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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by KieranK on January 9, 2004, at 9:28:15
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 Pathur on January 9, 2004, at 14:54:31
In reply to Marijuana dependance treatment using SNRIs/SNRIs, posted by KieranK on January 9, 2004, at 9:28:15
I hear you loud and clear, I'd been a heavy pot smoker for 20 years, I smoked with friends, by myself, at work etc... . I loved the stuff and swore that I'd never quit, but age takes a natural toll on our bodies and this is only magnified by substance abuse. so I quit cold turkey six years ago at the age of 38, and I haven't looked back. It took atleast three years to start feeling comfortable with myself, my amotivational attitude decreased over the years to the point where I finally can say that I now have more motivation than I ever had since I started smoking in my late teens. I guess what I'm saying is have Patience, six years of heavy pot smoking is alot less than 20 so I'm sure that it won't take you no six years to feel normal again. My personal opinion would be to accept that the draggy feeling will get better, forget the ssri's and look at each day as another day of cleaner lungs and clearer thinking, heck, you're still a young duffer and the brain is more forgiving at your age than mine. Just my thoughts, the best of luck to you. P.
Posted by krazybirdlady on January 10, 2004, at 0:47:24
In reply to Re: Marijuana dependance treatment using SNRIs/SNRIs, posted by Pathur on January 9, 2004, at 14:54:31
i concur wholeheartedly...
Posted by KieranK on January 12, 2004, at 5:14:10
In reply to Re: Marijuana dependance treatment using SNRIs/SNRIs, posted by Pathur on January 9, 2004, at 14:54:31
Thanx for your help Pathur - yeh i thought that perhaps over an extended period of time things would start normalising again, its good to know you experienced this. Looks like abstinence is definitely the first step whatever I do.
K
Posted by Andre on January 21, 2004, at 22:52:04
In reply to Marijuana dependance treatment using SNRIs/SNRIs, posted by KieranK on January 9, 2004, at 9:28:15
Jason,
I stumbled onto your essay by shear chance. It was like reading into a mirror. I could not believe how close your problems are to mine. I cannot believe how similar your findings are to mine.
I have been smoking heavily (bongs - finely chopped bud = big hit) for about 6 years. I returned home from the US - College and left all my buddys behind. This is when I started smoking on my own most of the time. About 8 months ago I decided to stop smoking pot. I thought it was causing me lack of sleep and a depressed attitude - I was also feeling a sence of social anxiety. I stopped for 6 months. After 2 months my problems were still present, in fact they worsened. I then decided to see a professional who diagnosed me as having depression. I thought he was right due to the fact that I didn't feel myself....at all. I was not sad and ideas of suicide never even came close to my thought process. However, he was the pro so I listened and started taking AVANTA. After 2 weeks I was sleeping better and not worring about not sleeping. But even after a decent nights sleep I felt like a freight train had run me over in the morning; besides I still had random sleepless nights. At that point I was happy that I was generally sleeping without MJ so dealt with the negatives of the anti-depres. The Anti-deprs simpily took my edge off. Over the 3 months I was prescribed, it was pretty much the same thing - in fact in the end I started drinking more (perhaps because I was lonely). I realized the drinking was a bad idea so stopped that and start smoking pot once a week (not like before......bongs everyday). WOW did that make a difference. I then decided that I was not depressed and did not want to be on the AVANTA. I stopped and immediately felt better. Waking up in the morning feeling clearer and happier. Work mates and family have even commented on my upbeat attitude.
I uderstand your position - as I am living it. It is my opinion that using these anti-depressants is not the answer. Here's an example: I am not depressed. I may seem a little down or unmotivated doing general activities but if you asked me to go out and play paint ball I would be there before you could sau "boo". The smoking of pot has elevated the satisfaction of these general tasks.
I believe the real permanent solution is to get to the root of the problem. Why did we start smoking pot heavily in the first place? For me I think it is Social Anxiety.
This is the end of the thread.
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