12 replies to this topic

[mewild]

Most GABA related suplements as Phenibut and Kava Kava build up tolerance. What if one was to cycle them lets say Phenibut for 2 weeks then Kava for another 2 weeks then maybe ashwaghanda, L-Theanine etc. Would there still be tolerance? I guess the real question is do they act the same way on GABA? Is the amount of GABA related suplements that counts or is there any difference if you cycle them?

[ikaros]

Psychiatrists cycle benzodiazepines for avoiding dependance and to keep the power of each med optimal. So in theory, if Phenibut and Kava Kava and Theanine work similarly to benzos (which isn't very well understood), then cycling them would keep them more effective. Though if I remember correctly theanine works through a bit different pharmacodynamic route than do benzos and does not induce observable dependance, though also not observable overwhelming inhibiting effects like benzos induce. Dependance symptoms are mainly an effect of too much GABAergic stimulation of the postsynaptic neuron which causes downregulation of benzodiazepine receptors of the ligand (drug) that activated them.

[xanadu]

I think the real question is whether those things have cross tollerance or not. I don't believe they do though they may to a small degree. Laying off something like phenibut for a while is a good idea. I only take it on special occasions, not regularly. As far as I know, kava does not build up tollerance.

[eternaltraveler]

Psychiatrists cycle benzodiazepines for avoiding dependance and to keep the power of each med optimal.

ummm what? That makes no sense at all as all benzos work the same way. They have slightly different affinities for various forms of the gaba receptor, but the primary difference between benzos is half life and marketing. Any pyschiatrists that do that as you say are simply irresponsible.

About half of psychiatrists wanted to be psychiatrists, but the other half couldn't do anything else because of poor board scores.

Other than phenibut I'm not aware enough of the pathways kava theanine use to mediate relaxation. If they use the same pathways cross tolerance will develop. It's best not to have to rely on anything to relax on a continuous basis, this can only escalate over time.

[zoolander]

Sounds like we could put an interesting and very valid study together.

Question: How long does one need to abstain from phenibut, after tolerance has been built, before the same effect of the initial dose can be felt?

My body is yet to build tolerance to Phenibut. The most I have used over a short period of time is 2 days in a row and roughly 1 week apart for a month or so. I only take phenibut once every couple of months or so and may have 3-6 months where I don't take it all.

I advised a friend of mine take it daily to deal with anxiety. I recommended that they start at approximately 1 capsule (500mg) per day taken in the morning with breakfast. They continue to do this for about 7-10 days until they started to build a tolerance to the dose. When this happen I increased the dose by approximately 30% until tolerance. Then another 30% until tolerance and so on. I continued this to a maximum dose of about 1.5g per day. After reaching 1.5g per day I advise they stop for a month or so and replace the phenibut with Rhodiola.

Has anyone else experimented with how long you need to lay off phenibut before your body loses it's tolerance?

[ikaros]

ummm what? That makes no sense at all as all benzos work the same way.

Yes of course they work the same way in principle, but for example if you take alprazolam for 1 month then it is generally smart to switch/wean yourself off it to for example clonazepam. While alprazolam loses its effect druring chronic use, then replacing it with clonazepam will reinduce the anxiolytic effects that started to fade with the continual doses of alprazolam, also it dampens the withdrawal of alprazolam. There are many GABA receptors, but bascially they all work to inhibit processes in the brain, especially emotional processes as amygdala is heavily populated with benzodiazepine receptors and amygdala is the center for emotional processing of information. Simply put, there are many switches for inhibition (collectively called GABA receptors) and each benzo works on different switches and this gives a way for playing with different benzos to avoid dependance (symptoms!) on one benzo, so in the future one can reuse the benzo that would have lost its usage if it had been administered long-term without replacement...well the other way would be also to just discontinue the benzo for a while (which is a major pain in the ass as benzo withdrawal is comparable to heroin withdrawal if it has been used very long) and then take it again with the original effects, but that's just being masochistic. Btw I have personal experience in this field.

[eternaltraveler]

I'm afraid you are misinformed. Different benzos may have higher affinities or lower affinities for various subunits of the GABAa receptor. The various subunits come together in multiple variations to form GABAa receptors. Different subunit configurations are present in different areas of the brain to varying degrees. So a drug can be made more specific for anxiolysis or sedation for example. However other benzos that are specific in such a manner would act in the same way. Alprazolam and clonazepam are both fairly specific for anxiolysis and less so for sedation (though they both sedate), the primary difference between them is half life.

Patients are often moved from benzos with a short half life like alprazolam to clonazepam or diazapam due to the much more peaky nature of shorter half life benzos. And in the course of withdrawl having a benzo with a longer half life can make the transition gentler.

Despite small differences in receptor subtype affinity all benzos are highly cross tolerant. Switching from one to another thinking that you are giving your brain a break from one simply is not true.

[zoolander]

Switching from one to another thinking that you are withdrawling from the effects of one simply is not true.

What!



tell me it's not true morphius

[opivy]

About half of psychiatrists wanted to be psychiatrists, but the other half couldn't do anything else because of poor board scores.

Have you looked at the average USMLE step 1 scores needed to become a psychiatrist. I'm sorry to side track this thread, but I just had to say something about this. You make it sound like psych. was their only option, nothing else, bottom of the bottom. I mean forget family and internal medicine. For some reason people see an internist in the hospital and they think "ah doctor" but when they see a psychiatrist they think oh this guy isn't even a real doctor. But matching for becoming an internist is on par with the match for becoming a psychiatrist and family medicine is even lower. Again sorry to go off topic.

[kottke]

any input on glycine supplementation?

[eternaltraveler]

Have you looked at the average USMLE step 1 scores needed to become a psychiatrist.

yes. And I admit that much of my statement about psychiatrists came through personal interaction. However the statistics don't really disagree with me either.

average usmle scores for matched applicants in various specialties (from NBME; I think 2005)

Plastics 242
Derm 239
Ortho 237
RadOnc 235
Rads 235

Path 223
IM 220
Surgery 220
EM 219
Anesth 219

Peds 215
OBGYN 212
FM 209
Psych 209
PM&R 208

so yes, they could match into FM (but not internal medicine). FM is however extremely rigoris post matching as individuals have to know about every system in the body including some psych. There is unfortunately a shortage of family doctors because quite frankly all the shit they have to put up with from insurance and what not is becoming increasingly not worth it. Though I am considering it because I am a generalist by nature (IM and general surgery are also possibilities).

Don't get me wrong, there are some very good psychiatrists who are masters of their craft (many of these have additional training in pyschology, or are simply masters of neurochemistry). In my experience however many are simply drug pushers that wanted to do something else. People generally don't go to pyschiatrists for conseling, they go to pyschologists. I suppose there are plenty of bad doctors in all fields, so it isn't entirely fair of me to single them out. I by no means think having top notch USMLE scores would make someone a good doctor of any kind. It's just a test. Being a doctor takes a lot more than being good at picking the right answer when it's already sitting right in front of you (ie multiple choice).

[superpooper]

It's amazing but Kava Kava actually seems to have a reverse tolerance. The compounds are fat soluble, so the theory is that it needs to build up in your system similar to marijuana.

[opivy]

yes.  And I admit that much of my statement about psychiatrists came through personal interaction.  However the statistics don't really disagree with me either.

average usmle scores for matched applicants in various specialties (from NBME; I think 2005)

Plastics 242
Derm 239
Ortho 237
RadOnc 235
Rads 235

Path 223
IM 220
Surgery 220
EM 219
Anesth 219

Peds 215
OBGYN 212
FM 209
Psych 209
PM&R 208

so yes, they could match into FM (but not internal medicine). FM is however extremely rigoris post matching as individuals have to know about every system in the body including some psych. There is unfortunately a shortage of family doctors because quite frankly all the shit they have to put up with from insurance and what not is becoming increasingly not worth it. Though I am considering it because I am a generalist by nature (IM and general surgery are also possibilities).

Don't get me wrong, there are some very good psychiatrists who are masters of their craft (many of these have additional training in pyschology, or are simply masters of neurochemistry). In my experience however many are simply drug pushers that wanted to do something else. People generally don't go to pyschiatrists for conseling, they go to pyschologists. I suppose there are plenty of bad doctors in all fields, so it isn't entirely fair of me to single them out. I by no means think having top notch USMLE scores would make someone a good doctor of any kind. It's just a test. Being a doctor takes a lot more than being good at picking the right answer when it's already sitting right in front of you (ie multiple choice).

Yeah I didn't mean anything negative towards you, it just kinda burns me to know that a lot of people think so poorly about psych. when I want to specialize in psych. And you are right about the tests scores, there are so many other things that are looked at when you match, and I am under the impression that IM, FM and psych. are generally even when it does come time to match. I mean yeah you have your USMLE and then you have your grades, if you have them, or if you are in a hp/p/f school then you have honors and then you have research and so forth and so on. So sorry for just saying look at the scores, you are right it's just a test. I'm hoping maybe I will be able to get into a dual psych/IM or neuro/psych residency, but that is a long long time from now. And sorry again for going off topic, I promise this is the last.