Hola DoctorX!
Gran hilo!!! Ojalá todos los médicos fueran como usted…
Estoy pensando en probar los disociativos… ¿cuál debería ser la opción más segura… PCP, ketamina o metoxetamina?

Originalmente publicada in SR 2.0 20/10/2013. Revisada 20/2/23


La ketamina es un fármaco muy conocido, ampliamente utilizado en terapia durante 50 años. El uso recreativo de ketamina tiene, más o menos, 15-20 años. En los últimos 5 años ha habido muchos informes científicos que hablan de problemas de vejiga y urinarios en usuarios de ketamina. Así que este era un problema desconocido hasta 2005 (más o menos), y se ha detectado después de 15-20 años de actividad recreativa. uso intranasal. En general sólo afecta a usuarios intensivos. La dependencia de la ketamina es otro problema con este medicamento.

La fenciclidina (PCP) se utilizó en medicina entre 1920 y 1950 y entonces se abandonó debido a sus efectos secundarios adversos, como alucinaciones, manía, delirio y desorientación. De hecho la ketamina tiene su sustituto, porque tiene menos efectos adversos. El PCP se ha relacionado con la neurotoxicidad en animales, pero probablemente no sea extrapolable a los humanos.

Además, el PCP puede ser letal en caso de sobredosis; este evento es mucho menos probable con la ketamina.

La metoxetamina es una sustancia muy nueva. No sabemos nada sobre sus propiedades farmacológicas y toxicidad en humanos, aunque existen informes de problemas relacionados con su uso:

En resumen, teniendo en cuenta los riesgos y beneficios generales, probablemente la ketamina sea el más seguro, más placentero y menos riesgoso de todos los disociativos, aunque de hecho tiene sus propios problemas asociados.


Ketamine or methoxetamine

Hi DoctorX!
Great thread!!! I wish every doctor was like you…
I am thinking about trying dissociatives…what should be the safest option…PCP, ketamine or methoxetamine?

Originally posted in SR 2.0 20/10/2013. Reviewed 20/2/22


Ketamine is a well known drug, widely used in therapy during 50 years. Recreative use of ketamine has, more or less, 15-20 years. In the last 5 years there have been a lot of scientific reports talking about bladder and urinary problems in ketamine users.So, this was an unknown problem until 2005 (more or less), and has been detected after 15-20 years of recreative, intranasal use. In general, it only affects to intensive users. Ketamine dependence is another problem with this drug.

PCP was used in medicine from 1920 to 1950 and it was finished then because of its adverse side effects, such as hallucinations, mania, delirium, and disorientation. In fact ketamine has its substitute, because it has less adverse effects. PCP has been linked to neurotoxicity in animals, but it is not probably extrapolable to humans.

Additionally, PCP can be lethal in overdose, this event is much less likely with ketamine.Methoxetamine is a very new substance. We don´t know anything about its pharmacological properties and toxicity in humans, although there are reports of problems linked to its use:

Considering overall risks and benefits, probably ketamine is the safest, most pleasurable and less risky of all dissociatives, although it has it own problems associated indeed.


Hyperthyroidism and drugs

I’ve posted a couple times about rapid heart palpitations I’ve been getting recently. I don’t believe it’s drug related, all I’ve been doing is LSD, psilocybin and DMT.

I had been taking Adderall but cut it out when this started.I got into a free clinic and was told my problem could be hyperthyroid. That also happens to run in my family (my mother had to get the radioactive iodine treatment to kill hers).

They said my thyroid was slightly englarged (no nodules though) and I HAVE been feeling a slight tightness in my neck right over the gland (didn’t even put it together until I was at the docs office).All they did was give me a beta blocker and ask me to come back in a month. The beta blocker IS slowing my heart and lowering my BP, but it’s only addressing a symptom and not the problem, right?I know there’s no sure fire cure for hyperthyroid issues, but do you have any experience/suggestions on how to control it? I’d rather not take thyroid suppressing chems and definitely don’t want to nuke my damn thyroid.I’ve heard that bugleweed and motherwort can help lower thyroid function over time. Is there anything dietary I should/shouldnt be doing? I’ve also heard it can be due to low/high iodine levels but I wouldn’t want to start meddling with that without knowing wether my iodine is high or low.

Could applied kinesiology give me a clue? Do you even believe in that and should I?I’m staying away from all stims, be it caffiene, decongestants or uppers. I’m still using psychedelics about 1x per week and the rapid heart beat is of course more noticable and worrying while in that state. It’s becoming a real bummer on my life and my trips!Again, I don’t expect conclusive answers but anything you have to offer on hyperthyroidism is greatly appreciated!

Originally posted in SR 11/3/14 .Reviewed 6/2/13

The type of treatment that is best for you depends on factors such as your age, sex, the cause of your hyperthyroidism, the amount of thyroid hormone produced by your body, and any other medical conditions you may have.

In general, antithyroid drugs, radioactive iodine, and surgery are considered to be the most effective options. Sometimes, treatment for hyperthyroidism can lead to hypothyroidism, requiring daily hormone replacement therapy via oral administration.

However, this is not a major concern for most people and has fewer risks and complications compared to uncontrolled hyperthyroidism. The effectiveness of natural herbs or supplements is unknown.

I would advise against the use of psychedelics for your specific condition, at least until your diagnosis is clearly established. Use of ketamine is particularly contraindicated in this condition.

Ketamine as antidepressant

How can I use ketamine as antidepressant?

Originally posted in SR 2.0 27/10/2013. Reviewed 20/2/22

Ketamine is a drug that works as a non-competitive antagonist at glutamate N-methyl-D-aspartate (NMDA) receptors. Its main use is  dissociative anesthesia. It was found to have antidepressant properties in 2000. Then,  subsequent studies have shown it to be effective in treating treatment-resistant depression (TRD) with a rapid clinical effect within several hours.

However, its antidepressant properties are transient. It lasts around  1 week following a single infusion and 18-19 days following repeated infusions. Ketamine has also been reported to have anti-suicidal and anti-anhedonic actions

Ketamine has been found to have a rapid antidepressant effect in several studies, with multiple meta-analyses concluding that it is effective for major depressive episodes in both unipolar and bipolar depression. While some studies suggest the effect can last up to 7 days, others suggest it may be shorter in bipolar depression. And other modalities of ketamine administration such as intranasal and oral routes have been studied. But their efficacy is less clear.

Intranasal esketamine has been approved by the FDA for major depression that has failed treatment with two or more antidepressants, with studies showing significant improvement in depression at 4 weeks compared to placebo. Ongoing trials are being conducted to track safety outcomes up to 5 years and explore the efficacy of R-ketamine.

Recent studies show that ketamine has strong antidepressant properties. Typical dosage is 0.5 mg/kg intravenous in infussion in 30-40 minutes; oral route seems also effective at that dosage (0.5 mg/kg). The effect is fast and strong but not lasting in time, it disappears in hours or days and further dosages do not reply this effect.

With actual knowledge, Ketamine may prove useful in a select group of patients but current medical knowledge looks to other treatments as the first line against depression