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Anticholinergic after stimulant binge = psychosis but why?

Y

yoyoman

Bluelighter
Joined
Jun 11, 2006
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320
This happened to me a couple times recently.

About a month ago, I did a bunch of 4-fluoroamphetamine, then at night I took 3mg xanax to get to sleep, but it wasn't doing it so i took 100mg benedryl (that dose doesn't normally make me see shit). I woke up a couple hours later with ALL sorts of interesting hallucinations.. the only reason I didn't freak was cause the xanax kept me completely calm. I saw spiders and things crawling all over the floors, walls, etc. Looking outside (sun was starting to come up), I would see things fly by, saw people up in trees looking at me, was actually really cool (only because of the xanax).

Went to the bathroom, and it was like entities were joking/fucking with me (reminds me of DMT), turning the light brightness up and down (looked totally realistic). I explored this state (like i said, thank god for xanax, made it fun) for a while and just went to sleep with no problem.
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Yesterday, I was doing bumps of MDPPP all day (no more than like 55mg total, spread out, which isn't all that much). At night, took ~150mg seroquel.. Laying in bed I stared to hear faint voices in the fan noise, felt too stimulated for sleep so I turned the light on. Without xanax or some downer, there's this feeling of my brain going into overdrive.. like too excited, feels like my mind gears up for combat - my vision gets crystal clear like everything is amplified (colors, brightness, edges). I realize "its happening again", get that feeling the entities are coming out to play.. so i throw my coat on and run to the store to get some beer, sort of in a panic.. I'm guessing its because of seroquel's anticholinergic effects.. since it felt very similar to the benedryl incident. I didn't see any full on hallucinations, but could tell they were sorta there, and I'd be sensitive to every sound or visual, not trusting my view of reality, just overall paranoid.

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I did some searching and did find a couple other people reporting the same thing, psychosis from taking an anticholinergic after a speed binge etc.

I'm just curious whats going on in the brain for this to happen? Taking benedryl when otherwise sober doesn't do this its only after i've used some kind of stimulant earlier in the day.. anyone got any idea's?

I also find the whole subject of psychosis, voices, entities interesting... like who are "they" etc.
 
Seroquel does not have any anticholinergic effects. It is however an antihistamine and so can seem to induce hypnagogia, iirc.
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Searching for quetiapine anticholinergic effects on google seems to show otherwise..

From http://www.merckmanuals.com/professional/lexicomp/quetiapine.html :
• Anticholinergic effects: May cause anticholinergic effects (confusion, agitation, constipation, xerostomia, blurred vision, urinary retention); use with caution in patients with decreased gastrointestinal motility, urinary retention, BPH, xerostomia, or visual problems. Relative to other antipsychotics, quetiapine has a moderate potency of cholinergic blockade.
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Also in the past I have taken Geodon (ziprasidone) to sleep after binging on stimulants, it worked well, nothing psychotic happened.

Another thing I found, comparing quetiapine, ziprasidone, and others: (http://www.ncbi.nlm.nih.gov/pubmed/16928430 )
A model of anticholinergic activity of atypical antipsychotic medications.

Chew ML, Mulsant BH, Pollock BG, Lehman ME, Greenspan A, Kirshner MA, Bies RR, Kapur S, Gharabawi G.

Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Abstract

BACKGROUND: Atypical antipsychotics clozapine, olanzapine, and quetiapine have significant affinity for the muscarinic receptors in vitro, while aripiprazole, risperidone, and ziprasidone do not. Dissimilarity in binding profiles may contribute to the reported differences in the anticholinergic effects of these antipsychotics. However, it is difficult with the available data to predict the likelihood of anticholinergic effects occurring with various doses of an atypical antipsychotic.

METHODS: We developed a model to assess the potential anticholinergic activity (AA) of atypical antipsychotics at therapeutic doses. A radioreceptor assay was used to measure in vitro AA at 6 clinically relevant concentrations of aripiprazole, clozapine, olanzapine, quetiapine, risperidone, and ziprasidone. Using published pharmacokinetic data, in combination with the measured in vitro AA, dose-AA curves were generated.

RESULTS: Clozapine, and to a lesser extent olanzapine and quetiapine showed dose-dependent increases in AA. At therapeutic doses, the AA (in pmol/mL of atropine equivalents) was estimated to range from 27-250, 1-15, and 0-5.4 pmol/mL for clozapine, olanzapine, and quetiapine, respectively. Aripiprazole, risperidone, and ziprasidone did not demonstrate AA at any of the concentrations studied.

CONCLUSIONS: Therapeutic doses of clozapine, olanzapine, and, to a lesser extent, quetiapine are associated with clinically relevant AA
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So it seems that it is probably the anticholinergic effect.
 
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I just got prescribed olanzapine, and at 2.5 mg after amphetamine use, it triggered a four day episode of a variety of psychotic symptoms of a nature not even experienced after week-long binges....

I just realized the connection now.

And I was planning on starting the olanzapine again tonight, good thing I caught this or I'd have been in a world of hurt again.
 
How much did you take mate ? The stimulation is not bad and relatively easy to deal with.
 
interesting coincidence. after about 14 hours of a ~10mg dose of aMT I took 37mg of diphenhydramine + 500 acetaminophen(excedrin pm) for a headache that came on. It worked, but I started seeing prominent visual static, enough that it looked like a bunch of mosquitos whirring around in a sphere. My lights(the light given off by them) also very noticably started to flicker and fade darker and lighter. Also saw some small beetles on my arms which disappeared as I looked closer.

I had also taken a benzo too, phenazepam, 1-2mg. So maybe it's a result of both of them combined with an over worked brain from the stimulants.. either way it wasn't scary in the least, but the visuals were pretty strong(I've done large amounts of dph before(much more than 37mg) and they just seemed to be at like 1/4 the strength I remember of a "full" dose.
 
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