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1996-05-06
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From: lamont@hyperreal.com (Lamont Granquist)
Newsgroups: sci.med.psychobiology,alt.drugs,alt.psychoactives,alt.drugs.psychedelics
Subject: NIMH Study Results: Hallucinogens and Antidepressants
Date: 3 Oct 1994 08:13:46 GMT
Message-ID: <36oefq$cfs@nntp1.u.washington.edu>
Kit asked me to forward this as she is having difficulties with posts
getting out of NIMH...
From: Kit Bonson <kbonson@helix.nih.gov>
To: Lamont Granquist <lamont@hyperreal.com>
}
} As many of you are aware, over the past months I have been conducting a
} retrospective study here at the National Institute of Mental Health on the
} interactions of hallucinogens and antidepressants in humans. I'm finally
} at a place where I can reveal my results. These data have already been
} presented at the Serotonin Club meeting in Chicago this summer and are in
} the process of being written up for submission to pharmacology/psychiatry
} journals (I'll post the references later, assuming the manuscripts are
} accepted).
}
} Thanks to all of you on the Net who responded to my requests for subjects!
}
} The basic idea of the study arose because I have a lot of friends who have
} been on antidepressants and also have a long-standing interest in
} hallucinogens. They would call me up (as their personal pharmacologist)
} and want to know why they had unusual responses to LSD while they were
} taking antidepressants. It turned out that the experience one had on LSD
} could be highly variable, dependent on which antidepressant one was taking.
} Based on these initial reports, I asked to interview people with similar
} histories by placing announcements in the local D.C. alternative newspaper,
} on newsgroups on the Net, and by an article in the MAPS (Multidisciplinary
} Association for Psychedelic Studies) newsletter. People also contacted me
} after hearing of the study by word of mouth or by being referred by a
} health professional.
}
} Although many many people responded to my request, I was only able to use
} those reports where there was a "control" condition, ie: either the person
} had taken the same hallucinogen prior to antidepressant treatment or else
} had friends who had taken the same hallucinogen but were on on
} antidepressants. Everyone who participated was given a structured
} questionnaire that first asked about the person's antidepressant treatment,
} other drugs they regularly consumed, and past experience with
} hallucinogens. Then I asked about the experience the person had with a
} hallucinogen while taking an antidepressant. The main thing I was
} interested in was whether there was an increase, a decrease or no change in
} the person's response to the hallucinogen in terms of the time it took to
} get high, the physical effects, the hallucinatory effects, the
} psychological effects, the total time they were high, any aftereffects or
} alterations in sleep and then their overall impression of the trip.
}
} In a nutshell, people who were taking serotonin-selective antidepressants
} or MAO inhibitors had a decrease or abolishment of their response to
} hallucinogens. This is in contrast to what happens when people were taking
} tricyclic antidepressants or lithium: they had a vast increase in their
} response to hallucinogens. Please note that everyone who responded had
} been taking antidepressants for at least 3-4 weeks, if not longer. This is
} the time necessary for therapeutic effects to begin, and this is thought to
} correlate with changes in neurotransmitter systems in the brain. We have
} no information about what happens when people have only taken
} antidepressants for a short time and then consume a hallucinogen.
}
} Below is a more comprehensive summary of the data:
}
} SEROTONIN-SELECTIVE ANTIDEPRESSANTS:
}
} *Fluoxetine* (Prozac) -- even at doses of this antidepressant ranging from
} 2mg/day to 40 mg/day, there was an overall decrease in most effects from
} LSD (no matter how much acid people took), as well as a decrease in
} response to ketamine. There was no change in response to psilocybin.
} There does seem to be a decrease in the response to MDMA.
}
} *Sertraline* (Zoloft) -- the effect with this antidepressant seems to be
} dose-dependent. At 50 mg/day, there was no effect on the response to LSD
} nor to psilocybin. However, at 100 mg/day, there was a decrease in
} response to both LSD and MDMA.
}
} *Paroxetine* (Paxil) -- decrease in response to LSD.
}
} *Trazodone* (Desyrel) -- decrease in response to LSD.
}
} TRICYCLIC ANTIDEPRESSANTS:
}
} *Imipramine* (Tofranil) -- increase in response to LSD.
}
} *Desipramine* (Norpramine) -- increase in response to LSD.
}
} *Clomipramine* (Anafranil) -- increase in response to LSD.
}
} LITHIUM:
}
} (*alone* or *in combination with a tricyclic antidepressant*) --
} increase in response to LSD or psilocybin.
}
}
} MONOAMINE OXIDASE INHIBITOR:
}
} *Phenelzine* (Nardil) -- decrease in response to LSD
}
} **TAKE NOTE OF THE RESPONSE TO MDMA: combining an MAO inhibitor
} plus MDMA has led to a hypertensive crisis and a near-fatal response in
} many people!!! This could be anticipated because MDMA is a substituted
} amphetamine, and stimulants should not be combined with an MAO inhibitor!!!
} DO NOT TRY THIS AT HOME!!!
}
}
} There were a few other psychotherapeutic drugs that people combined with a
} hallucinogen, but you'll have to wait for the journal articles for these
} odd responses.
}
} How do we explain these data?? Well, this is a bit of a theoretical
} problem. One would want to say that the hallucinogenic response occurs
} because of 5-HT-2 stimulation and therefore there was down-regulation of
} 5-HT-2 sites following serotonin-selective antidepressants and MAO
} inhibitors, thus leading to elimination of the hallucinogenic response.
} The problem is that these antidepressants do not always alter the brain in
} this way. The other, bigger, problem is that tricyclic antidepressants are
} thought to act very similarly to SSRI's in their ability to down-regulate
} 5-HT-2 sites, and thus there is no accounting for the appearance that TCA's
} increase response to LSD. We are at the stage now where we are trying to
} formulate a theory based on the difference between classes of drugs in
} terms of their effects on 5-HT-1A sites and in terms of the way the
} different antidepressant change serotonin levels. Since LSD has effects
} not only at 5-HT-2 sites but also at 5-HT-1A sites, this may allow for why
} these drugs affect the hallucinogenic response differently.
}
} So, thanks for all the support I received from everyone who helped out with
} this study. All of you who participated and then kept quiet about my
} results receive my gratitude. Special thanks to Lamont Granquist who not
} only was very helpful in recruiting subjects for me and for sending me
} references I might have otherwise missed but restrained himself for months
} from spreading the word about these interesting results.
}
} If anyone out there knows of someone who could be a subject, they can
} contact me with the information below. I'm basically in the last phase of
} writing the manuscripts, but could still interview someone if they wanted
} to step forward, especially those who have used MDMA. Contact me at:
}
} Kit Bonson, Ph.D.
} National Institute of
} Mental Health
} Building 10, Room 3D41
} Bethesda, MD 20892
} (301) 496-3421
} kbonson@helix.nih.gov
--
Lamont Granquist (lamont@hyperreal.com)