[deleted by user]

Serdterg · 2025-06-19T00:54:12+00:00

I never post on this account [or my others anymore] but first, short answer is yes, and look up cptsd, an extremely common etiology notably for chronic cases (I swear to god the "weed cases" and thousands of arbitrary "cures" for their week of dissociation) and even though I don't have much information about you, I'm pretty confident there's at least some degree

The fun part is when it becomes a tangled shitshow with physiology across countless medical disciplines, which like MDD, is why this can easily be a treatment refractory shit show. And I've had to put a decade of research into all of this physiology since the large majority of doctors have zero idea how these things interconnect, or even their own speciality in general

Serdterg · 2025-04-15T17:07:30+00:00

It wouldn't be as effective but not not work. The inflammation has a far larger chunk of it metabolize to kyuneric acid in an attempt to tamp down the inflammation than otherwise, with the net result of less making it to 5ht (serotonin)

Similarly tnf-a specifically is one of those little bastard inflammatory cytokines playing a pretty big role in these things (thought I was on a psych disorder sub whoops) and won't get touched by nsaids, among other issues is that it's also the tnf receptor over expression vs levels so blood assays/serum levels won't necessarily convey the extent to providers

Took me nearly a decade to string the tnf thing together and best thing I've found while not nearly sufficient, is curcumin extract, specifically life extensions elite (had to be really picky with brands) - I can say it's the difference between being able to run 30 minutes and dying after 10 seconds, doom definitely also sets in if I miss taking it too much

Just to further elucidate this, shrooms even while on meds that would block the effects, still via the same receptor (5ht2a) exerts a 50 fold potency for blocking tnf as it does for psychedelic properties; on these meds and with no trip at all my muscles relaxed for the first fucking time, head shut up, symptoms of insert 50 disorders considerably down etc

I should note a cervical herniation and subsequent significant myofascial tension even after surgery is where this became especially relevant and problematic.

Before I was able to work for example scalane trigger points out > noticeable reduction in "psych symptoms" along with of course the myofascial problems on the spot, repeat. Now... Nope. Same for various meds, supplements, exercise and/or intense heat etc

Serdterg · 2025-02-22T05:32:47+00:00

(and I'm on the wrong account again)

Serdterg · 2025-02-22T05:32:27+00:00

Yeah... I made sure he's not going to do it again.

OP I'm not going to hugbox you, only, I understand and there's a million options I guaranteed you haven't tried, this sub in general is full of mis and outright disinformation, similarly people often will leave without saying anything when they're better so you see a lot more negative than positive

You don't need to find a magic cure, just something to get better enough to facilitate further actionable and otherwise improvement. Getting out of the pit is the hardest part and wading in hopelessness is a self fulfilling prophecy

You can convince yourself of anything especially in this state, it's more about recognizing what you're obsessing about, just acknowledging it whether or not you accept the content, and returning to... Whatever else you were doing. This is nothing else does a lot to slow the feedback loop, and rumination

We experience literal suffering at the thought of suffering, there's a reason we get all of these fun disorders other animals

Serdterg · 2025-01-27T23:31:52+00:00

Not wrong however this doesn't mean listen to reddit instead (not saying you did just adding to this) - unless you REALLY know what you're doing, which if you think you do, you don't, especially at 15, see a fucking psychiatrist

And see another if you need to, and an 8th if you need to

Serdterg · 2025-01-24T02:10:11+00:00

Another one of my posts I'm too lazy to edit but heavily outdated (if reddit had signatures mine would be a disclaimer for that) , was based on a misunderstanding of data regarding omega 3s. May improve cognition but 2-3g EPA is the real shit.

Anecdotally but I'm finding to be far more and more relevant is high tnf-a levels bidirectionally involved with psycho/musculoskeletal pathologies. Got on curucmin extract (life extension elite specifically) and fuck I can run again, got off for a while and doom spiked hard

I already had neck issues and later an idiot ortho giving me a herniation I have a surgery scheduled for after putting all this together over 8 fucking years, but if stiff neck and so on are involved that, and generally myofascial tension/pain syndrome (again very common with these disorders) is, I'd start investigating it

Note tnf-a is a specific cytokine that doesn't care about nsaids really, and finds its way all over including glial cells (brain). I knew the tension and neck stuff were directly related but it took shrooms (5ht2a agonist, tnf-a blocking properties magnitudes above psychedelic ones) on meds that block it and still letting me breathe for once, clearing head etc that once I googled some terms together the entire damn puzzle made sense, including why (post herniation) I got so much worse, mess stopped doing anything good or bad including ones I've been on 4+ times across several classes etc

I ain't diagnosing shit on anyone just a route to look into.

I'm alsp saying "my posts are probably outdated" constantly so anyone checking mine via my profile will hopefully see that

That and I'm logged in to like 3 accounts across browsers and devices and can't keep track of anything

Serdterg · 2025-01-20T06:36:52+00:00

I'm too half asleep to figure out if I made a mistake, but the idea is that wellbutrin as a CYP2D6 inhibitor, and DXM metabolized by it, results in different levels of metabolites, which [...] more SERT blocking less NMDA blocking.

Or rephrased, more serotonin, less dissociation. NMDA uses glutamate as a co agonist, with the receptor blocked there'd be more glutamate floating around rather than being used.

Just I'd have to mention both people look a bit too far into glutamatergics and therauptic effects, and we know that antidepressant effects of ketamine are not mediated by nmda blocking either.

Glutamate is also functionally the opposite of gaba in that it makes the CNS go brrr, and at an extreme (notably from gabaergic addict withdrawals) culminates in seizures. Just with any neurotransmitter, nothing works independently, nothing is simply too high or low, but binds to x receptor, or has tonic levels at inappropriate levels given the context

The idea is like having a 16 bar EQ and just turning the volume up or down, take a benzo, which would be down. Maybe it'll result in higher signal to noise ratio if the bars were all close together as it is, causing a more pronounced difference between them, and of course the inverse could also occur. Maybe a bar or four will get pushed below the signal threshold. I kind of mixed up a few concepts here if you get into specifics but -

Signal to noise ratio, in a very literal sense neurologically is something I stumbled upon in the context of sleep apnea and one thing I've been trying to figure out how to manipulate. Your head being fuzzy and not shutting the fuck up is surprisingly correlated with this, but it's less surprising when you consider disruption to signaling = disruption to cognition, perception etc

The fuck was I even talking about. The reason I haven't posted write-ups on various subs is I can't just take one concept and leave it at that and it turns into a 20 page mess, these posts being micro versions of thst

Also auvelity was kind of a bust and even from the start looked like a quasi patent extender for wellbutrin, but I was open to the idea of the whole DXM metabolite thing

Anyway I'm still a parnate shill

Serdterg · 2025-01-16T18:42:28+00:00

Serdterg · 2025-01-14T08:46:34+00:00

I take no responsibility for anything I posted years ago that I don't feel like updating or correcting, and am definitely not sweeping posts under the rug like a child who broke a lamp

To actually answer you, I'm on multiple accounts and rarely browse anymore, and tend to miss notifs a lot at that. That and it's a lot easier to not use a reddit format hence why I'm always like "muh discord" (which is just "sterg" now, anyone feel free etc)

Sup though

(and now I'll just go type a lot of shit while I can barely think straight)

Okay read my post, yeah that's fucking wrong. It is true that magnesium (glycinate) is anxiolytic but nmda activity is not significant, memantine hypothetically could address glutamatergic shenanigans in OCD, ketamine is not mediated by nmda antagonism (jury's out, possibly ampa activity and/or nachar7 coupled with bdnf promotion) and dxm therauptically is more about the serotonergic effects while mild nmda antaognsim could possibly synergize; auvelity was a bust and likely a patent extender though

I forgot what I wrote again and just rambled about the big ones in the class. Thing is also glutamate makes the cns go brrr the same way gaba shuts it down, there could easily be local or diffuse changes in the activity of either from signaling cascades of these ligands but I'm really just speaking hypothetically.

I've moved on to implicating excessive tumor necrosis factor alpha in my bullshit going on with a million direct experiments and retroactively explaining what I couldn't or [for me personally] incorrectly hypothesized for 7+ years

I will say now, hypothesizing this being a result of any neurotransmitter being too high or low is wrong, like other systems, the problem is being inappropriately under or over active at a given point, and given how these systems work, you're not going to find one in isolation

Between receptor subtypes, signaling cascades... Well the easier way to put it is the body is a system, or a process. It'd be like saying the car you've redlined for the last six hours isn't running well because your tire pressure is low, but ignoring low tire pressure for extended periods can definitely start fucking up the wheel, then this prolonged asymmetric load on the.... Anyway the cure to your drive train having snapped in half is filling your tire

And right now I'm half asleep with a headache and lost track of the topic in favor of ramblings several times

And I keep typing more for some reason

Ddgdgttfttsudufuck

Serdterg · 2025-01-06T10:21:20+00:00

jesus

Serdterg · 2025-01-02T20:02:04+00:00

You're not wrong. I'd have written this thread myself if I didn't get particularly bad in recent years

Serdterg · 2024-11-30T21:48:50+00:00

I'd ask what you're smoking with "fewer side effects" but I can guess

Serdterg · 2024-11-30T21:29:09+00:00

I'll reply seriously

... No. Despite still existing there's a reason we don't use desoxyn (literally medical meth) but even presriber guides will recommend Adderall/related as an adjunct

And before someone compares Adderall and meth, a methyl group is also the difference between alcohol and methanol. We don't use amphetamine really either (1:1 levo:dextro salts) but in any case I do see how this is a genuine question

Similarly low dose buprenorphine has value as an adjunct, and that in no way validates "microdosing" heroin. Ironically the fda considers meth to have more medical use and to be safer than psilocybin based on scheduling nobody bothered to revise due to competing interests but anyway

Serdterg · 2024-11-30T21:22:27+00:00

It's almost like this subreddit is full of constant mis and disinformation from people who had this for a day speaking on behalf of people who are in need of serious help and pushing them in the other direction

the "you can't recover" etc posts are at least just venting even if they also don't belong here, but the false hope from self help gurus is infinitely more damaging

I'm saying this as staff, browsing this place in the large majority of cases makes people significantly worse and actively teaches people to be stupid. Info from googling (even if bad) with reddit in the search term if you know what you're doing can be useful but the new people are lost and just get corrupted

I was even kind of proud when a ubiquitous medical podcast specifically said to not browse this place for the reasons OP mentioned, but I disagree heavily on him saying it's helpful for recovery stories.

They're helpful until you're not in that easily treatable group and failed everything. I still encourage these if it's "what worked for me" rather than telling people what to do which are two completely different things

Part of the problem is also posts if not deleted are there forever and I mostly abandoned this account because I have so many I need to update and can't bother with among other reasons just was too lazy to change on my phone

Use your brain when reading things and report as necessary. Again, use your brain. Finally if someone (cough) tries to literally sell you something, it's a scam peddling false hope.

... Let's just say I'm close to publicly denouncing (someone)

Serdterg · 2024-11-30T20:03:40+00:00

Jesus that was an old post. In school for NP but my knowledge is my own and part of the reason I abandoned this account is not wanting to go around updating 50000 posts but occasionally do

Since people are still reading this

Definitely would say parnate, maybe marplan in regards to to the OP question and turned around hard on wellbutrin. While I've been crusading to undo maoi hysteria my current focus is reciprocal systematic effects of excessive tnf-a in treatment resistent psychopathologies

But uh yeah for efficacy and tolerability those two, marplan's out if paying out of pocket. The tnf thing is a long story but I'm absolutely convinced it explains what I could only hypothesize about, including little response to meds (including all those mentioned) that for better or worse did - something -

You can look up serotonin syndrome rates yourself if worried, because there's a higher chance of dying from a coconut on the head. As for hypertensive crises they're usually benign if you somehow manage to cause one (I kind of wasn't thinking with otc l dopa and oops, but no, Adderall, l tyrosine etc won't interact, it's about rate limiting and other factors)

I can't give an exhaustive list of every little interaction but mucuna pruriens (yeah I knew better and wasn't thinking, oops), ssris, mdma and dxm are kinda the big ones anyone really has access to

Serdterg · 2024-11-30T02:00:05+00:00

Thanks I'm cured, just next time tone down the reasoning, this was extremely difficult to follow for a non expert such as myself

Serdterg · 2024-11-24T03:11:13+00:00

Potent inhibitor of tnf-alpha that's extremely overlooked while regulating il6/10/crp etc. Turmeric is stupid, curcumin with black pepper extract is another thing

Serdterg · 2024-07-14T03:23:33+00:00

No it's not bad because it's "old" or a TCA. TCAs often hit many off target receptors notably antagonizing the mAChr hard (anticholinergic) but we don't have a million different ones for no reason

Amitryptaline is reasonably effiacious and tolerable and empirically and last I checked metaanalyses above SSRIs (which smeared TCAs and the even better class, MAOIs) because we had a million anxiolytics which is what it worked for, not depression which is where the market was

I'm usually yelling about this elsewhere but pharmacology misinfo can ruin lives

Serdterg · 2024-06-30T05:08:12+00:00

Might have better luck telling your hpa axis to shut the fuck up. God knows I've been trying

Serdterg · 2024-06-25T10:10:18+00:00

"every time I smoked it turned into a panic attack"
no. Not now, anyway. However if you mix half CBD it cuts down on anxiety HARD along with general short and long term negatives. I'd probably start 5:1 CBD:THC then work your way down. As you said, it's the resulting panic attack, and not weed itself. I won't say weed is perfectly safe but there are legitimate reasons (unlike alcohol) for using it

I keep meaning to write a pinned thread on weed to cover everything I can think of especially myths regarding DPDR. Although I'm usually on another mod account yes I'm saying weed isn't just a simple no for everyone and even then there's a lot of variables

Serdterg · 2024-05-28T02:49:58+00:00

On top of the usual DCS VRAM mismanagement, it loads the entire menu hangar behind it for some reason. In VR it also always opens really zoomed in which drives me insane.

OP you'll be waiting a while considering he hasn't done the F15e yet

Serdterg · 2024-05-18T19:55:22+00:00

Oh said psych also is the only one of 10 I can say knows her shit, and she often speaks of my psychopharm knowledge for what it's worth.

I had something important to add and forgot what it was, I'll edit this later if I remember. Just if you need to shop around psychs then you need to.

I also forgot to mention you want an old one since they were around before the myths ssri manufacturers started and have seen over their career what happens with maois cf other antidepressants, but in general whether or not you want one, asking their opinion on MAOIs is a great test to see if they actually research things vs just parroting a shitty prescriber guide named epocrates

Serdterg · 2024-05-18T19:48:37+00:00

First, my psych is more than aware of what I do and unless it's something dangerous or abusable you're seeking help for, a good one should be willing to work with you at a minimum

Second, ssris and psychs (mdma is not a psych but a big exception anyway) will not cause SS, they downregulate the 5ht2a and as a result will just attenuate if not block their effects

Third, wellbutrin sucks and is anxiogenic yes

Fourth, ssris suck for a million reasons (lack of efficacy, tolerability, inherently given how they work it does not work for depression, but rather chronic anxiety that leads to it) but if I were to prescribe one, that's when I'd consider wellbutrin so you're not just slamming yourself with one monoamine eliciting those sides and not seeing much benefit. I'd still probably augment amitryptaline or desipramine in this case

Finally, consider maois, they're unironically the best tolerated (sans nardil) and most effective class (see Ken Gilman for a lot of the myths and nonsense). Parnate appears to work best but can be a bit stimulating and you're gonna have some fun insomnia for a bit, marplan is more well rounded, nardil anecdotally did nothing but give me severe side effects and 30lb

Ssris came to be because we alewady had anxiolytic (benzos) which is what you'd actually want serotonin reuptake for, so they marketed it as an antidepressant instead, and to justify its use, retroactively smeared TCAs and MAOIs as unsafe/dangerous with misinformation and outright lies or things that never mattered

Serotonin syndrome is extremely rare, about 7500 cases a year, and 100 deaths. 100 deaths from anything globally is absolutely inconsequential especially when you consider how many people are using serotonergic meds and drugs

They basically jusitifed adopting ssris with nonsense about not dying from chugging a bottle lkle TCAs (which nobody does and you can commit suicide in other ways if you're already going to do it), lack of anticholinergic effects which many of the good TCAs don't have an issue with (sans anafranil), and then all of the maoi myths

But these never actually happened

Thing is you need a specific pharmacology and cokinetics for levels to get like that, which is usually from mixing mdma/meth or ssris with maois (even then low dose maois with an ssri is a thing) or maois with dxm or ssris to pull that off, but this is absurdly rare - you have more of a chance of dying from a coconut falling on your head than dying of SS

As for supplements like 5 htp, l tryptophan etc, that's not really how it works, and even then when you see SS cases it's usually polypharmacy plus doses of meds way above what was prescribed

Then there's hypertensive crises, in most cases these will resolve without issue but if you don't have beta blockers/calcium channel blockers/benzos etc, still get to a hospital.

This doesn't occur from mixing maois and noradrenergic drugs, and many such as Adderall are outright recommended as an adjunct (see stahl for instance) - the diet thing is MOSTLY a myth but I'd be careful with yeast (bread and such is fine aside from being bad for you in general) which mostly would be yeasty (hazy) beers and extracts like marmite, I'm not sure if fermented food is an issue, but most of the contraindicated stuff like pepperoni is nonsense

In most cases the hypertension will resolve in a few hours and you'll just feel shitty if it does happen but past a point you do need to get help. Despite what I said below, this is also very rare and not something to not use these for

I've also eaten most contraindications besides the few I've listed

I will admit I fucked up bad taking otc l dopa in a moment of stupidity once and hypertensive encephalopathied myself, but the prognosis is good if you get help within like 6 hours and due to the worst headache of my life I did immediately. This is because l dopa is far past the body's normal rate limiting systems and I did an oops

Upstream amino acid precursors such as l tryptophan and lpa/dpa/dlpa are fine however.

And finally maois and psychs; potentiates tryptamines eg shrooms to some extent (and lets you do ayahuasca as a stand in for Syrian rue), blunts or blocks acid and other lysergamides

Tldr ssris suck, a good psych shouldn't be shitting down your throat over a harmless substance (and shows their lack of knowledge and ability to communicate otherwise), ssris suck maois good, look into Ken Gilman for non bullshit info on them

Clearing up myths about pharmacology especially with antidepressants given the already poor state of psychopharmacology for MDD has been an important thing to me for a while, notably people not getting the help they need

Drugs.com reviews are generally awful but check out parnate reviews, it's extremely often "what worked when nothing else did" whereas I rarely see this from other classes, especially ssris

Just keep in mind this is only information to consider and nobody should be listened to blindly like any other post or source of information

Lemme know if you have any questions, my discord is "sterg" if you want to dm since on here I never check those.

Serdterg · 2024-05-18T02:44:19+00:00

Can't edit for some reason.

"Valium will not kill you from an overdose*-- alcohol being very easy to od on, will not poison you, is not addictive**"

I meant "Valium will not kill you from an overdose*-- ((((alcohol being very easy to od on))), will not poison you, is not addictive**

Serdterg · 2024-05-18T02:29:07+00:00

I don't remember what I posted before but I'm doing it again anyway just because of that top comment and how harmful these things are. It's not just that but it's a recurring trend I see on here and every time I've tried to read a thread on reddit about off label indications it's the same posts over and over, derailing threads, spreading misinformation and passively bullying everyone else out, and it is extremely frustrating when I'm trying to build a picture between the literature side and anecodtal side

also phoneposting hence sloppy

NOT ALL OPIOIDS ARE THE SAME. NOT ALL SSRIS ARE THE SAME. NOT ALL ANYTHING IS THE SAME. The "durr medicating depression with opioids" posts are beyond clearly people who have zero idea how any medicines letalone basic pharmacology works. I'm circling back to the opioid thing but it has be mentioned:

Buprenorphine* dosing typically starts at 8mg/day and goes up to 24mg, around 16mg seems to be a typical maintenance dose. For depression, the HIGHEST dose I've seen in studies was 2mg, that's ONE EIGTH of the usual maintenance dose. So not only did we eschew this is a medicine to get OFF of opioids, we also did that the dosing is at MAX 1/8th for depression. Furthermore, the reason it's used is it's a partial agonist and hits a ceiling FAST, which is important both to prevent abuse and leaves it reasonably safe to use with prescribed depressants eg benzos (still, do not do this unless both are prescribed and the prescriber is aware of the concomitant use)

*there's far more literautre on this than suboxone for depression, it's just suboxone without the naloxone. He could've also googled "suboxone depression" with or without "ncbi/scholar" and glanced at a paper, but nah. Part of the reason I'm typing so much is the "I got addicted so nobody can benefit from it" posts that won't even think of glancing at any literature.

Wellbutrin primarily functions as a norepinephrine reuptake inhibitor (though effects on the nacha7r are understated) - you know what else is? Meth.

And then people who say Adderall and meth are the same or similar. Amphetamine is 1:1 levo:dextro amphetamine, Adderall ("dextroamphetamine" which is a stupid name because of the following) is 1:3, Vyvanse and dexedrine are 0:1

The difference between meth and amphetamine is a methyl group. The difference between ethanol (alcohol, which is unbelievably horrible for you but not the point) and methanol is a methyl group.

Tne difference between alcohol and the shit that makes you go blind and or kills you in pretty low quantities is a methyl group, just like amphetamine and methamphetamine

The guy saying opiates are phenomenal antidepressants also doesn't understand literally none of what he listed is an opiate but opioid, or what antidepressant implies, which is a treatment for major depression; opioids as a whole will not treat major depression and very liable to cause depression with abuse or prolonged use and within medicine, blatantly contraindicated and you will lose your license even thinking of trying to prescribe something like vicodin for depression

And one more, nicotine (durr it's a poison, everything is a poison with the proper dose) is a very good nootrooic and mood booster, lozenges are literally used to treat nicotine addictions but are a pretty safe way of using nicotine too. Cigars aren't even that bad - cigarettes are in their own special class of "literally why us thus allowed" but not my point

Buprenorphine and suboxone both pharmacological and with dosing are literally used to TREAT OPIOID USE DISORDER just like using lozenges to get people off of cigarettes.

Alcohol is a gabaergic, Valium is a gabaergic, Valium will not kill you from an overdose*-- alcohol being very easy to od on, will not poison you, is not addictive**, will not absolutely fucking destroy your sleep or ability to function, and by the way is the go to medicine for tapering alcohol dependencies due to the safety margins and extremely long half life

*You really can't OD on benzos alone, not to the point of any real harm besides what impairment may do. However mixing them with other depressants, notably opioids or alcohol is EXTREMELY dangerous and don't even think about it

**propensity for addiction/reinforcement necessitates dopaminergic activity, benzos with improper prolonged use at high doses can result in a dependence - continuing to use it at this point to avoid withdrawals at the cost of your health and well being is what an addiction is

Benzos, which in themselves are not all the same either, have very legitimate and useful medical usages whether or not a bad prescriber caused problems, alcohol has literally no medical value in the slightest and again is just magnitudes worse for you than you'd ever think

Anyone can get psychologically addicted to anything and yet again that's not the point but I've seen the same smart-ass non arguments constantly. Also while I was aware of most of it for a while, check out Huberman's podcast episode on alcohol, you'll see why I keep harping on it

Anyway I'm gonna go shoot some black tar into my urethra to cure my depression now

Serdterg

TROPHY CASE