The reason I ask is because I’m autistic, but I wasn’t diagnosed until I was 18 so I never received any kind of assistance growing up. And every time I’ve used an NMDA antagonist drug, I’ve experienced amazing relief from all of my sensory issues.
I’ve never tried Ketamine, but I have used DXM and Nitrous Oxide, both of which are also NMDA antagonists. It’s like they partially sever the connection between the mind and the body. Nitrous Oxide isn’t very useful for this because it only lasts a couple minutes before you need to redose, but even on lowish doses of DXM I feel totally unencumbered.
My sensory issues tend to take up a lot of cognitive load when I’m out in public and interacting with strangers, resulting in social anxiety. My whole life I’ve been too focused on the feeling of wanting to crawl out of my own skin too much to put any effort into being social, making friends, or having fun.
But on NMDA antagonists that all just goes away and I finally feel free and clear headed in a way I had never imagined possible. They literally just make me feel free to be me. Has anyone else here experienced something similar? Is there any existing research on this?
Will have to get back to this question when I’ve got the capacity.
Previously I’ve been on topiramate, currently I take amantadine (chronically overlooked as a psychiatric medication, particularly useful for most mental illnesses going off preliminary studies as well as being about as good as methylphenidate/Ritalin for ADHD except without the potential for abuse/addiction and quite likely a safer alternative for children [and also this holds a lot of promise for auDHD/potential auDHDers] while also being without the nor epinephrinergic effects which makes it ideal for people sensitive to that in classic stimulants, although preliminary studies found that amantadine wasn’t useful for autism), am angling for ketamine therapy.
NMDA antagonists seem to hold a lot of promise for treating autistic burnout/autistic catatonia, especially as a long-term preventative.
You might find that a psychiatrist is interested in prescribing you with Auvelity/bupropion+DXM (if Auvelity is not available where you are or if it’s too expensive) as this increases the availability and the half-life of DXM and you’ll get a safe dose for longer term treatment.
I don’t really have intense sensory issues but ketamine analogs help me introspect and think without the anxiety caused by OCD or my emotional baggage so I really like them.
I have to warn you, if you overdo it with ketamine you will destroy your bladder. Also, take EGCG supplements when you trip because it might reduce the bladder damage (according to a study on rats it worked, no study has been done on humans AFAIK but it might work).
Definitely something to watch out for, I get annoying urinary retention side effects on DXM too. I’m not sure how it compares to Ketamine, but it’s concerning nonetheless. I try to keep doses low to avoid this for the most part.
And yeah, the type of introspection that NMDA antagonists produce tends to be very consistently useful and easy to accept. It’s totally unlike the potentially chaotic/paranoid introspection some people get with classical psychedelic drugs. At higher doses, it’s like they strip away all the emotional baggage connected to my insecurities, and they allow me to think about things as if I were an outside observer with a fresh perspective.
My only experiences with Ketamine were high doses that make you unconscious. I was trapped in a really shitty situation mentally and physically at the time. My self hate and baggage had me unable to even think about how to get out. A handful of high dose K experiences later and I was on the way to fixing things. The most positive drug experiences of my life.
I’m want to try it at more reasonable doses for depression, but last I looked those online clinics were super expensive.
Consistent n2o use greatly inhibits b12 absorption, so it is dangerous for that reason.
taking notes
I don’t think I’m going to have a good day time in the near future so I’m just going to sketch out a rough idea.
Note that the following things aren’t either/or but more like “yes, and…”
NMDA antagonists have an inhibitory effect on your neurones firing. This may be causing your brain to chill out and not respond in an excessive way to sensory stimuli.
NMDA antagonists are also known for treating anxiety and things like agitation. This relaxing effect might also be taking some pressure off of your sensory sensitivity and especially your psychological response to noxious stimuli.
If you consider it as a network you have:
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Your neurones firing in response to sensory stimuli
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Your immediate psychological response to how you process sensory stimuli
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The downstream psychological and emotional response to being overwhelmed due to sensory stimuli
The more your brain "over"processes sensory stimuli, the more you can expect sensory sensitivity; if you anaesthetise yourself, you aren’t going to have a negative reaction to noxious stimuli (let’s assume that the opposite happens in autistic sensory sensitivity and rather than little to no response, as it would be under anaesthesia, instead your brain lights up like a Christmas tree.) So I’m working under the assumption that NMDA antagonists are going to inhibit your response here.
This means that your immediate psychological response is going to be lessened because you aren’t going to end up being as overwhelmed as you otherwise would be and it’s going to lessen the negative reactions in you. The NMDA antagonist is also going to directly inhibit your negative reactions to a certain extent.
What that means is, at the end of the day, you’re probably going to feel less stressed out and exhausted etc. meaning that you’re going to end up with more headspace to do things like socialising because you are addressing your sensory needs (or “sensory diet”) from a neurochemical level.
This is a lot of hypothesising and putting things together from what we know of the basics about brains coupled with my own internal experiences and what you have described in your post. There isn’t any research on this that I’m aware of but I would genuinely encourage you to reach out via email to researchers who focus on autism with your experience because this might become an area that they investigate and they might even do some studies to examine what’s going on. The upshot of something like this is that it might open up new avenues for treating the negative symptoms of autism, which would be especially useful for high support needs autistic people and kids as there’s only aripiprazole that is approved for treating autistic “agitation” (which itself needs to be unpacked and examined much more thoroughly) and then a cousin to that drug is brexpiprazole which is undergoing research into the possibility of having a similar effect on autistic people currently. Aripiprazole is a good drug but it comes with significant side effects and it would be nice if there was the possibility of achieving a similar effect via something like topiramate instead as it tends to have far fewer side effects, so this would be especially good when it comes to autistic kids.
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