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Re: More on Cocaine » Jack Smith

Posted by not exactly on February 4, 2003, at 15:39:54

In reply to More on Cocaine, posted by Jack Smith on February 4, 2003, at 11:59:56

Although cocaine has no direct effect on serotonin (it is generally understood to be a reuptake inhibitor of dopamine, and to a lesser extent NE), I suspect it's capable of dramatically altering the balance among *all* of the mood-related neurotransmitters. I offer the following anecdote (which your SSRI + cocaine experience reminded me of) as further evidence of that theory.

Back in the 70's, some of my college buddies experimented with psychoactive "recreational" drugs. One of the favorites was DMX (dextromethorphan, the active ingredient in non-Rx cough medicines). In large doses (e.g. chugging 2 full bottles of cough syrup - yuk!) it acts as a psychedelic "dissociative". The euphoriant properties are most likely related to the fact that it stimulates serotonin release and inhibits its reuptake (DMX is not a narcotic and doesn't significantly affect opioid receptors). One evening, my friend John was enjoying a blissful DMX "trip" when he announced that he was going to try adding some cocaine (unlike myself, John had always liked cocaine). "Gee, I dunno, John; that doesn't seem like a good idea," I advised, but he insisted on performing the experiment. Minutes later, he appeared stunned and extremely disappointed. "Damn! It's gone! The high just vanished! Now I want something..." he remarked. He was severely depressed for the remainder of the evening, and as I remember it took him several days to recover. The cocaine had somehow cancelled & reversed the serotonin-induced euphoria.

Decades later, John was diagnosed with Chronic Major Depression, and responded well to SSRI therapy. However, I don't think the above incident "caused", "triggered", or even significantly contributed to John's lifelong depression. He was clearly depressed beforehand, and I believe that he (like many others) was in effect "self-medicating" his depression (temporarily) by the use of recreational drugs. Sometimes, such attemps can backfire.

- Bob


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