# DXM with Aniracetam



## alacazam (Jan 6, 2014)

does anyone have experience mixing dextromethorphan with Aniracetam? (I would use a low dose of DXM if I do this)

I am interested in this combo because I seem to develop tolerance to Aniracetam quickly, and I know DXM helps avoid tolerance buildup for some drugs.

After reading through this Longecity thread (http://www.longecity.org/forum/topic/58416-phenylpiracetam/), it appears I'm not the only one who was wondering this! Mematine can be used to avoid downregulation of nictonic acetylcholine receptors.

Or maybe I should take it with something, like Tyrosine, multi B vitamins, Taurine.....???? to help it work better. Choline bitartrate doesn't seem to make a big difference.


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## ionarevamp (Mar 19, 2018)

Thread is almost five years old, but I'll bite lol
Yes, I've tried this combo, and started another cycle just the other day. I plan to go with it for at least a couple weeks this time around, or until I run into the seemingly inevitable emotional instability (cause could be upregulation of glutamergic transmission, serotonin depletion, oversensitization of dopamine receptors, natural tendency to feel overwhelmed, etc).
For full disclosure, here's the other parts of my stack right now (not including obvious dietary prerequisites like B-Vitamins and Magnesium/electrolytes):
- Reishi 8:1 extract/Cordyceps 10:1 extract combo. They both have glutamate-releasing, NGF-modulating, androgenic, anti-cancer, and immunomodulatory effects which have always synergized perfectly for me. Can't really have one without the other, frankly
- Piracetam/Pramiracetam/Aspirin/Fish Oil combo. I call this a combo because these all work to enhance cell membrane fluidity. Furthermore, piracetam increases the rate at which VEGF is taken up into vessels and neurons, while aspirin increases circulating levels of it. Not sure about fish oil's effect on VEGF (I'll have to do some research on it eventually), but it increases the availability of choline for mah racetams so I'm not complaining.
- Other:
Oxiracetam, Noopept, Fasoracetam, Shilajit, C60, Dihexa, NSI-189, PRL-853, Methylene Blue (MAO inhibitory doses, as mitochondrial enhancement that is lost at this dosage is mainly made up for by Piracetam and Noopept), Niacinamide (3 grams before bed), Milk Thistle, ALCAR/ALA, Ginkgo

My dosing regimen for DXM is 10mg, three times a day. Once in the morning, once at/after noon, once before bed.
My dosing for Aniracetam is staggered against it, somewhat. ~70 mg (this is the smallest effective anxiolytic/creativity-boosting dose for me, as I've learned to harness a manageable level of anxiety in a way), three times a day. Once in the morning (w/ DXM), once at noon, once in the afternoon before mealtime.
I didn't mention that I also take memantine and adrafinil sublingually once in the morning.
As for subjective effects, I've noticed that while taking larger, more confidence-imparting doses of DXM can be good fun, the smaller doses give me enough of a taste of it while practically eliminating risk. It can make me a LITTLE spacey at times, but the trade-off for general clarity, memory, mood, and drive is worth it. I think it synergizes with my adrafinil via PFC histamine release, and the memantine via regulation of blood pressure and the competition for the NMDA receptor allowing it to bind to the D2 receptor. Aniracetam already brings on a "deeper" and more interactive-feeling experience for me, while making my visual input crisper and more vibrant. What DXM brings to the table on top of this is the confidence to act on this interaction, while offering me a choice to objectively observe. The combination of the two seems to make me a more well-rounded person who is better able to practice empathy, stay calm under stress, and understand motivations. What it doesn't quite solve, however, is any physiological inflammatory issues and the motivation to clarify and pursure higher goals.

Tyrosine is an eh. If you're worried about dopaminergic excitotoxicity, I'd be wary about the tyrosine unless you keep your dosages low. Besides, don't want to worsen the anxiety we're trying to self-medicate for here 
B-Vitamins, I would consider an essential for literally anyone but even more so for those dabbling in psychoactive compounds. B-vitamins and there intermediate metabolites are combined with amino acids to form functional proteins in the brain as well as precursors to ATP, compounds in the Citric Acid Cycle, mitochondrial support, yadayadayda--long story short, I wouldn't NOT take them.
Taurine definitely couldn't hurt. Aids in GABA synthesis, may aid in mitigating any excitotoxicity if you decide to surpass 100mg (for some weird reason). Also could be an anxiety treatment all on it's own, if I'm being honest.
Choline bitartrate, I would keep taking if you have it. Otherwise, if it makes no huge difference whether you do or don't take it I wouldn't fret about it. Just be sure to do your best to eat healthy and your choline, betaine, and b12 levels should stay pretty much functional.

Now for my personal recommendations.
I've read a study (that I'm too lazy to dredge back up at the moment) that concluded this:
if one is able to keep NAD+ levels up in mice when they're exposed to NMDA antagonists such as PCP or even amphetamines, it literally saves neurons. 
NIACINAMIDE is a precursor to nicotinamide riboside, which is a precursor to NADH/NAD+. Take a gram, save a (neuron's) life. To be clear though, you can take up to 3 grams without risk of liver damage--which I haven't seen proof of, but better to be safe. It's also best to take it once a day, as the longer high levels of the nutrient are in the system the more it affects the liver.
C60 is a general and mitochondrial antioxidant of high potency and virtually no toxicity. Should take care of any free radical formation, caused by DXM or anything else.
ASPIRIN, as I stated before, improves cell membrane fluidity. DXM itself, regardless of the presence of the bromide ion attached, actually reduces cell membrane fluidity. This may account for a lot of reduction in cognitive capacity associated with DXM use, but cholinergics, anti-inflammatories and drugs which increase membrane fluidity have been highly promising in my self-experimentation with finding a rational use for the joy that is DXM.

Good luck, and have respect for yourself and drugs. Cheers


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## sad1231234 (Jul 10, 2016)

Dxm for improving mental/physical health? Lol thats a first. Dont know what it would do if you were to mix it with another drug and to take it frequently. Dxm has been known to cause brain damage and Olney's lesions with extended use, although probably more like in the non-therapeutic doses, but you should still tread carefully. It is a powerful drug that does act upon, and cause damage to, the NMDA receptors which are responsible for activating/deactivating the brain. And considering the well known fact that it is generally a very unhealthy drug physically/mentally, i wouldnt recommend using it regularly. There are much better ways to improve your brain's functionality, including the use of safer nootropics such as caffeine. Also, memantine is a dissociative drug(probably similar to dxm) that can possibly cause damage to the brain. And anything that acts on acetylcholine receptors has a chance of damaging the acetycholine receptors, probably in larger amounts or with heavy excessive use but it would be good to play it safe. I do know that a certain amount of damage to the acetylcholine receptors can possibly result in paralysis of the entire body, as the acetylcholine receptors are part of the neuro-muscular system.


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## ionarevamp (Mar 19, 2018)

sad1231234 said:


> Dxm has been known to cause brain damage and Olney's lesions with extended use, although probably more like in the non-therapeutic doses, but you should still tread carefully. It is a powerful drug that does act upon, and cause damage to, the NMDA receptors which are responsible for activating/deactivating the brain. And considering the well known fact that it is generally a very unhealthy drug physically/mentally, i wouldnt recommend using it regularly. There are much better ways to improve your brain's functionality, including the use of safer nootropics such as caffeine. Also, memantine is a dissociative drug(probably similar to dxm) that can possibly cause damage to the brain. And anything that acts on acetylcholine receptors has a chance of damaging the acetycholine receptors, probably in larger amounts or with heavy excessive use but it would be good to play it safe. I do know that a certain amount of damage to the acetylcholine receptors can possibly result in paralysis of the entire body, as the acetylcholine receptors are part of the neuro-muscular system.


Please don't bother scaring the poor person with catastrophizing claims. DXM has never proven to cause Olney's lesions, it was only supposed to based on extensive research on other NMDA antagonists. DXM MAY cause lesions with extremely high continued dosage (due to its ability to enhance blood clotting), but memantine has never shown the same neurotoxicity. Memantine DOES have an optimal dosage range of .3-.5mg/kg in humans (for treating Alzheimers), but that isn't to say that it is toxic at higher dosages--it simply results in undesirable short-term cognitive effects. Furthermore, the chronic application of muscarinic and nicotinic acetylcholine receptor antagonists actually UPREGULATES THEM, resulting in a net increase in excitatory and dopaminergic transmission. The only thing to worry about at therapeutic doses of DXM and memantine is the adjusting period where memory may be worsened before homeostasis takes place. However, DXM acting as an SSRI and sensitizing dopamine and serotonin receptors has the effect of sustainably maintaining mood (in my experience) regardless of the adjusting period. In any case, everyone will respond differently. As determined people will likely try it anyway, it's important to reduce harm instead of reminding people of unrealistic and vague dangers.

Don't get me wrong though, messing with NMDA receptors and acetylcholine receptors can be risky business for the unwary. DXM really does have its own slew of risks though (involving inflammation, body temperature, and blood pressure), which is why I cycle it and take every precaution I can so that the positives outweigh the negatives. I can only hope that I can help others do the same


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## sad1231234 (Jul 10, 2016)

ionarevamp said:


> Please don't bother scaring the poor person with catastrophizing claims. DXM has never proven to cause Olney's lesions, it was only supposed to based on extensive research on other NMDA antagonists. DXM MAY cause lesions with extremely high continued dosage (due to its ability to enhance blood clotting), but memantine has never shown the same neurotoxicity. Memantine DOES have an optimal dosage range of .3-.5mg/kg in humans (for treating Alzheimers), but that isn't to say that it is toxic at higher dosages--it simply results in undesirable short-term cognitive effects. Furthermore, the chronic application of muscarinic and nicotinic acetylcholine receptor antagonists actually UPREGULATES THEM, resulting in a net increase in excitatory and dopaminergic transmission. The only thing to worry about at therapeutic doses of DXM and memantine is the adjusting period where memory may be worsened before homeostasis takes place. However, DXM acting as an SSRI and sensitizing dopamine and serotonin receptors has the effect of sustainably maintaining mood (in my experience) regardless of the adjusting period. In any case, everyone will respond differently. As determined people will likely try it anyway, it's important to reduce harm instead of reminding people of unrealistic and vague dangers.
> 
> Don't get me wrong though, messing with NMDA receptors and acetylcholine receptors can be risky business for the unwary. DXM really does have its own slew of risks though (involving inflammation, body temperature, and blood pressure), which is why I cycle it and take every precaution I can so that the positives outweigh the negatives. I can only hope that I can help others do the same


Not trying to thoughtlessly scare him away, i am just point out some dangers that may be associated with regular DXM use. I know that he uses DXM in very small doses, but it may still be good to be wary of any possible negative effects that may occur with such useage. DXM is a very unhealthy drug, and some doctors have claimed that it should not even be for medicinal use. I dont know if i would want to put that stuff in my brain every day for a long period of time. Especially not in recreational doses, those doses can wear away at the brain. Hmmm dunno much about memantine but since it is a dissociative drug then i would be wary of its effects. Lol you seem to know a lot about this subject, do you study pharmacy stuff by any chance? Im not really bringing up unrealistic or vague dangers, im more like just pointing out that OP should be careful about what drug he chooses to spend the rest of his life inserting into his brain. Especially if it is a drug like DXM. Dxm has been known to show neurotoxicity or damage to NMDA receptors or whatever, and whilst such cases are probably rare and caused by large doses, i would be very hesitant to give someone a recommendation to try any dose of such a substance daily.

Hmmm just curious, do you use it as an antidepressant, or for recreation? I'd be interesting in hearing about any benefits from the microdosing of DXM. Also i just realized this thread is 5 years old lol, whoops, oh well makes for an interesting topic.


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## ionarevamp (Mar 19, 2018)

sad1231234 said:


> Lol you seem to know a lot about this subject, do you study pharmacy stuff by any chance?


Not exactly... I've just spent a lot of time studying research papers regarding nootropics and potential nootropics. I got into the racetams a couple years ago, and I figured that if I was going to be taking them I should learn about them. A lot of the time I have to settle with trying to extrapolate from abstracts as a lot of interesting full studies are behind paywalls, but some information is better than none I guess.



sad1231234 said:


> Hmmm just curious, do you use it as an antidepressant, or for recreation? I'd be interesting in hearing about any benefits from the microdosing of DXM. Also i just realized this thread is 5 years old lol, whoops, oh well makes for an interesting topic.


I found out about DXM on erowid, drug-forum, and bluelight. I spent a couple weeks reading about recreational experiences, and I figured I'd take the plunge into recreation. With much stupidity, I binged for about a week of recreational 2nd to 3rd plateau doses.
After about 6 months of recovering and reflecting (with the help of racetams and other cholinergics), I realized that there had to be some therapeutic benefits. I experimented with microdoses, on and off, for weeks at at time, still occasionally taking higher 2nd/lower 3rd plateau doses every 1.5 months or so. I especially noted that the TIMING of the doses, and what I took it WITH, had the greatest impact on its efficacy.
So, having said that, I've discovered a few dos and don'ts with DXM use:
DO:
- Keep the dose as low as possible, if you want to retain as much personality and rationality as possible. ~30mg per day, split up throughout the day, seems to be the dose that I can still feel working without it having a negative impact on my perspective. I say this because, in my case, higher doses promote intellectual laziness. But, at lower doses, I have the perfect amount of inhibition reduction so that I can actually put my energy to good use instead of excessive rumination.
- Ensure that choline intake is high, sufficient exercise is performed, and/or take enough cholinesterase inhibitors. I take 1mcg huperzine A, eat 4 eggs, and swallow ~1.5 tbsp ground sage with black pepper, per day. I also have a physically active job, and have an intense full-body workout during an 18- to 20-hour fast every weekend. With these safeguards (which have their own benefits) in place, I get little to no brain fog or headaches that might be associated with unhealthy choline levels. Furthermore, I'm not worried about the depressant effect of choline as I'm already prone to depression and am generally able to drag myself out of undesirable states through sheer force of will and meditation.
- Control blood pressure. This can be done through low-dose aspirin, vitamin E supplementation, or long-distance cardio. Drugs with anticholinergic activity have a tendency to increase blood pressure, so this is an important thing to keep in mind.
DON'T:
- Take it at night. This may seem weird, as a huge proponent of DXM microdosing, the infamous Isochroma on reddit, took 30mg ~0.5hrs before bedtime. However, I've found that, for the purposes of reducing social and performance anxiety, it's better to take it during the day when tasks are going to be performed.
- Use Benadryl to potentiate it. Many people know that Benadryl significantly enhances the more hedonic effects of DXM use; again, for the purposes of ENHANCING abilities via inhibition reduction, Benadryl counteracts the positive effects by blunting ALL cognitive processes.
- Keep taking it if it doesn't work for you. If you find that it may be reducing your ability to function, even after a week or so of continued dosing, do yourself a favor and stop. There are times when I had to stop taking it because the situation I was in didn't call for it, and because my health wasn't in a good place. Just know your body and brain, and be sure you're not doing more harm than good.

Without further ado, here is a clearer outline of the effects I've noticed. I've sorted them into three categories: desirable, neutral, and undesirable.
Desirable:
- Improved mental energy. I'm assuming it's because of the glutamergic and dopaminergic sensitization, but I seem to have improved willpower to complete tasks, and improved situational information processing. Basically, I can come to functional conclusions more quickly, regarding what I should do about certain things. For example, I'm a lot less hesitant to do things that my friends or family may question, and I'm better able to explain myself for said things.
- Decreased procrastination. This may have to do with some increased level of impatience. I just want to do things well, and do them quickly. I don't always like the level of focus that may be required (I've been diagnosed with ADHD), but I dig in anyway and do it for the sake of a job well done.
- Increased confidence. This can get me into just as much trouble as it gets me out of sometimes, but being able to stand my ground to achieve what I want to achieve is really important to me.
- Expanded lateral thinking. This is already something I don't necessarily need help with, given my age and predisposition to mental gymnastics. HOWEVER, I have a highly creative project I'm working on that has been aided by an increased capacity to call upon arbitrary artistic concepts.
- Improved mood. This is likely the most pronounced effect, and may be responsible for (or at least be additive to) the previous positive effects. It's as if I have a "happy shield", I've heard it called. There are times I get sad, angry, disappointed, etc., but the difference is that I realize there's always something that I'm being told to do by these feelings and I can quickly pick myself back up.
- Eyes feel less tense. I initially was going to put this in the neutral category. This is helpful for me, because if I focus on something for a really long time the muscles around my temples become really tense and pained. This could be because of changes in physical sensations, or because I just feel more physically relaxed on low-dose DXM. It's hard to say.
Neutral:
- More vibrant visual input. This effect is the strongest 15min after dosing. It doesn't really aid or hinder my abilities, but it's an interesting thing to notice when the things I'm looking at glow just a little more and linger in my vision for an extra 75 milliseconds or so.
- Reduction in tinnitus (ringing in ears). It's not typically something that really bothers me either way, because it fluctuates moderately. Just be aware that it may be affected, if you experience this.
- Changes in physical feelings. At certain times I will be more or less sensitive to pain and itchiness. I haven't taken note of significant fluctuations outside of DXM dosing, other than being sick with the flu or being sore from exercise, so I attribute it to the cycle. Happens every time.
- Gastrointestinal changes. I become a little bit more sensitive to diarrhea, occasionally. I don't think of this as a big deal, because even if I eat the exact same diet for weeks on end I can get constipation or diarrhea out of nowhere.
Undesirable (which only happens if I breach my lowest-effective-dose limit):
- Increased distractability. I sometimes find it harder to filter out extraneous input, such as the conversations of people around me, or consistent annoying sounds like the hum of a fan.
- Increased irritability/decreased tolerance to change. My thinking and planning may become a bit rigid at times, which can cause me to react to situations in ways that aren't helpful to myself and others.
- Decreased motivation.
- Dehydration.

As always, your mileage may vary, and I wish anyone else as brave the best of luck. Just know that I'm still young, so the significance of these effects may be skewed by my health, mental state, and particular level of life experience. Hope this helps


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## sad1231234 (Jul 10, 2016)

@ionarevamp
I found your post to be very interesting. You certainly know your stuff when it comes to like pharmacokinetics and nutrition and stuff lol, especially for a 19 year old, damn. Although i still feel wary of putting any kind of drug into my brain on a regular basis lol, especially dissociatives. Even if it does seem good in theory or at first, who knows what may happen 20 years later or something. And then there is such a complex diet and routine to make sure it works. But good for you that it works alright. Im kind of lucky though in the sense that i dont need to microdose my drugs, i have HPPD so any drug i take pretty much stains my brain slightly forever lol! Anyways my battery is 1% so i cant fit in much more but whats the 3rd plateua like in comparison to 2nd?


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