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Discussion Starter · #1 ·
Good morning, I'd just like to send over some of the literature I was discussing yesterday (this is by no means a comprehensive look at everything I've read, I've taken courses in pharmacology and understand the pharmacodynamics, neurochemistry of different disorders to a standard I am proud of).

https://pubmed.ncbi.nlm.nih.gov/23983976/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736944/

https://www.mdpi.com/2076-3425/8/3/47/htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655617/

My hypothesises on what is wrong with me is one of the following sets of issues:

I have some severe trauma from before 16 years old. This trauma was potentially exacerbated by the salvia and psilocybin causing me to have panic attacks and GAD related to the derealisation and PTSD was triggered.

My other hypothesis is that the psilocybin and salvia caused HPPD and I am now terrified of HPPD episodes, I mention this as my symptoms go on all day from the second I wake up and the moment I fall asleep. I feel like I'm still tripping and this terrifies me as I feel disconnected from reality. However sometimes triggers can cause a full on flashback during which my HR reaches 185 bpm and my BP goes well over 220/180 during a flashback. Causing sudden pain, like cutting myself will snap me out of it often.

My triggers include (this is for a panic attack, the derealisation is always there):

  1. Long corridors
  2. Office style lighting
  3. The song that played when I took the salvia with the psilocybin
  4. Putting/taking my hands out of my pocket
  5. Being in the shower
  6. Opening doors
  7. Small spaces

……And many many more including small spaces etc.

All of these triggers I experienced during the trip 10 years ago and have only got worse over time. So I've been experiencing these terrifying symptoms for 10 years and have had numerous suicide attempts (albeit none serious, mostly looking to try to get help), I do not have suicidal ideation or suicidal thoughts.

The severity of my symptoms were so bad before going on diazepam at 30mg daily by my UCL university psychiatrist that I had to drink alcohol before leaving my room just to walk down the corridors. However symptoms returned when it got reduced to 8mg daily. (I am not asking for benzodiazepines, quite the opposite. I'd like to leave those for a last resort treatment).

I need Dr. Balu Pitchiah to assist me in working out which of the two possibilities is correct (or another cause! I respect his experience and knowledge greatly). I just wanted to write this email so I can be 100% honest and open about what is wrong with me, what has worked, what hasn't worked and give him all the information I can possibly give.

Therapies that have not worked:

  • CBT
  • CAT
  • DBT
  • Trauma therapy
Medications that have not worked:

  • Escitalopram
  • Citalopram
  • Clonidine
  • Propranolol
  • Duoloxitine
  • Hydroxyzine (10% reduction in symptoms approx)
  • Mirtazapine
  • Amitriptyline
(This list may not be complete as I've been on many different medications since I was 20, however I was never this honest with my psychiatrists)

Medications that have worked (even if prescribed for different reasons entirely):

  • Diazepam
  • Clonazepam (This had a better effect on symptoms than diazepam ever did)
  • Oxycodone [1] (For a back injury / brachial plexus injury from a car accident, however I am trying to come off due to side effects)
  • Ethanol [2]
My theory on these working is that they are all CNS depressants, a trivial guess I know; however it's the only thing they all have in common aside from 3 of them being GABA agonists.

I know this is a long email, this is the most honest I've ever been with people about my struggles. I'm fully invested in getting better and being honest with Dr. Balu Pitchiah and having his amazing input on my condition(s).

Thank you,
Lenny

[1] This only had a benefit when I was on a much higher dose than I am now.
[2] I no longer drink, due to the hangovers causing my symptoms to get extremely intense.
 

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Discussion Starter · #2 ·
Just a bit about myself :). I'm a 25 year old gay male who studied physics up to the PhD level (did not finish). I'm not studying to become a doctor. I love rowing, medical research Minecraft and loads of random things like guitar, piano etc. I'm super friendly and love to chat to people who need help, I find it helps me. i have experience helping people with addiction, anxiety and depression [1].

[1] I AM NOT A FULLY TRAINED MENTA HEALTH PROFESSIONAL, I CAN ONLY OFFER SUPPORT AND ADVICE WHICH SHOULD NOT BE TAKEN AS CLINICAL ADVICE. THIS IS SIMPLY A CLEAR DISCLAIMER THAT I AM NOT FULLY QUALIFIED YET.
 
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