5 ms·

>> once daily for the first 3 days and twice daily thereafter, for a total of 6 weeks > Ignore anyone who tries to compare this to recreational DXM consumption

>> once daily for the first 3 days and twice daily thereafter, for a total of 6 weeks > Ignore anyone who tries to compare this to recreational DXM consumption because they're quite different. Other promising trials for a fast acting treatment of treatment-resistant depression are using single doses up to 600mg of DXM. My personal experience is that a single dose of 600-900mg of dextromethorphan will cure depression like aspirin cures a headache, with the depression-suppressing effect lasting from a month up to 6 months and longer. The considerable side-effects of such a large dose are mitigated by 20mg of pepsid and allowing the sedative effects of DXM to sleep through the hallucinations, delusions, susceptibility to suggestion, etc. But we'll leave it to pharmaceutical companies to develop a patentable formula that requires the patient to take pills for the rest of their lives. Imagine if headaches were treated the same way. This ubiquitous ideology of permanently medicating mental health patients is nothing less than the commercialism of mental illness. Patients are being farmed by Big Pharm. There is a widespread stigma in medicine and society at large against self-medicating and specifically against using DXM to treat depression, due to its abuse by 14-year-olds and drug cowboys. I've only quoted you to remind you of same and that dosages of DXM in comparison to other pharmaceuticals is entirely arbitrary (for example, aspirin bottles indicate 650mg for a headache). The lethal dose of DXM is an estimation because, as of yet, no one has managed to achieve a fatal overdose of DXM. So it is a safe drug, and because it has been off patent since the 1950's, we're not going to see any ordinary unadulterated formulations. Lucky thing, DXM is not a controlled substance.

pstuart 4y ago
> 600mg of DXM That's over a pint of Robitussun -- I couldn't imagine chugging that down. I am intrigued by your claim though.
- Maursault 4y ago
  Robitussin is not dextromethorphan in the same way that beer is not alcohol. I'm not aware of any formula of Robitussin that doesn't include other drugs that are dangerous at high doses, including probable damage to kidneys and liver. Overdosing on Robitussin is an astoundingly bad idea.
  - Tildey 4y ago
    FWIW, I'm sick and am currently looking at a bottle of Robitussin Dry Cough Forte, and the only active ingredients are DXM. But yes, if you're wanting to do high doses, tablets are gonna be the least unpleasant option
    - Maursault 4y ago
      That's because, as far as it exists, America's nanny-state sucks, (the secondary drug ingredients have a dual purpose of treating some other ailment beyond cough, such as chest congestion, and dissuading from intentional medicative overdose), and you're probably D&U.
      - Tildey 4y ago
        > D&U I've never heard this term before, what does it mean
        Maursault 4y ago
        "down under"
      - pstuart 4y ago
        Agreed on the nanny-state bit, but we kind of get what we deserve since most people are ok with "protecting" us from dangerous drugs. Except for alcohol and tobacco, those get a pass for $ome rea$on. At least cannabis is making it's way into normality and states are recognizing that there's money to be made.
  - pstuart 4y ago
    Looks like they sell tablets with just dextromethorphan. Hooray for teh interwebs!
retrac 4y ago
All of the dissociative drugs likely have this effect, and likely by a common mechanism. Single-dose ketamine can have similar results. Unlike with ongoing low-dose dissociatives (which are more likely acting like a classic antidepressant), I suspect the strong single-dose effect is from cognitive changes that occur during the dissociative episode. It's oddly easy to look (metaphorically or literally) at things that would normally make you flinch (metaphorically or literally). As I once heard it put, you can only die so many times during the trip before you stop worrying about it. I am still inclined to a slightly more cautious tone than your post; for example DXM dosing is very sensitive to body weight and 900 mg for a large man vs. small woman will be very different. At high doses it interacts highly unpleasantly, and potentially dangerously, with a number of drugs, including common antidepressants and ADHD medications. It even interacts strongly with grapefruit.
- Maursault 4y ago
  > All of the dissociative drugs likely have this effect, and likely by a common mechanism. Single-dose ketamine can have similar results. I am only aware of 5 dissociatives: Dextromethorphan, Nitrous oxide, Ketamine, Phencyclidine, and Dimethyltryptamine. I have no idea if all or any of them would be effective at treating depression other than Dextromethorphan and Ketamine. Only Dextromethorphan is readily and legally available without a prescription. While Ketamine has promising results, between the time depression stikes and the date of a Ketamine clinic appointment, sudden death can occur. I'm certainly not telling anyone what to do, but from personal experience, clinical depression sucks and it kills. When facing a 6 week to 3 month delay in even getting a Ketamine clinic appointment, or just a PMH-NP appointment for a more ordinary antidepressent, it is infinitely easier and more comfortable to accept furtive looks at any of the local drug stores and know that by the following morning depression will be gone. > Unlike with ongoing low-dose dissociatives (which are more likely acting like a classic antidepressant), I suspect the strong single-dose effect is from cognitive changes that occur during the dissociative episode. I'm not sure cognition exists while asleep, nor if sleeping through a dose can be considered a dissociative "episode." But I do know that dextromethorphan at the doses I mentioned has an irresistible sedative effect, and falling asleep is inevitable, short of taking stimulants. > It's oddly easy to look (metaphorically or literally) at things that would normally make you flinch (metaphorically or literally). As I once heard it put, you can only die so many times during the trip before you stop worrying about it. That is clever, but tripping is recreational and neither it nor consciousness is necessary to curing depression with dextromethorphan. > I am still inclined to a slightly more cautious tone than your post; for example DXM dosing is very sensitive to body weight and 900 mg for a large man vs. small woman will be very different. This is a very good point, and the dosages mentioned can be considered for average weight and for average depressions. Whether heavier individuals and deeper depressions require larger doses, or with lower than average weight that lower doses will still be effective, I really cannot say, but it seams reasonable. > At high doses it interacts highly unpleasantly, and potentially dangerously, with a number of drugs, including common antidepressants and ADHD medications. It even interacts strongly with grapefruit. This is a very good point and mixing any dose of DXM with any other SSRI and even St. Johns Wart could cause Serotonin Syndrome, which can be fatal, but is definitely painfully unpleasant. Grapefruit contains compounds known as furanocoumarins which block CYP3A4 enzymes, reducing the body's ability to break down drugs. Drug blood levels may rise, resulting in a risk of heightened side effects. But I think you'd have to consume a lot of grapefruit or its juice for this to become a serious problem. I can't say for sure because its not in my diet. The OTC antacid drug cimetidine has the same mechanism, but because dosages are concentrated in a pill, the effect can be far greater.
PragmaticPulp 4y ago
> The lethal dose of DXM is an estimation because, as of yet, no one has managed to achieve a fatal overdose of DXM. So it is a safe drug Focusing on fatalities and LD50 is a red herring in drug safety. There are many drugs that can do a lot of damage at doses far lower than those that kill someone.
- Maursault 4y ago
  > Focusing on fatalities and LD50 is a red herring in drug safety. LD50 is ordinarily used as a measure of toxicity. In general, the smaller the LD50 value, the more toxic a substance is. The opposite is also true: the larger the LD50 value, the lower the toxicity. I don't believe it is beyond the realm of reason that, in general, the more toxic something is, the more lethal it will be. Your claim could be considered a red herring. Being that I neither focused on nor made any mention of fatalities, LD50, nor the field of drug safety, your comment is also a straw man. What I instead argued was that dxm, and only dxm, can be considered safe because it is an old drug (went off patent in the 1950's, leaving lots of time for plenty of safety trials, scientific and amateur), it is OTC (implicitly it has been tested and scrutinized for safety by the FDA at various dosages and been approved to have no scheduled controls), and the lethal dose is an estimation (being that it is so old and readily available without prescription, and drug abusers without restraint have survived all imaginable overdoses), which only taken together support my claim that DXM is safe, specifically, what I meant was that DXM is forgiving of mistakenly high dosages in a way that other OTC drugs, such as Acetaminophen, Diphenhydramine, and even Aspirin, are not. > There are many drugs that can do a lot of damage at doses far lower than those that kill someone. This is a bandwagon argument. You're implicitly arguing fallaciously that because there are "many drugs" that can produce significant damage at doses much lower than a lethal dose, then this is also true of dextromethorphan.
  - loa_in_ 4y ago
    >> There are many drugs that can do a lot of damage at doses far lower than those that kill someone. > This is a bandwagon argument. You're implicitly arguing fallaciously that because there are "many drugs" that can produce significant damage at doses much lower than a lethal dose, then this is also true of dextromethorphan. This is more like Pascal's wager - better don't mess with what you can't understand or see. Personality, memories, beliefs, goals, fears. Anecdotally I lost a portion of my memory and cognitive skills after a kind of flu. Instead of support, I've been met mostly with claims that I'm making it up or I am acting like a hypochondriac. All while I struggled to re-learn how to use my daily driver Linux system and where important things are.

pstuart 4y ago

> 600mg of DXM That's over a pint of Robitussun -- I couldn't imagine chugging that down. I am intrigued by your claim though.

Maursault 4y ago
Robitussin is not dextromethorphan in the same way that beer is not alcohol. I'm not aware of any formula of Robitussin that doesn't include other drugs that are dangerous at high doses, including probable damage to kidneys and liver. Overdosing on Robitussin is an astoundingly bad idea.
- Tildey 4y ago
  FWIW, I'm sick and am currently looking at a bottle of Robitussin Dry Cough Forte, and the only active ingredients are DXM. But yes, if you're wanting to do high doses, tablets are gonna be the least unpleasant option
  - Maursault 4y ago
    That's because, as far as it exists, America's nanny-state sucks, (the secondary drug ingredients have a dual purpose of treating some other ailment beyond cough, such as chest congestion, and dissuading from intentional medicative overdose), and you're probably D&U.
    - Tildey 4y ago
      > D&U I've never heard this term before, what does it mean
      - Maursault 4y ago
        "down under"
    - pstuart 4y ago
      Agreed on the nanny-state bit, but we kind of get what we deserve since most people are ok with "protecting" us from dangerous drugs. Except for alcohol and tobacco, those get a pass for $ome rea$on. At least cannabis is making it's way into normality and states are recognizing that there's money to be made.
- pstuart 4y ago
  Looks like they sell tablets with just dextromethorphan. Hooray for teh interwebs!

retrac 4y ago

All of the dissociative drugs likely have this effect, and likely by a common mechanism. Single-dose ketamine can have similar results. Unlike with ongoing low-dose dissociatives (which are more likely acting like a classic antidepressant), I suspect the strong single-dose effect is from cognitive changes that occur during the dissociative episode. It's oddly easy to look (metaphorically or literally) at things that would normally make you flinch (metaphorically or literally). As I once heard it put, you can only die so many times during the trip before you stop worrying about it. I am still inclined to a slightly more cautious tone than your post; for example DXM dosing is very sensitive to body weight and 900 mg for a large man vs. small woman will be very different. At high doses it interacts highly unpleasantly, and potentially dangerously, with a number of drugs, including common antidepressants and ADHD medications. It even interacts strongly with grapefruit.

Maursault 4y ago
> All of the dissociative drugs likely have this effect, and likely by a common mechanism. Single-dose ketamine can have similar results. I am only aware of 5 dissociatives: Dextromethorphan, Nitrous oxide, Ketamine, Phencyclidine, and Dimethyltryptamine. I have no idea if all or any of them would be effective at treating depression other than Dextromethorphan and Ketamine. Only Dextromethorphan is readily and legally available without a prescription. While Ketamine has promising results, between the time depression stikes and the date of a Ketamine clinic appointment, sudden death can occur. I'm certainly not telling anyone what to do, but from personal experience, clinical depression sucks and it kills. When facing a 6 week to 3 month delay in even getting a Ketamine clinic appointment, or just a PMH-NP appointment for a more ordinary antidepressent, it is infinitely easier and more comfortable to accept furtive looks at any of the local drug stores and know that by the following morning depression will be gone. > Unlike with ongoing low-dose dissociatives (which are more likely acting like a classic antidepressant), I suspect the strong single-dose effect is from cognitive changes that occur during the dissociative episode. I'm not sure cognition exists while asleep, nor if sleeping through a dose can be considered a dissociative "episode." But I do know that dextromethorphan at the doses I mentioned has an irresistible sedative effect, and falling asleep is inevitable, short of taking stimulants. > It's oddly easy to look (metaphorically or literally) at things that would normally make you flinch (metaphorically or literally). As I once heard it put, you can only die so many times during the trip before you stop worrying about it. That is clever, but tripping is recreational and neither it nor consciousness is necessary to curing depression with dextromethorphan. > I am still inclined to a slightly more cautious tone than your post; for example DXM dosing is very sensitive to body weight and 900 mg for a large man vs. small woman will be very different. This is a very good point, and the dosages mentioned can be considered for average weight and for average depressions. Whether heavier individuals and deeper depressions require larger doses, or with lower than average weight that lower doses will still be effective, I really cannot say, but it seams reasonable. > At high doses it interacts highly unpleasantly, and potentially dangerously, with a number of drugs, including common antidepressants and ADHD medications. It even interacts strongly with grapefruit. This is a very good point and mixing any dose of DXM with any other SSRI and even St. Johns Wart could cause Serotonin Syndrome, which can be fatal, but is definitely painfully unpleasant. Grapefruit contains compounds known as furanocoumarins which block CYP3A4 enzymes, reducing the body's ability to break down drugs. Drug blood levels may rise, resulting in a risk of heightened side effects. But I think you'd have to consume a lot of grapefruit or its juice for this to become a serious problem. I can't say for sure because its not in my diet. The OTC antacid drug cimetidine has the same mechanism, but because dosages are concentrated in a pill, the effect can be far greater.

PragmaticPulp 4y ago

> The lethal dose of DXM is an estimation because, as of yet, no one has managed to achieve a fatal overdose of DXM. So it is a safe drug Focusing on fatalities and LD50 is a red herring in drug safety. There are many drugs that can do a lot of damage at doses far lower than those that kill someone.

Maursault 4y ago
> Focusing on fatalities and LD50 is a red herring in drug safety. LD50 is ordinarily used as a measure of toxicity. In general, the smaller the LD50 value, the more toxic a substance is. The opposite is also true: the larger the LD50 value, the lower the toxicity. I don't believe it is beyond the realm of reason that, in general, the more toxic something is, the more lethal it will be. Your claim could be considered a red herring. Being that I neither focused on nor made any mention of fatalities, LD50, nor the field of drug safety, your comment is also a straw man. What I instead argued was that dxm, and only dxm, can be considered safe because it is an old drug (went off patent in the 1950's, leaving lots of time for plenty of safety trials, scientific and amateur), it is OTC (implicitly it has been tested and scrutinized for safety by the FDA at various dosages and been approved to have no scheduled controls), and the lethal dose is an estimation (being that it is so old and readily available without prescription, and drug abusers without restraint have survived all imaginable overdoses), which only taken together support my claim that DXM is safe, specifically, what I meant was that DXM is forgiving of mistakenly high dosages in a way that other OTC drugs, such as Acetaminophen, Diphenhydramine, and even Aspirin, are not. > There are many drugs that can do a lot of damage at doses far lower than those that kill someone. This is a bandwagon argument. You're implicitly arguing fallaciously that because there are "many drugs" that can produce significant damage at doses much lower than a lethal dose, then this is also true of dextromethorphan.
- loa_in_ 4y ago
  >> There are many drugs that can do a lot of damage at doses far lower than those that kill someone. > This is a bandwagon argument. You're implicitly arguing fallaciously that because there are "many drugs" that can produce significant damage at doses much lower than a lethal dose, then this is also true of dextromethorphan. This is more like Pascal's wager - better don't mess with what you can't understand or see. Personality, memories, beliefs, goals, fears. Anecdotally I lost a portion of my memory and cognitive skills after a kind of flu. Instead of support, I've been met mostly with claims that I'm making it up or I am acting like a hypochondriac. All while I struggled to re-learn how to use my daily driver Linux system and where important things are.