Kit asked me to forward this as she is having difficulties with posts
getting out of NIMH...
 
From: Kit Bonson <kbonson@helix.nih.gov>
To: Lamont Granquist <lamontg@u.washington.edu>
}
} As many of you are aware, over the past months I have been 
conducting a
} retrospective study here at the National Institute of Mental Health 
on the
} interactions of hallucinogens and antidepressants in humans.  I'm 
finally
} at a place where I can reveal my results.  These data have already 
been
} presented at the Serotonin Club meeting in Chicago this summer and 
are in
} the process of being written up for submission to 
pharmacology/psychiatry
} journals (I'll post the references later, assuming the manuscripts 
are
} accepted).
}
} Thanks to all of you on the Net who responded to my requests for 
subjects!
}
} The basic idea of the study arose because I have a lot of friends 
who have
} been on antidepressants and also have a long-standing interest in
} hallucinogens.  They would call me up (as their personal 
pharmacologist)
} and want to know why they had unusual responses to LSD while they 
were
} taking antidepressants.  It turned out that the experience one had 
on LSD
} could be highly variable, dependent on which antidepressant one was 
taking.
} Based on these initial reports, I asked to interview people with 
similar
} histories by placing announcements in the local D.C. alternative 
newspaper,
} on newsgroups on the Net, and by an article in the MAPS 
(Multidisciplinary
} Association for Psychedelic Studies) newsletter.  People also 
contacted me
} after hearing of the study by word of mouth or by being referred by 
a
} health professional.
}
} Although many many people responded to my request, I was only able 
to use
} those reports where there was a "control" condition, ie:  either the 
person
} had taken the same hallucinogen prior to antidepressant treatment or 
else
} had friends who had taken the same hallucinogen but were on on
} antidepressants.  Everyone who participated was given a structured
} questionnaire that first asked about the person's antidepressant 
treatment,
} other drugs they regularly consumed, and past experience with
} hallucinogens.  Then I asked about the experience the person had 
with a
} hallucinogen while taking an antidepressant.  The main thing I was
} interested in was whether there was an increase, a decrease or no 
change in
} the person's response to the hallucinogen in terms of the time it 
took to
} get high, the physical effects, the hallucinatory effects, the
} psychological effects, the total time they were high, any 
aftereffects or
} alterations in sleep and then their overall impression of the trip.
}
} In a nutshell, people who were taking serotonin-selective 
antidepressants
} or MAO inhibitors had a decrease or abolishment of their response to
} hallucinogens.  This is in contrast to what happens when people were 
taking
} tricyclic antidepressants or lithium:  they had a vast increase in 
their
} response to hallucinogens.  Please note that everyone who responded 
had
} been taking antidepressants for at least 3-4 weeks, if not longer.  
This is
} the time necessary for therapeutic effects to begin, and this is 
thought to
} correlate with changes in neurotransmitter systems in the brain.  We 
have
} no information about what happens when people have only taken
} antidepressants for a short time and then consume a hallucinogen.
}
} Below is a more comprehensive summary of the data:
}
} SEROTONIN-SELECTIVE ANTIDEPRESSANTS:
}
} Fluoxetine (Prozac) --  even at doses of this antidepressant ranging 
from
} 2mg/day to 40 mg/day, there was an overall decrease in most effects 
from
} LSD (no matter how much acid people took), as well as a decrease in
} response to ketamine.  There was no change in response to 
psilocybin.
} There does seem to be a decrease in the response to MDMA.
}
} Sertraline (Zoloft) -- the effect with this antidepressant seems to 
be
} dose-dependent.  At 50 mg/day, there was no effect on the response 
to LSD
} nor to psilocybin.  However, at 100 mg/day, there was a decrease in
} response to both LSD and MDMA.
}
} Paroxetine (Paxil) -- decrease in response to LSD.
}
} Trazodone (Desyrel) -- decrease in response to LSD.
}
} TRICYCLIC ANTIDEPRESSANTS:
}
} Imipramine (Tofranil) -- increase in response to LSD.
}
} Desipramine (Norpramine) -- increase in response to LSD.
}
} Clomipramine (Anafranil) -- increase in response to LSD.
}
} LITHIUM:
}
} (*alone*  or   *in combination with a tricyclic antidepressant*)  --
} increase in response to LSD or psilocybin.
}
}
} MONOAMINE OXIDASE INHIBITOR:
}
} Phenelzine (Nardil) -- decrease in response to LSD
}
}          **TAKE NOTE OF THE RESPONSE TO MDMA:  combining an MAO 
inhibitor
} plus MDMA has led to a hypertensive crisis and a near-fatal response 
in
} many people!!!  This could be anticipated because MDMA is a 
substituted
} amphetamine, and stimulants should not be combined with an MAO 
inhibitor!!!
} DO NOT TRY THIS AT HOME!!!
}
}
} There were a few other psychotherapeutic drugs that people combined 
with a
} hallucinogen, but you'll have to wait for the journal articles for 
these
} odd responses.
}
} How do we explain these data??  Well, this is a bit of a theoretical
} problem.  One would want to say that the hallucinogenic response 
occurs
} because of 5-HT-2 stimulation and therefore there was down-
regulation of
} 5-HT-2 sites following serotonin-selective antidepressants and MAO
} inhibitors, thus leading to elimination of the hallucinogenic 
response.
} The problem is that these antidepressants do not always alter the 
brain in
} this way.  The other, bigger, problem is that tricyclic 
antidepressants are
} thought to act very similarly to SSRI's in their ability to down-
regulate
} 5-HT-2 sites, and thus there is no accounting for the appearance 
that TCA's
} increase response to LSD.  We are at the stage now where we are 
trying to
} formulate a theory based on the difference between classes of drugs 
in
} terms of their effects on 5-HT-1A sites and in terms of the way the
} different antidepressant change serotonin levels.  Since LSD has 
effects
} not only at 5-HT-2 sites but also at 5-HT-1A sites, this may allow 
for why
} these drugs affect the hallucinogenic response differently.
}
} So, thanks for all the support I received from everyone who helped 
out with
} this study.  All of you who participated and then kept quiet about 
my
} results receive my gratitude.  Special thanks to Lamont Granquist 
who not
} only was very helpful in recruiting subjects for me and for sending 
me
} references I might have otherwise missed but restrained himself  for 
months
} from spreading the word about these interesting results.
}
} If anyone out there knows of someone who could be a subject, they 
can
} contact me with the information below.  I'm basically in the last 
phase of
} writing the manuscripts, but could still interview someone if they 
wanted
} to step forward, especially those who have used MDMA.  Contact me 
at:
}
}                                                    Kit Bonson, Ph.D.
}                                                    National 
Institute of
} Mental Health
}                                                    Building 10, Room 
3D41
}                                                    Bethesda, MD  
20892
}                                                     (301) 496-3421
}                                                     
kbonson@helix.nih.gov
 
 
--
Lamont Granquist (lamontg@u.washington.edu)