2a agonist (activates a specific subtype of serotonin receptor) and neither a SNRI nor a CYP enzyme inhibitor so it has no direct interactions with DXM the same way methadone (which is both a mild SNRI and also a CYP inhibitor) is, meaning methadone would be expected to potentiate and prolong the effects of DXM in a way totally unlike mushrooms would.

I KNOW THIS IS NOT SAFE BUT I NEED TO NOT HOW NOT SAFE IT IS!

If you've taken similar doses of DXM while on methadone and have no obvious complaints about e.g. palpitations or high blood pressure then you're probably fine. Especially if you have been taking methadone on a regular basis. But unfortunately, nobody can assign an exact probability to "how not safe it is". It's like asking how unsafe it is to drive without a seatbelt. Most people would be fine if they limit it to once in a blue moon but there's a nonzero risk something will happen.

 

[Thomas29]

https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1934431


Exhibit A. of many of my solo Research and I meant not that I am "not going to get high" "I am not trying to accomplish a third plateau for sole reason to get high" So FYI I wasted HOURS upon hours of Research when you simply could of idk told Me that I wasted my time lol?


Before anyone not point fingers points out that study does not have much information it was one very very few studies I found with a simple Google Search right now I simply just Googled Methadone And Serotonin Release and this was on first page but I don't like to do things half-ass I want to be 100% sure about things hence I made this Thread but it turned out to be moot point and conveniently you answered my questions which I THANK YOU but it's far far too late like everything in my life "fuck you tom oh sorry tom or Here you go Thomas oh wait it's too late shit sucks to be you!" This is becoming a common occurrence it's REALLY making Me angry a long with a lot of other things in my personal life.


But thank you Sekio for ACTUALLY ANSWERING the damn questions which is all I want. You all seem to feel like either to lazy to care to google it to possibly save a life or your just idk don't care and seem to just use itty bitty little information you collected from any plain no effort Google Search could tell Me and making it seem like absolute death if I do it.


No what else ain't safe Cocaine use go read about the users in E.R. visits that have consumed very small doses compared to the severity of symptoms they are experiencing no amount of Cocaine small enough is 100% safe to consume and feel the effects of it at least yet it's a risk you have to take if u want to use the Drug. But I have my reasons besides not being safe to not use like Dextromethorphan being the worse Dissociative to cause Tolerance Issues that never ever seem to go away when talking about using it and then it taking a break only to get bad side-effects.