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8Misplaced8
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HPPD? OCD\anxiety? not sure anymore.
#22065677 - 08/09/15 03:05 AM (8 years, 5 months ago) |
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Well hey. Just opened this account so i could get your opinion about my condition. Last year (up until 10 months ago) i've done 25i about 4 times (1/2 tab each time since it seemed highly toxic in higher amounts), 1 drop of MDMA, nitrous about 200 times (200 balloons that is) and 15g of magic truffles at amsterdam (never done anything more then once every 2 months though).
Then about 10 months ago i decided to quit my weed smoking habit (well, not so much habit as medicine, i use it to treat my anorexia, depression and insomnia), and i went thru DP and probably DR and a few massive anxiety attacks, also some HPPD symptoms after i stupidly read tons of articles about hppd since i was scared i might have it because of my 25i use and started noticing those symptoms. i had objects morphing a bit, sleep paralaysis, and a few other symptoms though they might be from the SSRI im on, also having the text moving a bit while reading if im stoned or tried but that could be my astigmatism.
Skip 10 months forward, i got over 90% of the anxiety and DP\DR and most of the HPPD symptoms went away, im smoking weed again, mostly at night so i can sleep and while i still get anxiety from time to time i generally enjoy it (not as much as i used to but perhaps thats a good thing since now i cant smoke over 0.25g per day, whereas a year ago i smoke around 1g per day). Lately ive noticed a bit of trailing while moving bright objects infront of a dark background, but thats probably from the SSRI im on (and past Zopiclone use which ALWAYS gave me trails), the only thing thats making me anxious is when i get high duting the day once every few days (or when i smoked the night before), and im driving or walking, objects passing on my peripheral (mostly cars though) seems to skip like the frame rate has been dropped. I used to get weird strobe light effect when i started smoking again which disappeard after a few week, but this skipping frames is constant, while it usually happens if i focus on one thing and not moving my eyes for longer then 2 seconds, and it really freaks me out since this also happen on a minor scale while im sober. Is this HPPD or since im always looking for HPPD visuals (which comes from my OCD and anxiety) i just notice a normal weed effect? I dont wanna give up smoking but more than that i dont want to fuck up my perception. So if thats likely to be HPPD i guess ill just quit smoking.
TL;DR- not sure if HPPD or regular low-weed-tolerance effects just messing with my head.
Sorry about the wall of text, hoping some of you might know the answer. also i think i should my mention that all my trips were AMAZING, never had a bad trip, so im pretty sure thats not the regular HPPD might be PTSD thing.
Edited by 8Misplaced8 (08/09/15 03:10 AM)
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Ped
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22066242 - 08/09/15 09:04 AM (8 years, 5 months ago) |
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That's a complex set of variables, and as such it's difficult or impossible to pin down exactly what's happening there. The best way to rule out involvement from ongoing psychoactive drug use is to abstain from psychoactive drugs for a good long while to see what things are like at baseline.
Which SSRI are you taking?
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Ped]
#22066270 - 08/09/15 09:13 AM (8 years, 5 months ago) |
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well currently im on 7.5 mg mirtazapine before sleep and just started 25mg amitriptyline per day (also clonazepam whenver i need, which is less than 0.25mg per day). about 2 weeks ago i went to London for a week in which i obviously couldnt smoke, baseline was constant anxiety\depression (reasons for said cannabis use...) and minor visual snow which i always had, no other visuals or anything. but i assume 1 week isnt long enough.
Used to take tons of SSRI and other stuff for some of my problems up untill 3 years ago which is when i started smoking cannabis, but i doubt it had any long lasting effects.
and thank you for the reply
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Ped
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22066443 - 08/09/15 10:02 AM (8 years, 5 months ago) |
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To be clear, mirtazapine is not an SSRI.
Both mirtazapine and amitriptyline can cause minor hallucinations and visual distortions, particularly when waking up or falling asleep. Anxiety is a rare side effect of amitriptyline (~1%), while nervousness is more common (~10%). It's at least conceivable the cannabis could amplify either effect. Combining mirtazapine and amitriptyline increases the absorption of both, such that they mutually potentiate each other.
I don't tend to suspect contributions from your earlier recreational drug use, but since NBOMe is a such a uniquely potent and unstudied category of compounds it's impossible to rule out any persistent changes occurring from its use. 25i-NBOMe is the most potent 5-HT2A agonist known to exist, and cannot be displaced from this site by any endogenous factor. Because of this, 25i-NBOMe may catalyze the absorption of the 5-HT2A receptors to which it's attached, such that alterations in the density and distribution of this receptor is a potential outcome of its use. This would have ramifications on how endogenous serotonin behaves at this site, and could play a role in your symptoms.
All of that is highly speculative, though. My tendency is to suspect mirtazapine and amitriptyline as the more likely main culprits, at least as far as visual disturbances are concerned. The psychological disturbances may be just that, but they could also be aggravated by amitriptyline.
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Ped]
#22066513 - 08/09/15 10:19 AM (8 years, 5 months ago) |
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So basically if ill stop taking each of them for around 2 weeks that side effect would disappear? and if not, than its probably the damage done by 25i (whcih i know now i shouldnt have taken)? I just want to know that im not doing any further damage by smoking cannabis since it helped me more than any med prescribed to me.
also, any way to reverse any damage done?
I suspected the mirtazapine for a while too, since that HPPD-like symptoms started around the same time i started taking mirtazapine (a few weeks after using 25i, since it gave me horrible insomnia for about 2 months) but since im on super-low dose (7.5mg, normal dose is 25mg) i didnt really believed it could be the mirtazapine.
and again, thank you for commenting
oh! and what is mirtazapine if not SSRI? is it SNRI? i always thought it was SSRI.
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Ped
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22066651 - 08/09/15 10:56 AM (8 years, 5 months ago) |
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Well, I don't recommend discontinuing your prescriptions without speaking to your doctor. It's appropriate to speak to your doctor about your visual disturbances, and to decide a course of action in cooperation with him or her. If ceasing those prescriptions does not lead to a resolution, then persistent changes (I wouldn't call it "damage" per se) from 25i increase in likelihood as a candidate explanation, but since there's no known mechanism for this it wouldn't be reasonable to reach that conclusion. There may well be contributions from factors unknown.
In the purely speculative and probably unlikely event that 25i-NBOMe has caused any persistent changes, only time can correct it.
Mirtazapine is formulated in 15 mg, 30 mg, and 45 mg tablets. While 7.5 mg is a low and non-standard dose, absorption is not bioequivalent due to involvement from amitriptyline. Plasma concentrations are therefore higher than 7.5 mg of mirtazapine taken alone. When they do manifest, visual disturbances increase together with concentrations of mirtazapine in plasma. Owing to the propensity of amitriptyline to increase the absorption of mirtazapine, and owing to the anxiogenic side effects relatively common to amitriptyline, in your position I would discuss the discontinuation of amitriptyline with my doctor first, see if that clears things up, and then consider discontinuing mirtazapine if symptoms persist. Taken alone, mirtazapine should not cause visual disturbances at 7.5 mg.
Of course, ongoing cannabis consumption will make it difficult to evaluate if these adjustments are producing the desired results.
Mirtazapine belongs to a classification called NaSSA, or Noradrenergic and Specific Serotonergic Antidepressant. It broadly increases serotonergic and noradrenergic neurotransmission by antagonizing α2A-adrenoceptors, and by antagonizing or inversely agonizing 5-HT2 receptors and their subtypes, as well as 5-HT3 and 5-HT7 receptors. This is different from SSRI/SNRI medications (such as amitriptyline), which selectively inhibit the reuptake of serotonin and/or norepinephrine, thereby increasing their neurotransmission in a somewhat more targeted manner. There is considerable controversy about which classification is superior, but generally speaking NaSSA medications have a higher therapeutic index than SSRI/SNRI medications, producing comparable benefits with fewer and more tolerable side effects.
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Lucis
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Ped]
#22066750 - 08/09/15 11:27 AM (8 years, 5 months ago) |
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Quote:
Ped said: My tendency is to suspect mirtazapine and amitriptyline as the more likely main culprits, at least as far as visual disturbances are concerned.
I was prescribed 3mg Klonopin a day for several years, I had to stop taking it because it was causing me to have visual disturbances, within a month of stopping it I was back to normal.
I just wanted to put that out there.
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Ped]
#22066760 - 08/09/15 11:29 AM (8 years, 5 months ago) |
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Just started the amitriptyline 4 days ago. Untill then i was on mirtazapine 7.5mg each night and edronax untill 2 weeks ago. So basically it cant be the mirtazapine alone doing that? Would you consider those visual distubances normal with low tolerance to weed or could this be a sign of HPPD?
thanks for the explanation, i was sure it was SSRI until now
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Lucis]
#22066904 - 08/09/15 12:01 PM (8 years, 5 months ago) |
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Quote:
Fennario said:
Quote:
Ped said: My tendency is to suspect mirtazapine and amitriptyline as the more likely main culprits, at least as far as visual disturbances are concerned.
I was prescribed 3mg Klonopin a day for several years, I had to stop taking it because it was causing me to have visual disturbances, within a month of stopping it I was back to normal.
I just wanted to put that out there.
Wow really? So far Klonopin (clonazepam) is the only thing helping my visuals, which makes me think they actually a symptom of anxiety\ocd and by taking clonazepam i just stop paying attention to them.
What visual disturbances did you have? if you dont mind me asking that
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Ped
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Lucis]
#22067037 - 08/09/15 12:36 PM (8 years, 5 months ago) |
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If amitriptyline is a new variable, and if your symptoms haven't increased or decreased in response to it, then it's probably not involved. Mirtazapine should not cause visual disturbances on its own at 7.5 mg, but it's not impossible. Clonazepam should not cause visual disturbances at 0.25 mg either (this would be a paradoxical reaction), but that too is not impossible.
Re-reading your posts, I notice that you mentioned the visual disturbances seemed to appear together with the start of your mirtazapine regimen. That could be significant. Have you noticed that these disturbances are more pronounced as you're going to sleep, or as you're waking up? Visual disturbances related to mirtazapine are most pronounced during those transition phases.
I'm a bit resistant to the HPPD self-diagnosis because of the apparent rarity of that disorder, because there are or have been so many pharmaceuticals involved, and because there are pre-existing symptoms which are features of other disorders that can include visual disturbances. Persistent psychiatric or perceptual disturbances are not uncommon to all recreational drug use, but the mere existence of such disturbances is not necessarily evidence of HPPD.
In the DSM-V (pg. 531), the diagnostic criteria for HPPD reads as follows:
Diagnostic Criteria:- A. Following cessation of use of a hallucinogen, the re-experiencing of one or more of the perceptual symptoms that were experienced while intoxicated with the hallucinogen (e.g., geometric hallucinations, false perceptions of movement in the peripheral visual fields, flashes of color, intensified colors, trails of images of moving objects, positive afterimages, halos around objects, macropsia and micropsia).
- B. The symptoms in Criterion A cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- C. The symptoms are not attributable to another medical condition (e.g., anatomical lesions and infections of the brain, visual epilepsies) and are not better explained by another mental disorder (e.g., delirium, major neurocognitive disorder, schizophrenia) or hypnopompic hallucinations.
Differential Diagnosis- Conditions to be ruled out include schizophrenia, other drug effects, neurodegenerative disorders, stroke, brain tumors, infections, and head trauma. Neuroimaging results in hallucinogen persisting perception disorder cases are typically negative. As noted earlier, reality testing remains intact (i.e., the individual is aware that the disturbance is linked to the effect of the drug); if this is not the case, another disorder (e.g., psychotic disorder, another medical condition) might better explain the abnormal perceptions.
Before considering HPPD as a likely explanation, it's necessary to rule out contributions from pharmaceuticals by eliminating them from the equation, and that should only be done in cooperation with your physician. It's also necessary to rule out other mental disorders, because visual disturbances can be a feature of other disorders which also count anxiety, depression, depersonalization and derealization as symptoms. Untangling all this is probably not something we can accomplish here. As I said in my original reply, this is a highly complex set of variables. Any of the substances mentioned could be involved, whether by itself or in tandem with the others, and any of your symptoms can arise independently of the substances mentioned. If you are continuing to struggle with visual disturbances, anxiety, and depression, this is probably something best sorted out with a physician or psychiatrist.
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Ped]
#22070354 - 08/10/15 02:35 AM (8 years, 5 months ago) |
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Yes they are stronger before going to bed and after waking up (though they're not hypnogogic\hypnopompic hallucinations), pretty sure thats because i take my mirtazapine dose about 2 hours before going to bed, if it is actually because of the mirtazapine.
I'm aware that HPPD could have the same symptoms as other mental conditions, but i had those conditions all my life and never had this kind of visual disturbances, but than again im only 23 so stuff changes i guess.
The only thing making me worry it is actually HPPD is the fact that after smoking weed those symptoms are much stronger, and weed isnt good for HPPD as far as im aware. I guess ill talk about it with my psych next time i see him and hope he'll have anything to say about it (if he wont know anything about it ill just talk to one of the HPPD specialist here and see if he think i should be worried)
Any idea if there are any nootropics\supplements that could help in any case? (either damaged 5-HT2A receptor\other 5-HT receptors\any visual cortex area)
Thanks again for explaining everything, it really helped my anxious part
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Perceptive
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22071131 - 08/10/15 10:16 AM (8 years, 5 months ago) |
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im pretty sure that I have the same condition as you - "HPPD" - though not as intense.
Visual snow, pariedolia(clouds make faces etc..)
And it causes me sooo much fucking anxiety and dissociation. !!!!!!!!
I meditate for hours a day.
I was thinking about doing MDMA to help resolve the anxiety. its been like 9 months, HPPd. the dissociation seems to be alot less, probly cuz the meditations an stuf.
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Ped
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Perceptive]
#22071215 - 08/10/15 10:45 AM (8 years, 5 months ago) |
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HPPD is probably a sensory gating disorder. If that's the case, MDMA is liable to amplify it.
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Perceptive]
#22071371 - 08/10/15 11:38 AM (8 years, 5 months ago) |
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Quote:
Perceptive said: im pretty sure that I have the same condition as you - "HPPD" - though not as intense.
Visual snow, pariedolia(clouds make faces etc..)
And it causes me sooo much fucking anxiety and dissociation. !!!!!!!!
I meditate for hours a day.
I was thinking about doing MDMA to help resolve the anxiety. its been like 9 months, HPPd. the dissociation seems to be alot less, probly cuz the meditations an stuf.
Well its not -that- bad, its just making my anxiety worse and doesnt really interfere with anything unless i get a panic attack out of nowhere. But i always had those...
By the way, faces in clouds, pretty sure thats imagination. I think hppd will cause u to see faces everywhere (one of my trips included 15 minutes of playing with grinded weed that looked like 1000 dwarfs). Seeing them in clouds is pretty normal.
Also all my symptom goes away after less than 1/4 clonazepam pill. So could be just anxiety, i hope.
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Perceptive
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22071395 - 08/10/15 11:47 AM (8 years, 5 months ago) |
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yeah thats what my theory is .
i think if we get over the anxiety, the HPPD can go away. just a theory
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8Misplaced8
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: Perceptive]
#22074690 - 08/11/15 02:18 AM (8 years, 5 months ago) |
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Thats what i thought, only problem is the anxiety fuels the possible HPPD symptoms and vice versa. What we do need is to forget everything we read about HPPD. Too bad thats not really possible :P
Just oredered some Lion's Mane extract since i read a number of posts saying that could help HPPD\anxiety\depression symptoms. Will let you know if that works.
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Perceptive
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Re: HPPD? OCD\anxiety? not sure anymore. [Re: 8Misplaced8]
#22076437 - 08/11/15 01:33 PM (8 years, 5 months ago) |
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yeah well we can re-integrate those memories.
nice. good luck man. and thanks
I smoked today and faced a lot of fears ! high meditation for 2 hours
Edited by Perceptive (08/11/15 01:34 PM)
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