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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by AMD on May 8, 2005, at 22:17:30
Subject says it all. I took a bit this week and I'm worried now that I am going to worsen my bipolar and trigger it into flashbacks and schizophrenia's negative and positive symptoms. Is this realistic? Just what I need.
Posted by medhed on May 8, 2005, at 23:07:34
In reply to Will ketamine trigger or cause schizophrenia?, posted by AMD on May 8, 2005, at 22:17:30
> Subject says it all. I took a bit this week and I'm worried now that I am going to worsen my bipolar and trigger it into flashbacks and schizophrenia's negative and positive symptoms. Is this realistic? Just what I need.
Disassociatives/Halucinagens can aggrevate an already existing disorder or bring forth a chemical imbalance that might have been dormant. Your state of mind will influence your experience with the drug and nobody likes a bad trip.
Posted by chemist on May 9, 2005, at 3:50:50
In reply to Will ketamine trigger or cause schizophrenia?, posted by AMD on May 8, 2005, at 22:17:30
> Subject says it all. I took a bit this week and I'm worried now that I am going to worsen my bipolar and trigger it into flashbacks and schizophrenia's negative and positive symptoms. Is this realistic? Just what I need.
amd: ketamine is an anesthetic that is noteworthy if only because it is used when one need worry about a patient's heart rate dropping into the danger zone. the positive and negative affect of schizophrenia involve specific dopamine receptor subtypes in very specific areas of one's brain. ketamine does as anesthetics do and is most active in the limbic system, followed by inhibition of neurotransmission in the cortex. i am certain that ketamine keeps the blood pressure from dropping by increasing the quantity of noradrenaline and adrenaline in the synaptic cleft, and NMDA receptors are hit: i am equally certain that the D_{2}/D_{3} receptors and dopaminergic neurons in the substantia nigra are not being targeted, and any hallucination and/or dissociation are/is not uncommon when a patient emerges from being put under. keep in mind that these statements refer to patients who have been anesthesized with the drug before a surgical procedure, and do not mistake the emergence psychoses with the onset of schizophrenia. while the catecholamine hypothesis could be invoked here - especially in light of the NA/A action - it is likely a relavent theory applied to a tangential problem. interesting - to me, at least - is the recommended administration of atropine or scopolamine, which will reduce excessive salivation: i am not aware of a relation between AChE binding - neuromuscular junction or neuronal - and this drug, and atropine and scopolamine are not to be used unless exposure to (this is one case at least) an AChEI/BuChEI such as a nerve agent has been confirmed. in any event, it does not make pre\"existing conditions any better nor does it preclude the more rapid emergence of as-yet-unseen problems from presenting (both noted by medhead)...the most effective antipsychotics for treating positive affect schizophrenia are those with very high affinity for the D_{2} or, more usually, D_{3} receptor subtype.
if you request a very real worry concerning a dopamine-related malady and drugs found on the street/in the gutter, i refer you to a manuscript that you ought to peruse (it is a 2-page journal article and the point is clear): namely a study that was published in Science in 1983 (Langston et al., 979-980). in san francisco in the early 1980s, MPTP showed up in ``heroin'' which in turn showed up in the bodies of six visitors to the ER in a short period of time. unfortunately for the users, they are the cohort that confirms that MPTP can induce irreversible Parkinson's disease. i do know that this is not a singular report and that caveat emptor applies in every market. all the best, c
Posted by AMD on May 9, 2005, at 15:49:46
In reply to doubtful, at best » AMD, posted by chemist on May 9, 2005, at 3:50:50
Are you suggesting I may have "picked up" Parkinson's? Now that is scary. How would I know -- have I put myself at future risk of Parkinson's through my use of cocaine, marijuana, and brief exposure to ketamine? Lovely, more to worry about ...
amd
Posted by AMD on May 9, 2005, at 15:52:53
In reply to doubtful, at best » AMD, posted by chemist on May 9, 2005, at 3:50:50
How long can I expect to wait before these symptoms would occur? Also, is there a general association between ketamine and MPTP, with one likely cut with the other?
amd
Posted by AMD on May 9, 2005, at 15:54:54
In reply to doubtful, at best » AMD, posted by chemist on May 9, 2005, at 3:50:50
Are there any OTC drugs I could take to preempt or at least help recover from any of the side effects or long-term consequences associated with the drugs I took over the past two months?
Btw, these occurred on a total of five occasions, spread out by two week intervals, only the last including the ~25 mg - 75 mg (estimate) of ketamine.
amd
Posted by AMD on May 9, 2005, at 16:53:54
In reply to One other question » chemist, posted by AMD on May 9, 2005, at 15:54:54
All right: now I am officially having panic attacks. I wish I had not done that ketamine, as several sites I've seen are given rather foreboding conclusions that even one-time use can cause brain malfunction. Plus the cocaine - maybe that's what's causing the real sequelae. Others say prolonged use results in no symptoms. Ugh -- so to say I'm distressed would be an understatement.
There's also mention of norketamine, which supposedly may still be in my system, and only after it has been excreted will the true after-effects (depression, memory problems, etc.) begin. So can I expect to feel worse over the coming days.
Further, I read about persistent spaced-out symptoms. Given that I'm slightly spaced out, with a headache, now, well -- more to worry about.
Finally, if there a chance I experienced brain swelling that may have caused damage. Argh!
What is my long-term prognosis, best guess, without having seen a doctor? I have an appointment on Wednesday, but I suspect he'll just slap me on the wrist and say "well, you shouldn't be doing that stuff," and then go into the possibility I did do real damage. Not what I need to hear.
amd
Posted by chemist on May 9, 2005, at 20:03:29
In reply to OK -- now I am freaking out! » AMD, posted by AMD on May 9, 2005, at 16:53:54
hi amd...you will have to settle for the condensed version as my copy of the manuscript has wandered off into (i think) the azoles....please check out langston's bibliography on pubmed for even more and more recent studies:
this first study (let's get it correct) was ``Chronic Parkinsonism in due to a product of meperidine-analog syntheses,'' and the number of patients - they thought they were using an analog of the drug trade name Demerol, hence the tag ``synthetic heroin'' - who beat up some rather innocent and important dopamine-specific neurons in the substantia nigra (the hypothesis, given the symptoms) were four (4) in number. two (2) of them had large amounts of MPTP and MPPP in their blood, intravenous route all patients. and yes, the ethyl ester hanging off the side does make the difference: caveat emptor......best, chemist
Posted by medhed on May 10, 2005, at 1:50:36
In reply to doubtful, at best » AMD, posted by chemist on May 9, 2005, at 3:50:50
> > Subject says it all. I took a bit this week and I'm worried now that I am going to worsen my bipolar and trigger it into flashbacks and schizophrenia's negative and positive symptoms. Is this realistic? Just what I need.
>
> amd: ketamine is an anesthetic that is noteworthy if only because it is used when one need worry about a patient's heart rate dropping into the danger zone. the positive and negative affect of schizophrenia involve specific dopamine receptor subtypes in very specific areas of one's brain. ketamine does as anesthetics do and is most active in the limbic system, followed by inhibition of neurotransmission in the cortex. i am certain that ketamine keeps the blood pressure from dropping by increasing the quantity of noradrenaline and adrenaline in the synaptic cleft, and NMDA receptors are hit: i am equally certain that the D_{2}/D_{3} receptors and dopaminergic neurons in the substantia nigra are not being targeted, and any hallucination and/or dissociation are/is not uncommon when a patient emerges from being put under. keep in mind that these statements refer to patients who have been anesthesized with the drug before a surgical procedure, and do not mistake the emergence psychoses with the onset of schizophrenia. while the catecholamine hypothesis could be invoked here - especially in light of the NA/A action - it is likely a relavent theory applied to a tangential problem. interesting - to me, at least - is the recommended administration of atropine or scopolamine, which will reduce excessive salivation: i am not aware of a relation between AChE binding - neuromuscular junction or neuronal - and this drug, and atropine and scopolamine are not to be used unless exposure to (this is one case at least) an AChEI/BuChEI such as a nerve agent has been confirmed. in any event, it does not make pre\"existing conditions any better nor does it preclude the more rapid emergence of as-yet-unseen problems from presenting (both noted by medhead)...the most effective antipsychotics for treating positive affect schizophrenia are those with very high affinity for the D_{2} or, more usually, D_{3} receptor subtype.
>
> if you request a very real worry concerning a dopamine-related malady and drugs found on the street/in the gutter, i refer you to a manuscript that you ought to peruse (it is a 2-page journal article and the point is clear): namely a study that was published in Science in 1983 (Langston et al., 979-980). in san francisco in the early 1980s, MPTP showed up in ``heroin'' which in turn showed up in the bodies of six visitors to the ER in a short period of time. unfortunately for the users, they are the cohort that confirms that MPTP can induce irreversible Parkinson's disease. i do know that this is not a singular report and that caveat emptor applies in every market. all the best, cChemist.
Your book knowledge is sort of impressive, if a little long winded. But my knowledge comes from life and experience. Any druggie looking for a kick is not looking to anesthesize himself, the amount of K is much different than used in an operating room. Therefore there is no being 'put out' at recreational doses, just hallucination/dissasociation very much like PCP but more intense and shorter duration.Ketamine is a pharmacutical product that is easily purchased from pharmacutical sources, most easily veterinary. Anybody getting a drug from a source that is not known should be suspect of it's quality and purity (some people don't care). I would presume AMDs specimen is somehow adulterated or not K at all if he did not get an effect, When you snort a bump of Ketamine you will know it and if it were not for the fact that a nasal sniff only lastes at most a half hour I don't think most people would take it. I won't go into IV use.
The next neighborhood over from me is in Maspeth, Queens and Forest park is near. There is much, much PCP and Special K trade going on, PCP labs blow up all the time! I would like you to explain how your book told you 'this and that' to those K-heads over there in the park with symptoms that look like scizophrenia to me.
I don't really care but you seem so one sided on your opinions and giving absolute advise on the side of... I don't know... NON-EXPERIMENTATION. It kind of reminds me of how alot of PDOCs are built.
You've said that I don't know you but I do know you are presenting yourself as an expert and not allowing for another point of view in your advice.
I'm going to stop posting here anyway, even the the most drugged out sites on the net have more objectability than some of you guys on PB. It kind of reminds me of religion.
Posted by chemist on May 10, 2005, at 3:27:23
In reply to Re: doubtful, at best » chemist, posted by medhed on May 10, 2005, at 1:50:36
hello there, chemist here...my comments below delineated by asterisks...
> Chemist.
> Your book knowledge is sort of impressive, if a little long winded.**** i did not request a literature review, nor does the phrase ``long winded'' strike me as neutral. ****
But my knowledge comes from life and experience.
**** this statement implies that mine does not: i never stated that factual information with references are not just that. are you taking issue with my opinions? ****
Any druggie looking for a kick is not looking to anesthesize himself, the amount of K is much different than used in an operating room. Therefore there is no being 'put out' at recreational doses, just hallucination/dissasociation very much like PCP but more intense and shorter duration.
>
> Ketamine is a pharmacutical product that is easily purchased from pharmacutical sources, most easily veterinary.**** it is a schedule III drug that is easily purchased with a prescription or a license from, among other sources, the DEA. it is no easier or harder to purchase than a schedule III drug prescribed by a doctor and filled at a pharmacy. that begs the question why any person in the normal physician-patient relationship should require a prescription for ketamine. if there are instances, i assume they are warranted. i fail to see the point. ****
Anybody getting a drug from a source that is not known should be suspect of it's quality and purity (some people don't care). I would presume AMDs specimen is somehow adulterated or not K at all if he did not get an effect, When you snort a bump of Ketamine you will know it and if it were not for the fact that a nasal sniff only lastes at most a half hour I don't think most people would take it. I won't go into IV use.
**** i assume the ``you'' above is in the general sense: i would personally not like to be identified with a group of users of ketamine and phencyclidine, thank you....****
>
> The next neighborhood over from me is in Maspeth, Queens and Forest park is near. There is much, much PCP and Special K trade going on, PCP labs blow up all the time! I would like you to explain how your book told you 'this and that' to those K-heads over there in the park with symptoms that look like scizophrenia to me.**** thank you for asking. my books do not ``tell'' me things: i read them and study the material. first, i suspect that something is awry by noting the claim that PCP labs are ``blowing up all the time:'' the books i need not open would lead me to conclude that the population to which you refer is largely ignorant of undergraduate-level chemistry, knowingly breaking the law, and exploding far away from me. second, i am hardly in a position to make a medical diagnosis based upon your observations of what you refer to as people exhibiting signs of schizophrenia. if this continues to trouble you, one option is to actively get involved in seeing to the needs of your community and ensure that the population to which you refer be subjected to free and thorough medical examinations and treated for any maladies uncovered. finally, this is not my problem nor is it my duty to provide a solution as per your demands. ****
>
> I don't really care but you seem so one sided on your opinions and giving absolute advise on the side of... I don't know... NON-EXPERIMENTATION. It kind of reminds me of how alot of PDOCs are built.**** my opinion is not something you have to heed or read; nor is subjective labeling - ``one sided'' - of an opinion from a person unexpected. whether you think i am what you designate a ``PDOC'' or not or whether i was naturally-birthed or, as you put it, perhaps ``built'' is more than a little insulting to me and my mother. i expect an apology. ****
>
> You've said that I don't know you but I do know you are presenting yourself as an expert and not allowing for another point of view in your advice.**** you do not know me. i wrote it and did not say it. you claim i am presenting myself as an expert, yet i have made no such claims: you are the one who has labeled me an expert. i do not mediate or have any special status on this or any other web site. i am not in any position to allow or disallow how information is disseminated here. this is not my property. and if a post is made with my nom-de-plume in the subject line and advice is sought, why should i not respond with such? ****
>
> I'm going to stop posting here anyway, even the the most drugged out sites on the net have more objectability than some of you guys on PB. It kind of reminds me of religion.
**** thank you for your time and insight. do not forget to address your statements concerning my birth mother as you close the door behind you. and this offspring holds a doctorate in chemistry and biochemistry, by the way. ****
Posted by Dr. Bob on May 10, 2005, at 4:09:41
In reply to Re: doubtful, at best » chemist, posted by medhed on May 10, 2005, at 1:50:36
> you seem so one sided on your opinions
>
> even the the most drugged out sites on the net have more objectability than some of you guys on PB.Please don't post anything that could lead others to feel accused or put down. The last time you were blocked it was for 1 week, so this time it's for 3.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
PS: Chemist, thanks for your restraint this time.
Posted by chemist on May 10, 2005, at 14:22:21
In reply to Re: blocked for 3 weeks » medhed, posted by Dr. Bob on May 10, 2005, at 4:09:41
>
> Thanks,
>
> Bob
>
> PS: Chemist, thanks for your restraint this time.thank you, and i am doing my best to keep my cool and perhaps forestall the next vacation....yours, c
Posted by AMD on May 10, 2005, at 15:41:10
In reply to Re: doubtful, at best » chemist, posted by medhed on May 10, 2005, at 1:50:36
medhed,
I completely disagree -- chemist offers unbiased scientific evidence which, to the best of my knowledge, is accurate, and only then does he opine.
Of course I also appreciate anecdotal evidence, the type you proffer (and thank you for that), as I believe it helps give an overall picture. But anecdotes alone are not sufficient in truly understanding the effects and ramifications of ketamine (or other substance) use.
amd
Posted by AMD on May 10, 2005, at 15:48:50
In reply to relax and re-read.... » AMD, posted by chemist on May 9, 2005, at 20:03:29
Day four and I still feel pretty bad. My mind is racing, and I don't feel "right." I am fearful the ketamine and some of my medicines interacted in a rather unfavorable way. I hope I get my concentration back soon -- I really need it!
My doctor has suggested I lower my dose of Celexa to 30 m.g., which I did today. That said, I have not yet intimiated her regarding my latest experimentations. Perhaps it would be best to keep the Celexa at 40 m.g. But then, I feel a bit manic, my mind is racing, and I'm in full-on panic mode that this isn't going to go away. What did I do to myself?
:-(
amd
Posted by chemist on May 11, 2005, at 4:28:12
In reply to Day four -- still feeling zonked » chemist, posted by AMD on May 10, 2005, at 15:48:50
hello there, amd...the concentration issue sounds like it is directly related to pre\"occupation with which neurons were sacrificed last week and things of that sort, to me...perhaps the lowering of celexa is meant to address to overactivation that is being interpreted as OCD-like, or just plain overactivation? it is up to you, just as the ketamine/cocaine/booze/etc. is, and it might be of help...
otherwise, i opine (seriously, and without sarcasm) that you dump the meds and the doctor: it's costing you time and money and you can get free opinions here and elsewhere; and from a pharmacological standpoint, the medications prescribed are weak compared to alcohol, nicotine, cocaine, 3,4-MDMA, and ketamine, so it makes absolutely no sense to follow both treatment courses with vigor. if you can mix the first course with moderation and choices from the second that are legal and not detrimental to your physical and/or mental health (good luck on that one: nicotine is used as an insecticide and is so toxic that skin contact with fresh tobacco leaves will leave a rash at best and a trip to the ER within hours at worst, and ethanol is a not unattractive replacement for gasoline in powering automobiles), it is your choice...
speaking for myself: therapy and medication is optimized when used as directed. the three parties involved have mutually agreed - implicitly, i add - that there is no reason to waste our collective time and effort as well as my money if we are not all going to follow through on what we decide is a reasonable plan of action. this does not mean that i have a chaperone following me around town day to day, nor am i prohibited from purchasing alcohol in the region; likewise, therapists and doctors have vacation time, sick days, and personal lives that preclude regularly-scheduled appointments with patients as scheduled, although these interruptions are infrequent in my experience...the only person who is likely to be a loose cannon is yours truly, so i have to be on my game..
as for ``what did you do,'' the answer remains ``almost certainly nothing.'' you keep coming back to ketamine and other medication interactions as a focal point for continued anxiety: i have to point out that at some time in your life, you will likely be (or have been) the lucky winner of a minor or major surgical procedure, which will include a generous assortment of chemicals. the physicians like to be aware of what you are taking to prevent things like respiratory failure and death presenting while the patient is on the operating table...a blood test and your word should be good enough: if a polygraph is called for, this is not a good sign.
yours, c
> Day four and I still feel pretty bad. My mind is racing, and I don't feel "right." I am fearful the ketamine and some of my medicines interacted in a rather unfavorable way. I hope I get my concentration back soon -- I really need it!
>
> My doctor has suggested I lower my dose of Celexa to 30 m.g., which I did today. That said, I have not yet intimiated her regarding my latest experimentations. Perhaps it would be best to keep the Celexa at 40 m.g. But then, I feel a bit manic, my mind is racing, and I'm in full-on panic mode that this isn't going to go away. What did I do to myself?
>
> :-(
>
> amd
Posted by AuntieMel on May 11, 2005, at 10:32:43
In reply to Re: blocked for 3 weeks » medhed, posted by Dr. Bob on May 10, 2005, at 4:09:41
chemist has always kept his cool at the beginnings of these type discussions. It is only after they go on for a long while without any intervention that he loses it.
Posted by Dr. Bob on May 13, 2005, at 2:58:39
In reply to Re: might I add » Dr. Bob, posted by AuntieMel on May 11, 2005, at 10:32:43
> chemist has always kept his cool at the beginnings of these type discussions. It is only after they go on for a long while without any intervention that he loses it.
So could others intervene to help him out before then?
Bob
Posted by chemist on May 15, 2005, at 2:47:27
In reply to Re: might I add, posted by Dr. Bob on May 13, 2005, at 2:58:39
> > chemist has always kept his cool at the beginnings of these type discussions. It is only after they go on for a long while without any intervention that he loses it.
>
> So could others intervene to help him out before then?
>
> Bobhello dr. bob...they're on it...and for that i thank all parties....yours, chemist
This is the end of the thread.
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