It's what I got from blowing through a three-figure number of arylcyclohexylamines (with MXE probably being the least harmful and - really! - K the most. Not including these crazy potent PCP analogues and the HO ones, which I didn't tolerate well, also assuming pure substances without impurities). Strange alternations in thought patterns, with similarity to yet qualitatively very different from "hearing voices" - something people outside of the psych ward don't speak about and these poor ones inside only get shot up with antipsychotics and more antipsychotics, and there isn't even a differential diagnosis for what I got:
isolated, acoustic pseudo-hallucinations. On some occasion I also experienced true voices, calling down from the houses, paranoia etc. but this included an involuntary RC stim overdose together with sleepless nights and isn't that special
but this incident offers a possible cause of course. If not of toxic origin then at least that the brain somehow learned how to "do" this feature. Yet, as said, it's very different, it never had actual volume even when it could become pretty "loud" but load as in screaming in thoughts vs. real, noisy screaming. Like it happens in a different dimension (probably the one of my own mind, for whatever this means, ask the psychedelic folks).
Other possible cause are toxic adulterants, which might boil down to similar than RC stims.
Or then it was the O-PCM itself. For which would speak that any dissociative, even memantine when dosed highly enough, can and will trigger the "feature" but after a year of healing it is even less random commentaries than it was before, sometimes it was like an entity of its own with which I could have conversation and sometimes still is but primarily it's like a mirror of myself, my own thinking. It can't provide any info I didn't know myself. The most annoying thing is an echo, when a "conversation" with it ends, the last word or the last few remain halling back and forth in my thoughts for maybe 30-45s (short time memory??).
I guess, but can't confirm it, that a mild 1cP-LSD trip at the end of my disso abuse career might have strongly contributed to things healing a bit, while antipsychotics - and opioids, but they felt reversible - had the tendency to cause worsening. I only said some little bit about "some acoustic hallucinations long ago while heavily intoxicated", big mistake, since then I couldn't get anymore Rx stims but rather antipsychs. Tried next to all of them and none worked or felt beneficial. Some, like risperidone or aripiprazole, caused acute worsening, a reoccurrence of whispering in noise and hearing conversations, screams, etc in running water. This alone is worrying enough but low-mid dose memantine, being a fucking D2 agonist, did not cause any worsening besides mentioned high dose inducing which happens at like 80mg.
The primary episode remained for longer time without any drug but faded pretty quickly after the 1cP-LSD. Now it comes and goes with dissociatives, which too is worrying because they were my favorite class of drugs & guess need to stay clear off them for longer, but it doesn't last any longer than the substance's effects. Notable exception seems to be dextromethorphan, when used together with a CYP2D6 inhibitor.
Strange, weird stuff. I heavily suspect my concomitant morphine/bupe use to have been a factor too, as I did abuse dissociatives before and got away with it. Or it was just toxicity of some batches, but then it shouldn't be so reliably triggerable by dissociatives, or the brain just learned to associate it with that state, or or or...