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Re: Anyone take more than 4mg of Klonopin daily? tendency

Posted by Ame Sans Vie on October 6, 2004, at 16:28:24

In reply to Re: One month on selegiline now and loving it!! Ame Sans Vie, posted by tendency on October 6, 2004, at 14:11:55

> Damn! that's alot of adderall. Why do you take it with dextromethorphan?

lol, yes, it's a bit above the FDA's recommended maximum daily dose for dextroamphetamine (1mg/kg). I take it with a solution of Alka-Seltzer Gold. I use this because it contains no aspirin, and it effervesces in water to form primarily sodium citrate and potassium citrate, both of which raise the pH (i.e., decrease acidity/make more alkaline) of the gastrointestinal contents and the urine. Amphetamines, as the prescribing information for Adderall/Adderall XR, Dexedrine/Dexedrine Spansule/DextroStat, Desoxyn, and Didrex will inform you, are absorbed more readily into the system when the stomach contents are alkaline, and are both more slowly excreted *and* reabsorbed into the bloodstream when urine is alkaline. So to make each dose of Adderall I take reach its full potential, I use the alkalinizers which increase the effects by 150-175% (YMMV) and increase the duration of effect from approximately four to closer to six hours. I take my dose every six hours, and that includes a dose right before bed as (believe it or not) it improves my sleep quality drastically where Halcion, Restoril, Ambien, Sonata, Placidyl, Nembutal, Tuinal, Seconal, Somnote, and Equanil have all failed miserably. Sorry, I just felt compelled to explain all that junk I'm sure you could care less about, lol -- now I'll answer your actual question.

Many drugs which block certain subtypes of receptors in the brain known as N-methyl-D-aspartate (NMDA) receptors have been shown to prevent development of tolerance to drugs for which this is a known problem. Dextromethorphan (DXM) is one such drug. Many drugs that achieve this ultimate goal in the brain are illicitly abused dissociative anesthetics (i.e., phencyclidine [PCP; angel dust] and ketamine [Ketalar; Ketaset; Special K]). DXM is available over-the-counter and also extensively abused, but at low NMDA-antagonist doses it has been shown to prevent tolerance (and even *reverse* tolerance in critically ill patients) to narcotic analgesics. There's a product in the works called MorphiDex that combines morphine and DXM and has been shown to allow chronic pain patients to remain at a stable dose in the majority of cases. There's another in the works using oxycodone instead of morphine, though the name eludes me at the moment.

I'm not aware of any specific studies involving the effects of DXM therapy on amphetamine or other psychostimulant tolerance (though there very well may be some), but based on anecdotal evidence and upon being given the greenlight by my psychiatrist, I began taking OTC Delsym (dextromethorphan polistirex), an extended release form of DXM lasting eight hours per dose. It's worked beautifully for me, and several other stimulant-treated patients in my psychiatrist's practice now that I've brought it to his attention, and I wouldn't go without it.

Recently, a product called "Dexalone" became available which is available in 10- and 30-packs of 30mg DXM HBr capsules and I've switched to that because a) I'm pre-diabetic, and the Delsym is a sugary syrup, and b) Delsym tastes like *ss, lol. Only problem -- you'll likely only find Dexalone in non-chain pharmacies, as the large-chains don't like to stock it because of the increasing awareness of DXM's abuse potential. Occasionally they carry it behind the counter, though.

Other NMDA-blockers are available which are worth a shot, but I'm not going to try them -- why rock the boat? Magnesium is one that's easily obtainable. Namenda (memantine -- for Alzheimer's disease) and Symmetrel (amantadine -- for Parkinson's disease), both Rx only, are also very good NMDA-antagonists, though Symmetrel also increases dopaminergic action through unknown mechanisms and so may cause more undesirable side effects.

~Michael
SAD, GAD, PD, OCD, agoraphobia, dysthymia, MDD, ADD, AvPD


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poster:Ame Sans Vie thread:399488
URL: http://www.dr-bob.org/babble/20041002/msgs/399715.html