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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?

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[-] ReadFanon@hexbear.net 2 points 1 month ago* (last edited 1 month ago)

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:

  • Your neurones firing in response to sensory stimuli

  • Your immediate psychological response to how you process sensory stimuli

  • 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.

this post was submitted on 12 Aug 2024
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