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Comedown is a term most often used to describe the temporary after-effects that manifest during the offset of a psychostimulant experience. These effects are often unpleasant, and contrast the effects experienced during the comeup or peak of the experience. It is also sometimes used as a misnomer for the after-effects of alcohol.
It is important not to confuse the words comedown and withdrawal. A comedown is a temporary set of symptoms caused by the offset of an acute drug dose. Withdrawal is a protracted and often severe set of symptoms caused by the sudden cessation of a drug by a dependant individual.
Cause of a Comedown
Psychostimulants work to heighten energy and cognitive performance by increasing the availability of certain neurotransmitters in the brain, increasing metabolism and speeding up the cardiovascular system. The brain and body immediately begin to acclimatize to this sudden increase in performance; after a psychostimulant begins to leave the system, energy and cognitive performance are negatively affected due to neurotransmitter depletion and lowered cardiovascular performance. Depending on the type and dosage of the psychostimulant, the user may take several days to recover to a normal level of function, as neurotransmitters and metabolism return to pre-dosage levels.
Certain symptoms of a comedown may be aggravated or created entirely by other secondary causes, such as abstinence from eating or sleeping. The failure to consume regular meals during a psychostimulant experience can further aggravate weakness, lethargy, and fatigue upon coming down. However, it is often difficult to avoid these circumstances if one does not force themselves to consume a regular diet, as psychostimulants themselves inhibit hunger. Failing to consume water can result in headaches and fatigue due to dehydration.
Compounds within our psychoactive substance index which may cause this condition include:
The effects below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. The listed effects are fairly consistent between comedowns of different stimulants, but experiences may vary due to body type, weight, experience and dosage taken.
- Addiction suppression (During Comedown) - The extremely negative effects of a comedown caused by potent stimulants or high doses may turn one off of re-dosing out of fear for another comedown.
- Compulsive redosing- The negative effects of a comedown, or one's dependance itself, can create a desire to re-dose in order to ease a comedown (At the expense of worsening the next).
- Cognitive fatigue
- Dream potentiation - This varies between substances.
- Focus suppression
- Information processing suppression
- Increased or Decreased libido - Some find that sexual activity becomes more or less desirable, due to individual reactions to comedown or a stimulant.
- Motivation suppression
- Thought deceleration
- Thought disorganization
- Cognitive dysphoria
- Depression - More likely to occur with high doses and/or more powerful stimulants.
- Feelings of impending doom
- Paranoia - Also more likely to occur with high doses and/or more powerful stimulants.
- Suicidal ideation - An extremely severe effect occurring with high doses of powerful stimulants. Usually occurs when underlying depressive disorders are present beforehand.
Some comedown effects, such as wakefulness, occur during the early stages of the comedown due to a still-high level of stimulant in the body. Other symptoms occur later on in the comedown, as stimulant levels in the body drop below an active level; these "latter" effects are often the inverse of the "early" effects, and vice versa.
- Vasoconstriction - Occurs during the early stages of a comedown.
- Difficulty urinating - Occurs during the early stages of a comedown.
- Orgasm suppression - Due to vasoconstriction in the early stages of the comedown.
- Wakefulness and Sleepiness - Early stages see Wakefulness, whereas the latter stages of a comedown see increased sleepiness.
- Appetite enhancement and suppression - During the early stage of a comedown Appetite suppression continues; latter stages see increased hunger.
- Abnormal heartbeat - Early stages.
- Dehydration - May occur if one fails to stay properly hydrated during a stimulant experience, and can result in headaches, dry mouth and nosebleeds.
- Gustatory hallucinations - This is common for dissociatives and deliriants.
- Increased heart rate
- Increased blood pressure
- Physical fatigue
- Temporary erectile dysfunction - Caused by vasoconstriction during the early stages of a comedown.
Managing a Comedown
There are numerous subjective methods for easing the symptoms of a comedown. These can be broadly placed within two separate categories- one involving the use of psychoactive substances, and the other containing methods that do not. Note: Always ensure that you are educated about the substances you take, and make sure that you do not take any combination of drugs that would be dangerous.
Specific substances or categories of substances within our psychoactive substance index that may ease the negative cognitive and/or physical effects of a comedown include:
- Anti-histamines - Certain anti-histamines, such as diphenhydramine can help to induce sleepiness in those who cannot sleep.
- Alcohol - Small amounts of alcohol can ease vasoconstriction and can induce sedative effects to counter wakefulness, but large amounts may aggravate a comedown.
- Gabapentin - Can help to reduce restless leg syndrome and can be used as an anticonvulsant. Gabapentin has been shown to potentially increase the risk of suicidal ideation when taken long term, but his effect has not been witnessed during acute dosages.
- Opioids - Opioids such as oxycodone may help to increase sleepiness during a comedown, but the use of opioids are discouraged as they may worsen comedown effects and lead to addiction.
- Benzodiazepines such as alprazolam and diazepam can help reduce wakefulness in the early stages of a comedown due to their sedative properties, but habitual use can lead to addiction.
- Cannabis may help to sedate those who experience wakefulness during the early stages of a comedown.
- Alcohol- Although large amounts of alcohol consumption are discouraged due to the potential worsening of comedown effects, small amounts of alcohol (About 1 to 3 units, depending on tolerance and weight) can help to lessen anxiety with it's anxiolytic properties.
- Benzodiazepines such as alprazolam and diazepam can help to greatly lessen or even completely eliminate anxiety with their strong anxiolytic effects.
- Cannabis may help to reduce anxiety in some during a comedown. It may also help to ease physical and/or cognitive dysphoria as well as depression.
- Gabapentin may ease anxiety due to it's anxiolytic properties.
- Opioids can ease anxiety, cognitive/physical dysphoria and depression, but the use of opioids are often strongly discouraged as they can worsen difficulty urinating, nausea, appetite suppression, and respiratory depression, as well as being extremely addictive in themselves.
A considerable amount of these methods are subjective in nature, but common preventative methods should be taken by anyone who endures a stimulant comedown. These methods are derived from the personal experiences of PsychonautWiki contributors and discussion among popular online substance use forums.
Common advice for handling a stimulant comedown
- If you took a stimulant recreationally, try not to re-dose until you've recovered. - Re-dosing during a comedown will only make the subsequent comedown more aggressive than before.
- Remind yourself frequently that the comedown is only temporary. - Particularly aggressive comedowns will depress and demotivate an individual. These effects are only temporary, so a positive frame of mind and keeping the comedown in perspective will help you overlook negative thoughts.
- Follow a regular diet during and after a stimulant experience. - Consuming a regular diet while undergoing a stimulant experience will keep one's blood sugar and energy levels up, minimizing weakness and fatigue upon comedown.
- Drink plenty of water. - This helps to hydrate and aid in cleansing, reducing headaches.
- Try to maintain a normal sleep routine. - Lack of sleep can aggravate numerous comedown effects.
- Avoid demanding mental tasks/doing too many things at once. - Keeping as clear a mind as possible will reduce stress and anxiety.
- Tell those who are trustworthy and close to you about what's happening. - If those who are closest to you understand what you're going through, they may offer you more support. They may also be better prepared to handle any irrational or unusual emotions that you might display.