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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by KieranK on January 9, 2004, at 9:35:47
Hi all. I am in a situation where I am trying to either reverse or better my cognitive abilities, which I believe are lower than what they used to be following a period of heavy marijuana use, using either SSRI's or SNRI's. I'm having great trouble finding either a GP or a psychologist who knows what to do, or even recommend a treatment regime other than what I suggest to them. Maybe someone out there can help?
The background is this: I started using marijuana about six years ago. It took about six months from the first time I used it to really get into using it regularly and hard, but following that I smoked regularly and heavily for about two to three years. My use was nearly always social - there was a group of us who got stoned together, and pretty much the only time I got stoned was in that group - the number of times I got stoned by myself I could probably could on both hands, over that full 4 year period.
For about 2 years out of the 4 that I was with that group and smoking, we used a method called 'buckets' or 'rockets' which concentrate the smoke into a single 'hit'. This gets you REALLY stoned. A few of these will get you more stoned than smoking any amount of joints or bongs. Most people who try these methods will attest to the fact that it is a different type of high - not just more intense, but also slightly different (ie in the same way that smoking a joint gets you a different type of 'high' than the 'stoned' you get from a bong).
Anyways, following that 2 year period of really heavy rocket/bucket use, I noticed a *very* distinct decline in cognitive ability and social function. This decline started during the period of rocket/bucket use, and its inception is what started me on the path to stopping marijuana use, or at least cutting it down. The situation did seem to improve a little while I was stoned, but both on and off the pot, the social function and congitive ability were both severly impaired. Stopping the pot use did not stop the decline in cognitive function or social ability.
The social group which I was smoking in eventually drifted apart, and with it, my social marijuana use declined and pretty much ceased. I specifically took a trip overseas to remove myself from any temptation which may lead me to smoke, and completely abstained from use for a period of around 8 months. This did not rectify the situation - if anything, i found myself even more socially impaired upon returning than when I left.
Through experimentation I found that the situation did improve with casual marijuana use. I found I was able to concentrate better, remember more, interact with people better etc whilst *slightly* stoned. ie using a small amount of marijuana, so i was 'high' (not 'stoned') did help.
This led me to the assumption/belief that the problems I experiencing were biochemically-based ie in a normal, unstimulated state, my brain was not functioning *as well as it had* or as well as I wanted it to (from previous expectations).
Smoking pot everyday, even in small amounts, was not the solution. I tried this, but hey, you cant be stoned all the time, its just not practical, and its not the solution. Plus, I would start off using small amounts just to get 'high' as i've mentioned, to feel better and get that increased cognitive function/social ability, but as my resistance to the pot increased, so did the amounts i was using, until i was smoking heaps all the time and the benefits of small amounts of usage were completely nullified - i was just stoned all the time.
I have to stress at this point that the problems i was experiencing were not completely and utterly reversed or solved by using small amounts of pot, only made slightly better. Even when under the influence of small amounts, I still did not function as well as I wanted to or was used to, it was just better than not being under the influence at all.
There obviously was a whole underlying and ongoing lifestyle problem caused by this situation. I couldnt study properly, my grades dropped, I found it very hard to make new friends or interact well with old ones, I found it hard to impress or interact with work collegues and this problem was affecting every aspect of my life. The resultant set of problems could well be labelled amotivational syndrome in that, yes, I did loose energy and avoid social situations. However whereas the aforementioned syndrome seems to be related primarily to detoxing off marijuana, i had tried detox on the trip overseas and the problems had persisted.
So I went to see a GP who I had heard helped people in our town with drug dependancy and asked him what do to? He said that the 'solution' were something called SSRI's - you all know them - selective serotonin reuptake inhibitors, or antidepressants. I tried one, it knocked out my sex drive, so I changed to Aropax. Note that at the time of going on the SSRI's, I wasnt using pot at all, I was totally clean. The GP's explaination of what had happened was that my years of heavy pot use had made my brain 'used' to higher levels of serotonin, or was dependant on the pot to determine the levels of serotonin in my brain. Without the pot, i had decreased levels, and hence the problems. Small amounts increased the levels of serotonin, hence the problems were made less bad. Too much pot though, and I got stoned, which was just plain old getting stoned.
It made sense to me, so I kept taking the Aropax. After a bit of getting used to, they did seem to make a bit of an improvement, but really it didnt feel totally right. I liken it to taking a step sideways instead of a step forwards - different, a bit better, but not really the solution i was looking for.
So I tried smoking pot on the Aropax. Whalla! Solution. Aropax+marijuana and (probably needless to say really) I felt great. Social function good, cognitive ability great. Pretty much what I had been aiming for in the first place, a return to normal function. However, I get back to the original problem - you cant be stoned all the time, and resistance problems meant that I was just on a roller coaster of light use to heavy use to nullifying the effects and just being stoned all the time. Whoops! Not the solution...
Again, at this point, I want to stress that this treatment cycle has taken some years to go through and work out what does and doesn't work. Ive tried heaps of different combinations of everything - exercise, diet, lifestyle, on aropax, off aropax, on pot, off pot, combine all the above in different combinations... The only time i feel right is when i smoke just a bit of pot whilst on the aropax.
So here I am, on SSRI's, which I believe are still taking a fair whack out of my sex drive and making me a bit tired, and by themselves are not effective. After two years on them, simply taking them every day without any pot if anything is has a negative effect on my life and lifestyle. The exchange of energy and sex for the little, if any, increase in cognitive ability they give is, i believe, not worth it. I havent suffered from depression, as in sadness depression, either prior to, during, or after my pot use, at least no more than the average person exposed to normal life and stress.
Looking up the effective pathway of marijuana in the brain, I've seen that its effects are more targeted upon dopamine and norepherine/noradrenaline than serotonin. Dopamine, the 'wow, that was nice' or reward brain chemical, i dont really think is the problem (i'm not looking for a state of euphoria all the time - thats not normal, and i'm just after normality). Instead, I have been looking at noradrenaline/norepherine. As I've mentioned, the Aropax are giving me sexual disfunction. I noticed it really badly when i first went on them, the symptoms subsided a bit after a while, but i still have greatly decreased sex drive and trouble getting an erection. Im 25 and in a relationship, so it's a bit of a problem. I have been thinking of swapping SSRI's or getting off them all together (the latter my preference at the moment) as I believe that they were not the exact solution in the first place. IE marijuana's effect on serotonin is somewhat limited, and plus SSRI's seem to be used to treat depression, and i wasn't depressed in the first place?
Considering the SNRI's dual effects on serotonin and norepherine, I have been seriously considering trying them out. At the moment I believe that they may hold the real solution to my problem - ie increased serotonin levels (that i got with the aropax) AND increased norepherine levels (that I was getting with the pot) to put me in the situation that I was in when i was smoking pot on aropax - one that seemed to be 'right'.
Does anyone have any idea what I'm talking about? Any experiences, or even recommendations? I've read/heard different things about the SNRI's and their side effects, I really dont want something that im going to have to make negative trade offs of other things in my life to be on, eg my health, more energy, mental well-being or more of my sex drive. In fact, in a beautiful, wonderful world, they would give me the brain function I am looking to retreive without any noticeable side-effects, and give me back my sex drive. Being on the SSRI's have given me an insight into the functioning of my brain and have led me to understand more about this problem i'm experiencing, but overall I can't say that their impact on my life has been positive, so I'm worried that taking the next step 'up' to SNRI's will also perhaps have a similar negative effect - taking away more things I hold valuble and that I don't want to loose.
Perhaps I'm asking too much, but the situtation as it is at the moment, ie still dependant on marijuana, having problems being on Aropax, is not acceptable anyway, so I think it is worth a try. It can only be a different type of bad, and hey, with some luck, it'll be a better kind of good!!!
Please anybody, your input will be so deeply appreciated. Its a problem that ive grappled with for the better part of a decade, and I still consider myself to be young, i want to get this sorted out and get on with my life, and get on with it in a non-drug-f*cked state of mind.
Infinite thanx for your help,
Jason
Posted by crazychickuk on January 9, 2004, at 10:36:41
In reply to Marijuana dependance treatment using SSRIs/SNRIs, posted by KieranK on January 9, 2004, at 9:35:47
it takes 6 mnths for marjuanna to come out of your system.. try not to go onto any ssri's just live it out with no meds and no marjuanna.. maybe try ginka as an option or ritalin!! they both help with maintaining good consintration... (sp)
Posted by Twuffy on January 9, 2004, at 13:25:52
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by crazychickuk on January 9, 2004, at 10:36:41
I am in the same boat as you Jason! Excellent post by the way, you certainly haven't lost all of your brain function. :-) Okay, so I am having the same problem, though my use has been longer than yours. There have been periods when I don't smoke but that hasn't been for awhile. I really don't feel normal unless I am slightly high. Its all in what you said so I won't repeat. I have been trying to quit for months now and I just can't seem to manage it. I have no friends, no job, and no life basically. This is not the way it should be. So I just got on Lexapro for depression but from what you are saying I think I too should investigate other alternatives. I was on Wellbutrin for awhile and was able to quit then. hmmm, actually later I started up while still on it and perhaps the combo was what made it all that much more irresistible. I eventually went off the WB because I was concerned about the combo. If you get any info, please let me know. I never even heard of an SNRI. Which ones are SNRIs? I wonder about Ritalin. Somebody help us!!! If I had any pot right now, I would be smoking it...
Posted by mtdew on January 9, 2004, at 21:36:13
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by crazychickuk on January 9, 2004, at 10:36:41
I feel like throwing in my opinion even though I've never been a marijuana addict. In my gut I agree with crazychickuk about pursuing sustained abstinence, for at least a year. Marijuana doesn't act directly on dopamine, serotonin, or norepinephrine; it has its own receptors and acts on a totally different brain system. So don't worry about trying to duplicate the effects of marijuana on your brain. It sounds like having marijuana in your brain for such a long time has upset the natural equilibrium, and so ideally, your long-term goal is to allow this equilibrium to come back on its own, which may take a long period of abstinence. If you feel you are depressed, you may experiment with different psychiatric drugs (or even therapy) to alleviate this separate problem. I would recommend caution in this area, however, as some psychiatric drugs are in many ways "harder" drugs than pot, and you may wind up digging yourself a bigger hole. The experience of many suggests that SSRIs are relatively safe and benign, so I would suggest trying out more than one of these (e.g. prozac, celexa, zoloft, luvox, etc.) before moving on to something positively frightening like Effexor. I am not sure where Wellbutrin fits into this spectrum, but I think it's probably more dangerous than SSRIs and perhaps somewhat less than Effexor.
People who have been addicted to heroin often find that they can't function well after coming off it, even after getting through the acute withdrawals, and that's why there are methadone maintenance programs. It sounds like this is the sort of thing you need, if it existed, for pot.
Perhaps look into an actual drug treatment counselor, or a support group, as you will benefit from their experience. The theories about neurotransmitters that your psychiatrist has cooked up are probably nonsense.
Posted by Sebastian on January 10, 2004, at 17:39:34
In reply to Marijuana dependance treatment using SSRIs/SNRIs, posted by KieranK on January 9, 2004, at 9:35:47
Hi!
I'm an ex-heavy pot smoker too. Try some zyprexa, with the SSRI. The zyprexa is like pot but you won't be stoned, and I found it to be realy good for my grades. Straight A's. the SSRI will make you happy.
I take 10 mg zyprexa and 60 mg Celexa. Also 300 mg Wellbutrin SR for energy and not as much smoking (ciggs).
Posted by Sebastian on January 10, 2004, at 17:46:28
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by mtdew on January 9, 2004, at 21:36:13
I want to put in more 2 cents. Without any medicine and no pot or alcohol, I would go crazy and be vary depressed. I stoped the heavy pot cold turky went to school didn't drink and studied very hard had a 3.33. Went back to pot then school off the pot and very depressed. I have drug induced psychotic depression. No meds, no good.
Posted by KieranK on January 12, 2004, at 5:12:46
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by Twuffy on January 9, 2004, at 13:25:52
Wellbutrin is an option I have been really looking seriously at, mainly because it does seem operate on the same brain chemicals as pot does, and seems to have few side effects. The way I am leaning at the moment is to start up on Wellbutrin whilst still on the SSRI, stay totally clear of the pot, and see how things go, with the intention of dropping the SSRI once I've stabilised and gotten used to the Wellbutrin. It would seem that perhaps the Wellbutrin would have been better to go on that the SSRI in the first place, as I mentioned in the original post I dont think the SSRI was the right move initially.
The question of relapsing and starting to use pot again whilst on Wellbutrin or a Wellbutrin/SSRI combo is one I've also thought about... Question is really whether the Wellbutrin was effective? If it was I think I'd probably be able to stay away from the pot, for my own good - its kinda of put me in a hard situation already as it is. How did you find yourself whilst on Wellbutrin - you said it made you able to quit - did it do this by removing any cravings you had, or did it allow you to function normally without the pot, therefore allowing you to not have to use it to feel normal? And any side effects for you?
Your help is much appreciated,
Kieran
Posted by KieranK on January 12, 2004, at 5:28:52
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by mtdew on January 9, 2004, at 21:36:13
> I feel like throwing in my opinion even though I've never been a marijuana addict. In my gut I agree with crazychickuk about pursuing sustained abstinence, for at least a year. Marijuana doesn't act directly on dopamine, serotonin, or norepinephrine; it has its own receptors and acts on a totally different brain system. So don't worry about trying to duplicate the effects of marijuana on your brain. It sounds like having marijuana in your brain for such a long time has upset the natural equilibrium, and so ideally, your long-term goal is to allow this equilibrium to come back on its own, which may take a long period of abstinence. If you feel you are depressed, you may experiment with different psychiatric drugs (or even therapy) to alleviate this separate problem. I would recommend caution in this area, however, as some psychiatric drugs are in many ways "harder" drugs than pot, and you may wind up digging yourself a bigger hole. The experience of many suggests that SSRIs are relatively safe and benign, so I would suggest trying out more than one of these (e.g. prozac, celexa, zoloft, luvox, etc.) before moving on to something positively frightening like Effexor. I am not sure where Wellbutrin fits into this spectrum, but I think it's probably more dangerous than SSRIs and perhaps somewhat less than Effexor.
>
> People who have been addicted to heroin often find that they can't function well after coming off it, even after getting through the acute withdrawals, and that's why there are methadone maintenance programs. It sounds like this is the sort of thing you need, if it existed, for pot.
>
> Perhaps look into an actual drug treatment counselor, or a support group, as you will benefit from their experience. The theories about neurotransmitters that your psychiatrist has cooked up are probably nonsense.
Thanx for ur input Matt... Yeh I actually have tried going to a drug treatment counselour a couple of times before. When it comes to pot, the treatment regime was entirely based on cognitive therapy and control approaches to minimising then eradicating use, with emphasis on the short-term detoxification rather than any long-term problems which may arise, such as this one. Unfortunately, no-one there was able to offer any advice for what I've experienced other than to recommend I go see a GP or pychologist, neither of which again have really been able to help either...And yes, one of the main reasons I am being so cautious about going on any further medication is because I dont want to just be jumping out of the fire and into the frying pan - my GP recommended Effexor as a potential swap from the SSRI I'm on to avoid sexual dysfunction... When reading about it, I think i'd be glad to *only* get sexual dysfunction from using it. One of the reasons why I am trying to draw my own conclusions rather than blindly follow the word of someone else.
Thanx again,
K
Posted by KieranK on January 12, 2004, at 5:33:54
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by Sebastian on January 10, 2004, at 17:39:34
> Hi!
>
> I'm an ex-heavy pot smoker too. Try some zyprexa, with the SSRI. The zyprexa is like pot but you won't be stoned, and I found it to be realy good for my grades. Straight A's. the SSRI will make you happy.
>
> I take 10 mg zyprexa and 60 mg Celexa. Also 300 mg Wellbutrin SR for energy and not as much smoking (ciggs).
Sebastian,Might seem morbid, but I'm glad to see i'm not the only one... :) Zyprexa sounds pretty hardcore, a few potential side-effects... Did you start going on it specifically because of pot-related problems? Its the first I've heard of it for use in this type of situation is all.
Wellbutrin, as I've put in a seperate post, is an option I have really strongly been considering, most probably as an alternative to the SSRI I'm on. Was thinking about starting the WB whilst still on the SSRI, no pot, see how things go, if its working well, then I'll drop the SSRI and see how things are with just the WB.
And yes - i do find keeping away from ciggs helps heaps too - they just deaden me.
Thanx for ur help!
Kieran
Posted by Sebastian on January 12, 2004, at 11:38:10
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by KieranK on January 12, 2004, at 5:33:54
PTSD, which is also sort of drug induced psychotic depresion. Pot was the drug of choice.
Posted by BCBud on August 31, 2007, at 15:48:22
In reply to Re: Marijuana dependance treatment using SSRIs/SNRIs, posted by Sebastian on January 12, 2004, at 11:38:10
I've been a pothead for over 35 years. I'm also a reformed alcoholic with 15 years of sobriety. For many years alcoholism was a big contributor, and it masked my underlying depression.
After quitting drinking and pot use at the same time I became suicidal and was prescribed Effexor, which I was on for 6 years, and suffered several undesirable side effects. It was harder to stop using Effexor than alcohol, weed or tobacco. Weed actually alleviated the side-effects of Effexor.
For the last 10 years my daily consumption of weed has been between 2-7 joints. If I stop using weed the depression returns.
Clinical studies I have seen show that weed's effect on seratonin function provides similar result to those achieved using SSRI's. I have been tested by doctors while under the influence of weed and found to be in the 98th percentile for memory skills, and suffering no cognitive impairment.
Now I simply accept that I have a genetic predisposition to depression that the weed is relieving. I don't get stoned anymore, but the weed makes me feel "normal". Very few "straight" people know that my "normal" state of mind is always under the influence of weed.
It's too bad the legal and medical professions can't get their head around the truly remarkable benefits of this naturally occurring remedy.
Posted by JohnnyBLinux on September 1, 2007, at 0:04:54
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by BCBud on August 31, 2007, at 15:48:22
Wow, I could never afford that much marijuana. I haven't used it in years. Well, if marijuana were legal, and I had a choice between an SSRI / SNRI or marijuana, I'd choose marijuana. The question is what's the lesser of two evils (when you overlook the legalese) in terms of unpleasant side-effects and overall effectiveness in relieving symptoms and improving mood? I don't know -- one person's nirvana is another person's hell -- but clearly it's a controversial question that I'm not qualified to answer. I don't think doctors treat marijuana/cannabis dependence. Instead, they hope to treat the underlying disorder. Alcohol is my subsitute for marijuana b/c I cannot afford to get another mark on my criminal record (unrelated to prior marijuana use). Alcoholism runs in my family so I need to exercise moderation as much as possible. So far so good...Still, it was prescription drugs, Tylenol and alcohol that teamed up to help kill my mother. Marijuana is a minor irritation compared to what's w/in easy reach at the pharmacy and ABC store.
Posted by JohnnyBLinux on September 1, 2007, at 0:39:33
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by JohnnyBLinux on September 1, 2007, at 0:04:54
I apologize b/c I'm off topic now, but I have something else to say. Another case in point albeit no less morbid: my best friend in high school committed suicide by overdosing on Sleepinol gel tabs. Sleepinol's active drug is diphenhydramine, which is a common ingrediant in numerous cold & allergy remedies (i.e. Benedryl) that are widely available in grocery stores and pharmacies OTC [over-the-counter].
Posted by Biolochic on November 6, 2009, at 7:44:56
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by JohnnyBLinux on September 1, 2007, at 0:39:33
Please follow up with this thread and let us know of the Wellbutrin worked. I'm going to see a Psychiatrist on Tuesday and would like more information, please.
Posted by Deneb on November 6, 2009, at 22:02:43
In reply to Re: Marijuana dependance treatment using SSRIs/SNR, posted by Biolochic on November 6, 2009, at 7:44:56
Hello Biolochic,
Welcome to Psycho-Babble! The last person to post on this thread did so in 2007 so they may not be here anymore.
I suggest you start another thread asking your question. New threads tend to get more responses than old threads.
Deneb
This is the end of the thread.
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