Consultations on Health, Addiction, and Harm Reduction

[Paracelsus]

Greatings everyone!

After discussing with the administration, I've decided to open a small consultation room in this section of the forum.

A little bit about myself: I am a doctor specializing in psychiatry and addictology, and I have been working in this fields for years. Based on my experience, I've found that the primary challenge in addiction-related healthcare is the lack of knowledge, and absolutely fair distrust of the system amongst individuals.

Fortunately, platforms like Breaking Bad provide people with a degree of freedom, allowing both patients and professionals to communicate directly and anonymously, without being bound by the system constraints.Yes, no one here will give guarantees, and will not solve all your problems for you (just like everywhere else). However, here you can get the honest information for free and without obligations.

In this topic, you can ask any questions related to health, substances, addiction, harm reduction, or other topics that are either relevant or somewhat unrelated to the issue.

While I cannot promise to respond promptly (most likely quite the opposite), I will do my best to answer each and every one of you. I would like to remind everyone that online texting has its limitations, not just in terms of response time, but also in terms of obtaining information necessary for objective, helpful, and safe recommendations.

If you prefer more private communication, feel free to contact me via private messages.

Lastly, I also encourage everyone to explore the entire forum section on Medicine and Health, share it among you connections and participate in its content if possible. If you have knowledge or experience on this topic, but you do not know where to start - also feel free to write to me.

In any case, I would be more than happy to answer your questions and provide assistance to the best of my abilities.

Stay in touch and be healthy!

 

[CamilleSilva]

Just wanted to give a big shoutout to the doctor specializing in psychiatry and addictology who's opening a consultation room in this forum section.

 

[Paracelsus]

Thank you for your kind words. I hope this topic will help someone. Unfortunately, it is not very active here yet

 

[KokosDreams]

It will come once the forum grows

 

[Paracelsus]

Thank you and I really hope so

 

[miner21]

Doc we are so fortunate to have you! I have seen group discussion boards where people can talk to eachother about these subjects, and there is good conversation to be had there. However i have NEVER seen a doctor (not to mention a psychiatrist) jump in these forums to be there for the users to talk with. This is greatly beneficial and I truely appreciate you being here. Thank you

 

[Paracelsus]

Thank you for the kind words. I am glad to be here, and I know that my colleagues are among us, even though they do not like to advertise their specialty. Doctors need to be more open, especially in the area of mental aspects.

 

[prophet]

I think this is a great idea and hopefully people will utilize this section of the forum if needed, and honestly I think as users, or even your average person who is not using needs someone to talk to and vent to about issues that they cannot otherwise discuss and having someone who is a specialist to go to is beneficial. It makes we wonder what other professionals are on here. Because of opsec I'm not sure many of us would adveertise it though.

 

[Paracelsus]

Yes, the current disposition hinders everyone, both users and specialists. But we see how the situation is changing very slowly. This is encouraging

 

[cofita666]

Hello doc,why i have so mich tics on face when combine mdma and amphetamine,i hate it,i need go to public, job or other public place with that issue
Frst take mdma and later when is comming down add amphetamine
Thanks
Sorry if some already write can not finde

 

[Paracelsus]

Greetings. The facial tics and muscle twitching you’re experiencing are likely due to a combination of overstimulation of your nervous system, neurotransmitter imbalances, and the taxing effects of these substances on motor control and muscle tone.

MDMA causes a massive release of serotonin and some dopamine. Amphetamines predominantly increase dopamine and norepinephrine levels. Combining them leads to overstimulation of dopaminergic and serotonergic pathways. Dopamine dysregulation in particular is associated with motor control problems, leading to tics and twitches.

Both substances increase the activity of the sympathetic nervous system ("fight or flight"), which can cause hypertonic muscles (tightened muscles) and involuntary movements.

MDMA alone can cause jaw clenching and muscle tension (sometimes called "gurning"), a side effect related to serotonin receptor activation. Adding amphetamines exacerbates this tension due to increased dopaminergic drive.

MDMA and amphetamines both dehydrate you and deplete essential electrolytes like magnesium, potassium, and calcium, which are critical for smooth muscle function. An imbalance can result in twitching or cramping.

Prolonged or repeated use of these substances can exhaust the brain’s ability to regulate neurotransmitter levels, leading to a rebound effect or dyskinesias (involuntary muscle movements) as your system struggles to stabilize.

Why It’s Worse in Public or Work Settings? Public places and professional settings often cause stress, which amplifies CNS excitation and exacerbates tics. The stimulant-induced anxiety (from amphetamines) can add to this. Becoming self-conscious about the tics can make them worse, as psychological stress can feed into physical symptoms.

Strategies to Mitigate Facial Tics:

• Hydration and Electrolytes: Sip water regularly (avoid overhydration to prevent hyponatremia) and include electrolyte solutions.
• Magnesium Supplementation: Magnesium (preferably magnesium glycinate or citrate) can help relax muscles and reduce tics. Take 300-400 mg before or during your session.
• Chewing Gum or Mouthguard: Chewing gum can reduce jaw clenching, and a soft mouthguard may help if tics are pronounced in the jaw area.
• Control Doses: Lower doses of both MDMA and amphetamine may reduce overstimulation of your nervous system.

Preloading and Postloading Supplements:

• 5-HTP (after MDMA) to replenish serotonin (wait at least 12-24 hours post-use to avoid serotonin syndrome).
• Vitamin C and E for antioxidant protection.
• L-Tyrosine for dopamine support during recovery (not during active stimulant use).

Avoid Combination or Overuse: Combining MDMA and amphetamines significantly increases neurotoxicity risks. Using them separately with longer breaks in between may help reduce symptoms.

Combining MDMA and amphetamines carries a risk of serotonin syndrome, which can include muscle rigidity, tremors, and twitching. Chronic or high-dose use of these substances may cause long-term damage to dopamine and serotonin systems, potentially leading to persistent movement disorders.

If you experience tics even when sober, you might have a predisposition to a condition like Tourette’s syndrome or essential tremor. Stimulants can unmask or worsen these conditions.
If these symptoms persist even when you're not using substances, consult a neurologist or psychiatrist to rule out underlying conditions.