Depression, Ketamine, Cannabis, Benzos and a few Questions

[Pihuechenyi]

First of all thanks to everyone who has posted in the threads about depression, reading these has given me a lot of useful information. I'm hoping the Nexus can provide some opinions on a couple of questions I have.

My girlfriend has suffered with depression for about ten years. For most of that time she took Pareoxetine aka Seroxat. She was largely stable with this drug but especially towards the end of her time taking it didn't like some of the side effects - emotional flattening (she couldn't experience happiness), lower sex drive and it didn't really help with her depression. Anyway she quit with a self prescription of yoga, exercise and art and went from someone who did no exercise to doing 5 sessions a week. After she had quit paroxetine she realised her heavy cannabis habit wasn't doing her any favours and was making her lethargic and unmotivated in some areas in her life. She therefore quit that and also alcohol for good measure. She really did have an abusive relationship with cannabis (in my opinion) and it could have definitely done with some rebalancing.

Soon after an enormous crash in her mental state followed. It happened slowly over a few weeks then reached crisis point. We treated it with some Ketamine which provided some very temporary relief. She describes it as if she still had the physical effects of anxiety but it wasn't reaching her mind. It took us 12 hours at A&E but eventually she was admitted to a psychiatric hospital for a week due to her suicidal thoughts and intentions to act on them.

They released her with a new antidepressant, some sleeping tablets and some antihistamines for anxiety. She still feels incredibly low and yesterday said she had recently found new levels of despair that she didn't know existed even compared to how she felt when she was admitted to the mental hospital. I've been taking her for long walks in nature and they help a lot. Today after spending most of the day in the countryside she says she has found some peace. However when someone wants to kill themselves i'm not sure antihistamines are strong enough so she has also been taking (unprescribed) 1mg of etizolam a day. She doesn't sleep well which won't help and after reading Null24's Insomnia Bites thread we will soon have some Kava Kava, lemon balm and melatonin but i'm going to try absolutely everything described in that thread. Eventually her new antidepressant should kick in and hopefully things will be fine.

So my questions are these:

- do you think quitting the heavy cannabis habit shortly after quitting antidepressants could have contributed to her crisis?
- can quitting a heavy cannabis habit cause intense anxiety (i've done some searching and can see people who quit can sometimes have anxiety but couldn't really gauge how severe this was)
- I really don't want her to have problems with a benzo habit (i'm aware etizolam isn't a true benzo). She has been on 1mg per day for 2.5 weeks, is this enough to start worrying about withdrawal symptoms? How much longer do you think she could take it before it gets risky or is her dose sufficiently small that we don't have to worry for a little while? We also have some 10mg diazepam but haven't taken any of those.

This girl is the mother of my child and it breaks my heart to see her suffer like this. Any advice or opinions will help give us some context and also might help us avoid the benzo withdrawals that would probably put her back to square one.

On a lighter note I now have my GVG back from her but it is taking ages to clean all the resin build up. Looking forward to vaping some of the DMT/THC mix I get out of it after the acetone evaporates!

 

[corpus callosum]

I'm sorry to hear of your girlfriends woes.

Quitting a heavy cannabis habit can be associated with anxiety and if this is superimposed upon a backdrop of depression it would be difficult to rule out a contributory role for a subsequent worsening in ones mental well-being.

Although etizolam is purported to have a lower potential for causing habituation then the more 'regular' GABA-ergics there is accumulating and reliable evidence that one should exercise the same cautions as if one was using the standard benzodiazepines. The havoc that an etizolam habit could cause to someone with pre-existing mental health troubles is something to be avoided at all costs and I would want to keep the course length to 4 weeks as an absolute maximum, and avoid dose escalation, to avoid rebound effects.

Best wishes to you both.

 

[Jin]

being depressed like forever and thinking suicidal thoughts everyday was a way of life here.........a while back

if it was'nt for birds and animal friends , being alive today would not be possible

get her to spend time with nature , and get her a few animal friends , rabbits , ducks , pigeon , squirel's , insects , whatever , it does'nt matter which animal friend to have around , as they are all angels ,

also quitting cannabis while being depressed did contribute to the crisis , however too much cannabis use also causes depression , for depressed people - the absolute best way to smoke cannabis is to have a gap of 4 hours between each smoke

meaning - dont puff a small hit every few minutes or every 30 mins , rather smoke as much as possible all at once and then wait 4 hours before smoking again , this provides a very different kind of effect compared to smoking all the time ,

also cigarettes are the worst thing for depression , never do that

 

[Pihuechenyi]

Corpus - thank you for your wishes and your advice. I will ensure we don't go beyond the 4 weeks. I just have one more question if you don't mind.

In addition to her antidepressant (sertraline) she is currently taking promethazine and etizolam for anxiety and zopiclone to sleep although she finds the zopiclone doesn't keep her asleep so sometimes uses the etizolam or promethazine to help her sleep and the takes the zopiclone if she wakes up. Is there any danger in stacking these drugs together, i.e. is there too much of a CNS depressant effect if she takes two or three of them in combination over the course of a night? In additon she might be prescribed pregablin next week - are there any contraindications with etizolam we should be cautious of?

Jin - thanks to you too for relaying your experiences. When she is ready to go back to the green goddess we will try that approach instead of constant toking all day and maybe stick to strawberry kush instead of amnesia haze. She has expressed a strong interest for working with animals or in nature. Unfortunately our home circumstances don't allow for too many animals. However we have a meeting next week with someone who can help organise voluntary work and we will see if there is anything animal related. She has also enquired about volunteering in our local nature reserve as a gardener. Really these last few weeks the only thing that has saved us is being in nature. In the meantime I will however try to incorporate animal life into our daily experiences. It can be as simple as feeding squirrels or visiting a wildlife reserve. I concur with you animals are angels. For example how come cats are so damned amazingly sensual? Where does that come from?! Don't worry about the cigarettes - not her thing.

 

[Jin]

another thing that does'nt get noticed is the caffiene intake ,

people are always overdosing on caffiene , even nescafe on its packet recommends 4 times the amount required , perhaps its a global conspiracy to dumb down the people of the planet ,

anyways its useful to drink 230mg of coffee every 4.5 hours , for optimal effect

notice this is even less than 1/4 of a teaspoon , and 230mg coffee only contains approx 17mg of caffiene , 300 ml coke cola/pepsi also contains approx the same amount of caffiene as 230mg coffe, so substituting cola for coffee is ok as long the amount is appropriate

some people drink strong coffee with heaping teaspoons of that $#!t in the morning and wonder why the day is so offf

its so reallyy good to drink just 230mg coffee after every 4.5 hours , its neither too upliting nor dull , 300 ml coke cola/pepsi can be substituted at times , however keep the timeframe 4.5 hours , never drink inbetween the timeframe , its not like cannabis and can be toked all day

also weighing at 54 kgs only , 230 mg coffee is required , doseage can vary a litte with body weight or it might not , but its not goint to be heaping teaspoonful as nesacafe recommends , don't do that

eitherways the point is be mindful of caffiene intake

and 230 mg of coffee is not the same as 230 mg caffiene
230 mg coffee only contain 17mg caffiene

don't drink 230mg caffiene as that would be an overdose

 

[obliguhl]

don't drink 230mg caffiene as that would be an overdose

I like a hefty dose like this for depression. If i have no tolerance and then drink that amount of caffeeine, i'm in a brilliant energized mood all day. Unfortunatly, with tolerance development, the dopaminergic effects fade rather quickly.

Not every case of depression has to do with "low serotonin".

Good luck to you OP. You're a good friend to your friend

 

[Ufostrahlen]

I like a hefty dose like this for depression. If i have no tolerance and then drink that amount of caffeeine, i'm in a brilliant energized mood all day. Unfortunatly, with tolerance development, the dopaminergic effects fade rather quickly.

The stimulant fallacy. I can fly one day on ethylphenidate/Red Bull and have a headache the next 3 times I consume it.

In addition to her antidepressant (sertraline) she is currently taking promethazine and etizolam for anxiety and zopiclone to sleep although she finds the zopiclone doesn't keep her asleep so sometimes uses the etizolam or promethazine to help her sleep and the takes the zopiclone if she wakes up. Is there any danger in stacking these drugs together, i.e. is there too much of a CNS depressant effect if she takes two or three of them in combination over the course of a night? In additon she might be prescribed pregablin next week - are there any contraindications with etizolam we should be cautious of?

Since this seems to be a real medical case, I'd leave all unprescribed drugs alone. Why even Etizolam when you have Diazepam? This thread cries drug abuse. Better talk to a doctor and leave the drug boards alone.

 

[Pihuechenyi]

Obliguhl and Jin - thanks for your comments and wishes. I too no longer have any tolerance for caffeine and if I use it sparingly (once a week say) get a great social and energetic high from it.

Ufostrahlen - Could you clarify your comment 'Why even Etizolam when you have Diazepam?'. In your view is the diazepam better for anxiety and/or insomnia? We only have a limited supply of that though.

With regard to your comment about drug abuse i'm not sure I fully understand you. All medications with the exception of etizolam (and diazepam but we aren't taking that) were prescribed by a doctor. I have added etizolam myself because the anti histamines weren't combatting her suicidal thoughts and she needed something stronger. These are the same anti histamines they prescribe for travel sickness. We cannot discuss this or the history of cannabis use with a doctor because in the country I am in I would run a very real risk of having my daughter taken into care. Even if that didn't happen I would be involved with social services for a significant timeframe which would not be helpful for the recovery of my partner. I have therefore seeked out advice from the only place I know that I can get some confidential, knowledgeable and appropriate information to ensure that any actions I am taking outside of the routine medical prescriptions are safe for my partner. My partner gave up her original anti depressant as well as cannabis, caffeine and alcohol so I can assure you drug abuse is the last thing on our minds. I may however have misunderstood so please forgive me if that is the case. In any case thank you for your contribution.

 

[Ufostrahlen]

Etizolam = thienotriazolodiazepine || Biological half-life: 6.2 hours
Diazepam = benzodiazepine || Biological half-life: 20–100 hours

Diazepam = much longer duration, leave the Etz & Zopiclone away if it doesn't help with sleeping.

Is the cold turkey a good idea? Why not slowly tapering it off?

I don't like the amount of drugs that are involved:

Etizolam, Diazepam, Sertraline, Zopiclone, Pregablin, Ketamine, Melatonin, Kava Kava, Lemon balm. Do you track all the side effects? I doubt that a doc prescribes this crazy mixture.

If you can't sleep on Diazepam alone, you're a case for a psychiatric doctor. Nevertheless, good luck with your partners health.

 

[obliguhl]

The stimulant fallacy. I can fly one day on /Red Bull and have a headache the next 3 times I consume it.

Well, i do not get a headache if i drink coffee three days in a row. But i think caffeeine metabolism is highly genetic The interindividual differences in the 3-demthylation of... : Pharmacogenetics and Genomics . Maybe you are a slow metabolizer and overdose after three days of high caffeeine consumption?

I was referring to the dopaminergic effects of caffeeine:

Differential effects of caffeine on dopamine and acetylcholine transmission in brain areas of drug-naive and caffeine-pretreated rats - PubMed

The effects of caffeine on extracellular dopamine and acetylcholine have been studied in freely moving rats implanted with concentric microdialysis probes in the nucleus accumbens shell and core and in the medial prefrontal cortex. Intravenous administration of caffeine (0.25, 0.5, 1.0, 2.5 and...

www.ncbi.nlm.nih.gov

Therefore, in rats made tolerant to the locomotor stimulant effects of caffeine, tolerance developed to the dopamine stimulant but not to the acetylcholine stimulant effect of caffeine in the prefrontal cortex. The lack of acute stimulation of dopamine release in the nucleus accumbens shell by caffeine is relevant to the issue of its addictive properties and of the role of DA in drug- and substance-addiction. On the other hand, the dissociation between tolerance to the locomotor effects of caffeine and stimulation of acetylcholine release in the prefrontal cortex suggests that this effect might be correlated to the arousing effects of caffeine as distinct from its locomotor stimulant properties.

Probably a good thing that tolerance does develop to the dopaminergic effects, otherwise it would be even more addictive.

Now that it hink about it:

Has your girlfriend tried raw cacao beans ? See this Thread: Raw Cacao Beans & Combinations - Other Psychoactives - Welcome to the DMT-Nexus

I think my conclusion was that it is a unspecific amplifier, but it often lifted my mood. Important to try a few different sources of cacao beans, since they all have varying alkaloid contents. Some have almost none, others are really strong.

 

[Ufostrahlen]

Maybe you are a slow metabolizer and overdose after three days of high caffeeine consumption?

Could be. 80mg caffeine is the max. I can tolerate per day. It makes me also more tolerant to thirst and I dry out easily. Stupid drug, but I'm kinda addicted to it. If only I could do lysergic compounds every day, the next day after acid I feel peace in my life. Until it wears off the next 2 days.