tlehmbecker

Hey all, I've been on aripiprazole, duloxetine, and gabapentin for about 4 months now with no adverse effects on my HPPD. I know that generally, people get worse on such medications, but for me things are going alright. They haven't caused any symptoms to get worse and are helping with my comorbid disorders somewhat. That said, they aren't making my symptoms better by any means. I'm more or less still at my HPPD baseline. For those wondering, I was prescribed the aripiprazole for MDD w/ psychotic features, the duloxetine for MDD, and the gabapentin for anxiety and seizure prevention when I had to cold turkey benzos while in the psych ward. So, for those with similar comorbid disorders, these meds might be worth a shot, but as always YMMV. Hopefully, in the long run, these meds help with the HPPD by nudging my brain chemistry in the right direction, but who knows. Peace.

I use a nootropic stack, but it seems very ineffective at this point. Anyway, my stack: MORNING 10mg Abilify 300mg gabapentin 100mg 50% alpha-GPC 200mg CDP choline 800mg piracetam 750mg oxiracetam 100mg caffeine 200mg L-theanine Nicotine from 1-2 cigarettes AFTERNOON/EARLY EVENING 300mg gabapentin 100mg 50% alpha-GPC 200mg CDP choline 800mg piracetam EVENING 300mg gabapentin 50mg hydroxyzine pamoate Another cigarette Sleep And that's it.

So, after a hospitalization for a suicide attempt I've been put on 10mg Abilify (aripiprazole) and have been taking it daily. Haven't noticed my symptoms getting worse. Perhaps slightly, but nothing unbearable at this point. Additionally I have tried 1:1 THC:CBD weed with no worsening of symptoms. This suggests to me at least that the mechanism behind my HPPD is entirely different than the common hypotheses.

So, for the past week or so I've been smoking a strain that's nearly all CBD and (almost) no THC (I think it's about 13% CBD and maybe 1% THC). I smoke it in joint form, usually shortly before bed. I haven't noticed anything getting better or worse. However, it has done wonders for my insomnia and helps me feel relaxed before I hit the sack. Excellent stress relief. I have a strain that's nearly 1:1 THC to CBD to try still, so I have no idea how the THC will play into things. Planning on doing that this weekend since this will give me ample recovery time should I have a bad time (I don't expect to though). Also, the joints I roll tend to be pretty light, about the size of a hand-rolled cigarette. Also, as a sidenote, I have asthma and the smoke hasn't aggravated it all, usually only if I take a hit that was a little too much. Even then, a few hearty coughs and sips of water later and I'm fine

Well, my journey with HPPD (and mental illness in general) has come a long way in the two years since I started having issues, and it hasn't really improved. It feels like I've plateaued in terms of my illnesses. For awhile it was really bad and getting worse, but everything has tapered off some and I'm just kind of stuck at the same level, not really improving nor worsening (though I do feel like I'm getting worse). Through everything my HPPD hasn't improved and if anything, has actually gotten worse. I've learned to live with it somewhat, but it still causes me a lot of distress. I really just want something to actually help. Everything I've tried has failed in one way or another. Even if that something only reduces my symptoms by 10 or maybe 20% I'd be happy. Anything that makes me feel normal, like how I felt prior to 2015, is a plus and so far I've found nothing. Sure, the clonazepam has helped tremendously with my anxiety, but I've traded one problem for another, namely dependence and tolerance. While I've managed to halve my daily dosage, I'm still dosing daily and I don't want to. Not only that, but the clonazepam is losing it's effectiveness. Before it used to kill all my anxiety, now it just sort attenuates the lingering, daily anxiety and does nothing for circumstantial anxiety unless I pop another tab on the spot (I had two panic attacks on Saturday, both simply because my phone rang and it took me several hours and an extra clonazepam just to get back to baseline). I'm also getting more and more depressed, and the suicidal thoughts are starting to creep back in. Most days it's a chore getting out of bed to go to class and work. Most days I just want to stay at home in my bed sleeping or browsing the internet. I've lost my motivation and joy. This might just be seasonal though as in the summer and fall I was hardly depressed. I don't know, maybe it's the stress and pressure of my new job, or some deep seated anxiety about what happens after I get my degree, but I just feel stuck and quite frankly helpless. Sorry if this wasn't informative or thought provoking, or anything really. I just wanted to vent since I really don't have anyone to talk to, no friends, no therapists (not to mention I think therapy is a crock of shit), no family, no one that I can turn to and just say, "Hey, is it all right if we just talk for a minute? I really need to get some stuff off my mind." I mean, being lonely and not having anyone really gets to you, and your emotions just sort of bottle themselves up and fester. I've got a lot of things pent up inside, but no release and it's just really getting to me as of late. Thanks guys.

Thanks for the concern. Anyways, I dropped all nootropics sans Lion's Mane and l-theanine. Don't worry, I had only been using them off and on for a few days. With that said, visuals seem to have mostly returned to baseline. So one or more of the racetams were causing a worsening in symptoms. Regarding the clonazepam, I've been doing a daily micro-taper for the past two and a half months, so I can't really just stop. I mean, I can, but then I would have to taper again and daily micro-tapering is a tedious and arduous thing (I have to get up 2 hours before I normally do just to prepare solutions). Also, since I've stopped using racetams there shouldn't be any problems in continuing with a micro-taper.

So, I started trying out nootropics to get some of my cognitive spark back. My stack *was* as follows 750mg oxiracetam 750mg aniracetam 400mg alpha-GPC (in 50% form, so 800mg of powder) 200mg l-theanine in split doses But I'm altering it. I believe the aniracetam is making my HPPD worse, my ghosting/double-images in particular. The reason I think this is that aniracetam has an affect on serotonin and dopamine. I can't remember if it's an agonist or antagonist. Since HPPD is apparently linked to serotonin and dopamine to some extent, I would think messing with either would be bad. Then again, it could be anything in my stack. Anyways, I'm dropping aniracetam and seeing where that gets me. I will be adding the following 1g Lion's Mane extract 15mg Noopept (maybe) 300mg pramiracetam (maybe) So, I'll see where that gets me. In addition to this I'm also tapering off clonazepam from 2mg/day (I'm down to 1.21mg/day as of today), I'm working my way up to 16mg/day of tiagabine, and I'm holding at 100mg/day lamotrigine. So, I don't know, what's your guys' experience with nootropics? I'm mainly interested in if any made HPPD symptoms worse.

So, bit of an update. About 3 weeks into starting this medication. I'm at the full 8mg/day. No noticeable effect on any HPPD symptoms. However, that being said, 8mg/day is a paltry dose compared to the average dose which is 32mg/day or more. I discussed this with my psychiatrist today and he suggested to up my dose to 16mg/day in split doses, 8mg in the morning and 8mg at night since I'm tolerating it well and I don't feel drowsy when taking it. However, it has improved my quality of sleep quite a bit. I may not be getting more sleep or falling asleep easier, but I am certainly getting much more quality sleep (REM/'deep sleep') which leaves me not feeling so groggy and out of it if I only get say 4 hours of sleep (I average 5-6 hours a night during the week and anywhere from 8-12 hours on the weekends since I don't have to get up so damn early). But overall, with regards to HPPD and mental well being, nothing has really changed. School is starting up soon (tomorrow in fact) and as such I'm going to be trialing some nootropics to aid with studying. Part of my stack is going to be Alpha GPC and Lion's Mane, so those might help with HPPD. I am also going to try thiamine cocarboxylase. And on an unrelated note, I had my psychiatrist write a letter to my university's disability support services so I can take tests in a quiet room and take as long as I want. Tests have always been tough for me because more often than not I know the answer and the process of arriving at an answer, but the way my brain works doesn't allow me to give complete answers in the time allotted. I mean, I can get the answer it just takes me a little longer than average to get it so I need more time to formulate my answers. Not to mention, but the rushed nature of tests at the university level (you usually only have an hour), my anxiety shoots through the roof and I'll just get stuck, sitting there starting at my test wondering what the fuck I'm gonna do and how the hell I'm going to come up with answers in such a short amount of time.

So, I'm starting a trial of tiagabine for potential treatment of HPPD symptoms. I'll give a quick rundown and then I guess use this thread as sort of a log. Tiagabine is, for those that don't know, an anticonvulsant typically used as an adjunctive treatment for seizures. However, it has been used off-label in the treatment of panic disorder and generalized anxiety disorder. Tiagabine works as a selective GABA reuptake inhibitor, specifically it works by blocking the action of GAT-1. In turn this increases the overall level of GABA in the brain. Since GABA is an inhibitory neurotransmitter, it would make sense that increasing the levels of it would increase the inhibition of interneuron transmission which in turn would reduce a number of things, the most notable of which is seizures. However, because of the effectiveness GABA receptor modulators such as benzodiazepines in treating anxiety disorders, increasing GABA levels would suggest it would be effective at treating anxiety disorders as well. This is where it starts for me. First my psychiatrist considered the effectiveness of clonazepam in treating HPPD (or at least some of the symptoms of HPPD) with which I believe most of you are familiar. Unfortunately, this wasn't necessarily the case for me. Clonazepam had no effect on visual symptoms but it did have a marked effect on my comorbid panic disorder and the DP/DR associated with HPPD. So next he looked at the inhibitory nature of GABA and hypothesized that increasing overall GABA levels would be beneficial since it seems the main hypothesis is that HPPD is simply neuron disinhibition. So that's what led him to suggesting that I at least give it a try. So far I've run the gamut in terms of medications, SSRIs, NDRIs, antipsychotics, lamotrigine, and clonazepam. I decided to go ahead with it because why not? According to everything I've read it is relatively benign. At the very worst it does nothing, and at the very best it works wonders for HPPD. Somewhere in the middle it simply helps with my panic disorder. Should it not work, we'll just move on and try carbamazepine, and then the other treatments like clonidine, tolcapone w/ levodopa, and naltrexone. I'm only 3 days into this new medication so I don't have anything to report. My psychiatrist says that in his experience and in the literature that the effects of tiagabine should come on fairly quickly, within a few days to a couple of weeks. My dosing target is 8mg/day taken at bedtime and my taper schedule is 2mg for 4 days, 4mg for 4 days, 6mg for 4 days and then finally the full 8mg/day. The only negative side effects I have to report at the moment is a headache (though I'm not sure if this is actually a headache or just a manifestation of dizziness, I'm inclined to think dizziness because it is the number one reported side effect) and some abdominal discomfort (also slightly expected). I'll keep posting in this thread with updates, probably on a weekly basis.

I know. They've done studies, mostly in older folks and found that long term use of anticholinergics like DPH definitely have an effect on the brain. Most notably long term use leads to a highly increased risk of Alzheimer's and if you're young like me, both an increased risk of Alzheimer's and earlier onset of Alzheimer's. Not to mention chronic central anticholinergic syndrome. At least it was just DPH though and not something like MDMA. Hoo lord, if I did MDMA every night, hell even just like 3 times a week, for even just a few months I would be in a much worse position than I am now.

Super old thread, but I was using 200-300mg or more each night.

So, awhile ago I began investigating the role acetylcholine might play in HPPD. This was mainly driven by the fact that my case of HPPD was likely caused by diphenhydramine, an antihistamine with potent anticholinergic properties (i.e. it "blocks" the action of acetylcholine). Other driving factors were the fact that many people seem to at least have a temporary worsening of HPPD symptoms when using anticholinergic/antihistamine/antimuscarinic medicines and also to the eerie similarities between central anticholinergic syndrome/anticholinergic toxicity symptoms and HPPD symptoms. I decided to run a little experiment. I went back to my roots of taking diphenhydramine in a somewhat recreational manner. I was having issues with some nausea of unknown origin (though I likely suspect it has to do with caffeine because at the time I was pounding 2-3 energy drinks back-to-back in the morning, diphenhydramine has antiemetic effects) and insomnia (also probably due to caffeine and also potentially due to my tapering off of clonazepam). I decided to keep the doses relatively small, no more than 50mg at a time and no more than 100mg per day. My condition at the time and also as of present left me quite sensitive to the "recreational" effects of diphenhydramine so a 50mg dose was pretty much enough for me to feel the full effects I used to crave. I kept my dosing to only when I more or less needed it, when I felt nauseous and at night approximately 1 hour before bedtime. I did not notice an immediate worsening. However, as the "experiment" progressed over these past few weeks, I noticed my symptoms started to get worse. In particular my double-vision/ghosting and trailing, my two major symptoms. These symptoms have remained at this worsened level since the end of the experiment (last week). Of course, some might attribute this to the caffeine since so many people have trouble with it. Caffeine for me is not an issue except for mild, temporary worsening of symptoms at high doses and the worsening fades when the caffeine more or less leaves my system. Getting back to acetylcholine. Acetylcholine acts as a neuromodulator and messing with its function is known to cause neurological/psychological problems. It would make sense that HPPD could be caused by messing with acetylcholine. I mean we think HPPD is a sort of sensory disinhibition and acetycholine is a neuromodulator thus if acetycholine levels are decreased significantly it would make sense for sensory disinhibition to occur.

Xanax aka alprazolam is safe to take with HPPD. However, alprazolam just like all other benzodiazepines is highly addicting when not used in a controlled manner. With alprazolam it is especially easy to get carried away with it and end up with one of the nastiest addictions to quit, probably second only to alcohol (benzodiazepine withdrawal is hell. Not only could it potentially kill you, but the effects could last years if you don't come off it properly, and coming off of it properly takes months to years for some people and even then they still could exhibit withdrawal symptoms). Even when you do use it in a controlled manner, if you use it for more than a month (in general), you'll probably end up psychologically and physically dependent on it. You won't be addicted to it in the sense that you'll have to keep taking more and more to get your fix, but your body and brain will simply not allow you to stop taking it without consequences. Ergo, tread very carefully when dealing with benzos.

Mainly because I don't have another appointment with him for another 2 weeks and I can't necessarily talk to him over the phone (he's booked from 8-5 on most days). I know his suggestion would be a quick taper since I've only been on it a few weeks (counting the taper week). I've stopped cold turkey on meds before, but those were of course different meds. Anyways, I stopped cold turkey (I know, I know, you should never cold turkey any med) and haven't noticed anything adverse. I still have the pills on hand should things start to go south. I'm gonna give it a week, if nothing happens then fine. If something does happen I still have the pills so I'll be fine. I will talk to my doctor about it though. Also, it's worth noting that my condition isn't that severe. I've managed my symptoms without meds for over a year, I just decided to try this because of it's potential benefits for HPPD and my other symptoms.

I've been on it 3 weeks if you count the week of tapering up. Currently on 5mg (from what I understand a relatively low dose). Can I just stop or do I need to taper off of it? The side effects are horrible at this point and I want off this stuff ASAP.