Dissociatives Delirium on ketamine, THC and oxycodone... indications of psychosis?

[gfasfdgasf]

I was hoping I could come here to get people's thoughts on a very strange experience I had a few days ago. I was on relatively small doses (10mg oxycodone, 30-60mg ketamine) and I had only a few hours of sleep that night. I sat on my bed and began scrolling on my phone in a complete stupor. At first, I noticed I could see faces in the patterns across the room, which was a little unsettling. Then the hallucinations took on a more delirious character. Piles of my clothes became figures staring at me. I remember vividly seeing the hat man walk across my room. Thinking back on it, it seems extremely frightening, but I somehow was not scared in the moment. Seeing the hat man for the first time felt like finally meeting a celebrity. It felt completely real, although I remained aware rationally that it was not.

What could have caused such a reaction? I have used similar combinations a few times, but without the mild sleep deprivation, I did not become so delirious.

On many drugs and psychedelics, I quickly become paranoid. For example, very frequently on LSD, if I close my eyes for too long, I feel an overwhelming fear that a figure will come rushing towards me while I can not see it. I remain aware that I am being totally irrational, but it does not change anything. It's like being afraid of monsters under your bed when you were younger.

I have noticed that I have a low threshold to become mildly delirious on THC—it takes me a small dose before I start misinterpreting my peripheral vision completely and having vivid auditory hallucinations. This effect is potentiated by amphetamine, which could indicate a psychotic mechanism, as amphetamine causes dopamine release.

In this case, I was obviously experiencing euphoria from the drugs which overcame some fear, but I still find that I usually can feel dysphoria on these drugs, whereas in this case, it felt more like a stupor where nothing could scare me. Could signs like these be an indication that I am predisposed to psychosis?

 

[SpiralusSancti]

Well it isn’t really a delirium/psychosis if you don’t think it’s real.

How long do you take drugs? How old are you if you don’t mind saying?

 

[Kaleida]

It could be a sign of something, but it doesn’t have to be. Opioids, dissociatives, cannabis, and sleep deprivation can all make you delirious, so a combination of all four doing it is not surprising. You said you’ve done similar combinations before minus the sleep deprivation and had no issues, right? I think there’s a decent chance it was just a one-off event.

Achieving hallucinations is easier than most people tend to think. Pleasant visual delirium doesn’t really sound like a psychosis warning sign.

Opioids alone actually do this a lot more than they’re ever given credit for, for what it’s worth. I suspect it’s because, obviously, people don’t want to overdose, so they hesitate to push it. In the hospital where they’re free to administer it in large amounts for pain to people with low or no tolerance and keep an eye on them so they’ll be fine, delirious hallucinations on opioids are very common. People on things like morphine drips can easily become a rambling, delusional mess. Although luckily it still seems like they often just stay in bed, at least from what I’ve seen. I know you took a low dosage of oxycodone but still, thought it was worth mentioning.

 

[Pissed_and_messed]

this incident seems just good trip, however, the whole picture is what matters. I can not say anything definite, so I leave it be.

 

[gfasfdgasf]

Well it isn’t really a delirium/psychosis if you don’t think it’s real.

How long do you take drugs? How old are you if you don’t mind saying?

Yes exactly. I'm always self-aware of being delusional, but I'm worried that one day I won't be.

18. I started taking them a few months ago. At first, it was mainly weed and psychedelics, which is when I noticed the most "psychotic" symptoms, so I reduced my use of those two. Now it's, in general, one psychedelics trip every two weeks, weed (a few times per week—I have a propensity for high doses, which are the worst offender for psychotic symptoms), opioids (~50mg oxy/w—no addiction yet), phenibut (~5g/w, seems to reduce psychotic symptoms associated with THC, which makes sense due to GABA action), and dissociatives for their euthymic and nootropic effects. I am out of my honeymoon period with psychs, but I am experimenting with dissos and will probably lower my frequency of use after another month.

 

[gfasfdgasf]

It could be a sign of something, but it doesn’t have to be. Opioids, dissociatives, cannabis, and sleep deprivation can all make you delirious, so a combination of all four doing it is not surprising. You said you’ve done similar combinations before minus the sleep deprivation and had no issues, right? I think there’s a decent chance it was just a one-off event.

Achieving hallucinations is easier than most people tend to think. Pleasant visual delirium doesn’t really sound like a psychosis warning sign.

Opioids alone actually do this a lot more than they’re ever given credit for, for what it’s worth. I suspect it’s because, obviously, people don’t want to overdose, so they hesitate to push it. In the hospital where they’re free to administer it in large amounts for pain to people with low or no tolerance and keep an eye on them so they’ll be fine, delirious hallucinations on opioids are very common. People on things like morphine drips can easily become a rambling, delusional mess. Although luckily it still seems like they often just stay in bed, at least from what I’ve seen. I know you took a low dosage of oxycodone but still, thought it was worth mentioning.

Yeah I became aware of the hallucinogenic properties of opioids from tramadol, which produced more delirium than oxy (from those I have tried, the most to least hallucinogenic opioids are tramadol, tapentadol, oxy, DHC, codeine). Without sleep deprivation, the hallucinations were mostly during nods, which is obviously to be expected, but it seems that I experience hallucinations (and nods) at lower doses than most people (15-20mg oxy, 200mg tram, 100mg tap). I've also noticed that even on non-deliriant doses of anti-histamines, I experience EXTREMELY vivid hypnagogic hallucinations as I fall asleep.

I'm not extremely worried about psychosis with opis specifically, but I would like to know more about the problem in general. It's better than before now but I'd like to know what to do in case it flares up.

 

[Kaleida]

Yeah I became aware of the hallucinogenic properties of opioids from tramadol, which produced more delirium than oxy (from those I have tried, the most to least hallucinogenic opioids are tramadol, tapentadol, oxy, DHC, codeine). Without sleep deprivation, the hallucinations were mostly during nods, which is obviously to be expected, but it seems that I experience hallucinations (and nods) at lower doses than most people (15-20mg oxy, 200mg tram, 100mg tap). I've also noticed that even on non-deliriant doses of anti-histamines, I experience EXTREMELY vivid hypnagogic hallucinations as I fall asleep.

I'm not extremely worried about psychosis with opis specifically, but I would like to know more about the problem in general. It's better than before now but I'd like to know what to do in case it flares up.

For what it’s worth, delirium and psychosis are not the same thing. I have taken anticholinergic drugs in large recreational dosages and have bipolar disorder and have experienced psychotic episodes. The similarities are minor or superficial. Delirium feels like dreaming while psychosis feels like being more awake than you’ve ever been in your entire life.

Hypnagogic hallucinations could be intensified by a psychotic condition, but they’re not a sign of them inherently, especially when drugs are also involved. It’s entirely normal for healthy, sober people to experience hypnagogic hallucinations occasionally.

I took drugs for over ten years before I had my first psychotic break and there were no general kinds of drugs I was taking at the time that I hadn’t already taken many times before, and my heavy drug phase actually ended many years before that. For me it was psychedelics that finally brought it out, but psychedelics are the drugs I’ve used by far the most, the most frequently, and in the highest dosages and numbers, literally dozens of them sometimes in the highest dosages I’ve ever read or heard of someone using, and I was purposefully binging on them at the time to see if I could smoke some research chemical tryptamines several times a week for months without tolerance.

What I’m saying is, just because you’re predisposed to psychosis even if you actually are, doesn’t mean the relationship between that and your drug use is simple. It’s so not simple that I don’t want to say much more than that, but I think it’s worth putting out there.

 

[SpiralusSancti]

As you’re so young it’s really good idea to minimize use, even better stop alltogether at least for some time.

If you end up experiencing full blown psychosis, unfortunately after that, for some people following that even drugs that generally don’t cause psychosis can do so, and in worst case scenario it progress into full blown mental illness.

I’m not trying to scare you but if you are worried, I certainly must consider you have reason to be so and it’s better to be safe than sorry.

 

[gfasfdgasf]

For what it’s worth, delirium and psychosis are not the same thing. I have taken anticholinergic drugs in large recreational dosages and have bipolar disorder and have experienced psychotic episodes. The similarities are minor or superficial. Delirium feels like dreaming while psychosis feels like being more awake than you’ve ever been in your entire life.

Hypnagogic hallucinations could be intensified by a psychotic condition, but they’re not a sign of them inherently, especially when drugs are also involved. It’s entirely normal for healthy, sober people to experience hypnagogic hallucinations occasionally.

I took drugs for over ten years before I had my first psychotic break and there were no general kinds of drugs I was taking at the time that I hadn’t already taken many times before, and my heavy drug phase actually ended many years before that. For me it was psychedelics that finally brought it out, but psychedelics are the drugs I’ve used by far the most, the most frequently, and in the highest dosages and numbers, literally dozens of them sometimes in the highest dosages I’ve ever read or heard of someone using, and I was purposefully binging on them at the time to see if I could smoke some research chemical tryptamines several times a week for months without tolerance.

What I’m saying is, just because you’re predisposed to psychosis even if you actually are, doesn’t mean the relationship between that and your drug use is simple. It’s so not simple that I don’t want to say much more than that, but I think it’s worth putting out there.

Thank you very much, this is a helpful post. I appreciate your distinction between delirium and psychosis—I'll use the terms properly in the future.

 

[Kaleida]

Thank you very much, this is a helpful post. I appreciate your distinction between delirium and psychosis—I'll use the terms properly in the future.

No problem, I wish you luck in your journey.

 

[paranoid android]

If you know you are delerious it's not really delerium in my opinion. Also psychosis is really not like anything caused by drugs except actual deleriants like dramamine anyway

 

[gfasfdgasf]

As you’re so young it’s really good idea to minimize use, even better stop alltogether at least for some time.

If you end up experiencing full blown psychosis, unfortunately after that, for some people following that even drugs that generally don’t cause psychosis can do so, and in worst case scenario it progress into full blown mental illness.

I’m not trying to scare you but if you are worried, I certainly must consider you have reason to be so and it’s better to be safe than sorry.

Thank you for your concern—for what it's worth, I'd say it's very good advice to someone in my position, and it would be best to stop completely for some time. Unfortunately, or fortunately, drugs have in general caused a complete transformation in my character and mental wellbeing, even when I am not under the influence, so I can't convince myself to stop. I suspect that the only thing that would cause me to truly want to "get out" would be a psychotic break, or if I break the rules I have set for myself to the point that I become physiologically addicted. Until then, who knows?

 

[SpiralusSancti]

If you really love drugs it’s a big chance even psychotic break wouldn't prevent you from doing them so better do yourself favor and minimize chance of that happening.

 

[Achten]

Opioids alone actually do this a lot more than they’re ever given credit for, for what it’s worth. I suspect it’s because, obviously, people don’t want to overdose, so they hesitate to push it. In the hospital where they’re free to administer it in large amounts for pain to people with low or no tolerance and keep an eye on them so they’ll be fine, delirious hallucinations on opioids are very common. People on things like morphine drips can easily become a rambling, delusional mess. Although luckily it still seems like they often just stay in bed, at least from what I’ve seen. I know you took a low dosage of oxycodone but still, thought it was worth mentioning.

Wow, I didn't know this. I realise now that's what my grandfather was experiencing on his deathbed. It seemed he was thinking he was younger and in a certain part of his professional life. I thought it was endoflife anxiety or some such. It wasn't all bad. We shared a few last laughs too ! Also gave him his favourite beer. He did remember what that was :d.

 

[nepalnt21]

What could have caused such a reaction?

sleep deprivation, opioid (-ate? wasn't it found in p. soms?), disso (and k to boot, ime it's the one [also dck] most prone to visual oddities), cannabis which is a serious potentiator and can be very psychedelic in its own right (ever notice how a weed high can be different day to day, even with the same strain?)

shoot, dck and weed gave me one of my only daylight hallucinations episodes. and k and weed had my partner's face warping into all sorts of wild and realistic weirdness.

and dissociatives are even more tempermental in terms of quality/ depth of experience day to day, same dose same batch.

edit

and this part:

I have noticed that I have a low threshold to become mildly delirious on THC—it takes me a small dose before I start misinterpreting my peripheral vision completely and having vivid auditory hallucinations.

sounds familiar, but yeah... i'd say you hit all the right tripping pud buttons.

i've also experienced the opioid delusions thing; i've had both a visual daylight hallucination (once), and auditory (numerous times) hallucinations.


(coming from a place of not a doctor)

i wouldn't worry