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Guidance About Psychosis

RaiseHellPraiseDale

Greenlighter
Joined
Oct 24, 2023
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9
Hi all, looking for some guidance about how to proceed after an experience with a (mild) drug induced psychosis.

A little background: Approximately 6 months ago, I had an odd experience that ultimately lead to me seeing a psychiatrist who diagnosed me with a DIP. I’m in my mid 20’s and an experienced drug user (daily cannabis, reasonably heavy drinker, occasional benzo use on hungover Sundays, weekend warrior with cocaine a couple of times a month, and sporadic use of psychedelics, ketamine, and MDMA at concerts throughout time in various doses and combinations). I also do have a limited history of mental illness in my family in that my great grandmother was LIKELY a paranoid schizophrenic or some sort of bipolar, based on details provided about her life, not confirmed but the antecdotes seem to suggest it.

The gist of it is, after a heavier than typical period of cocaine and nitrous use for a few months (large amounts of daily nitrous and cannabis, cocaine about 2-3 days a week every week with alcohol), I began hearing voices I believed were my neighbors “talking shit” about me in my apartment complex. The voices did not specifically talk to me, per se, but talked about me as if they were a couple arguing (one taking my side and backing me up, the other one doing the shit talking). Commenting on my lifestyle, things I was doing they couldn’t possibly know about, seemingly focused on insecurities I had and have, etc. I became thoroughly convinced that one of them was going to try to put spyware on my phone, “out” me on the internet for being a “racist” (which I am not), contact my employer to try to get me fired, etc. A large part of me understood that it couldn’t possibly be real and I couldn’t possibly be hearing them, but it still “felt” real enough it confused me. I did not hear them other places initially - this has changed some with time, but they’re nowhere near constant or anything, and typically only happen in quieter areas when with friends (I have a level of paranoia involved around how much noise we’re making and whether we’re possibly offending or annoying people because we do talk some shit joking around and can be pretty loud late into the night).

I did a 3 month stint back at my parents’ house, saw the aforementioned psychiatrist, and leveled out a bit. During this time my use of drinking has not change, but cannabis and cocaine use has been significantly curtailed (limited to small amounts on weekends). They do not appear to make the problem significantly worse, save from a little increased paranoia if I mix them in doses too high. Aside from a single use of ketamine, and a couple of mild mushroom trips, I have not touched “harder” stuff. Today, I still hear voices that sound like my neighbors talking or other people talking about me from time to time (get significantly worse in large social settings such as concerts), but aside from a couple of isolated incidents that caused me anxiety and prompted me to remove myself from the situation to return home, they’ve been more “annoying” than truly distressing, and I maintain a level of cognizance about the fact they are not real. The most distressing part is realizing they exist, rather than the content of what they’re saying (if that makes sense). I’ve never been violent or unhinged, or even really acted strangely in public or tipped anyone off about the internal turmoil I’m experiencing (save for being a little quieter than normal possibly), but they are occasionally an emotional disturbance on some level that prevents me from fully enjoying situations I used to thrive in.

I have a 3 night run of concerts coming up this weekend for Halloween, and I would love to be able to partake in MDMA. It would be a normal dose of 120 mg, tested and confirmed clean. Aside from some alcohol beforehand, I do not plan on consuming other drugs during the experience. I do, however, have some concerns about exacerbating my current issues or having a difficult time. I have access to about 3 mg of Xanax I plan to keep on me as a backup plan should things get insane, and can likely get the lurasidone prescription I have filled prior to the weekend if I need to (never cashed in after initial doc visit) for extra safety. Given all of this:

1. Is this just an objectively absolutely horrible idea? I understand there is some risk involved with ANY drug use in these circumstances, but wondering if there’s an increased MDMA-specific risk, given the experience laid out above.
2. Does anybody have experience taking MDMA following a similar set of circumstances, and how did it go for you?
3. Aside from having the aforementioned “trip-killers” on hand, are there any tools or tips you can give me to mitigate the risk of both short and long term negative consequences, should I make the decision to partake?

Thank you all in advance and apologies for the giant wall of text.
 
Should note that I would only take the MDMA one of 3 nights and stick to the typical usage outlined above for the other two.
 
I haven’t heard that MDMA increases the risk of psychosis. Others may have more info. I like the fact that you’re testing your stuff and taking a safe dose. Don’t take more, as much as you’ll want to. That will increase your risk of problems.

I don’t think you should combine it with alcohol, however, or anything else. I don’t think you’ll need trip killers either. MDMA is not that drug for most people. The other thing that increases MDMA’s toxicity is heat, so I make efforts to not get too warm.
 
Not related to MDMA but I have an ex-mate who triggered schizophrenia with heavy cocaine use. Also, your heavy drinking could also trigger psychosis.

I have not ever experienced psychosis caused by MDMA in anyone I know or myself (as opposed to the aforemention cocaine and alcohol.....and meth....especially meth).
 
Should note that I would only take the MDMA one of 3 nights and stick to the typical usage outlined above for the other two.
Can you let us know how things worked out?

It's my understanding that any amphetamine type stimulant can worsen psychosis.

From the symptoms that you describe, if I were you, I would ask for risperidone. When I had an episode of stimulant induced psychosis from a prescription of 90 mg of Adderall and 50 mg of Vyvanse a day for a year and a half, 3 days and the psych ward and a week of 1 mg risperidone twice a day fixed me up perfectly, for about another 2 weeks. I had to take a milligram as needed. If I heard any thing or saw anything. It's been four years now and not a peep.

Since yours is so pervasive and continuing, I would really try and get an antipsychotic medication to take on a daily basis.
 
I have seen MDMA psychosis at a festival. The girl ended up getting hauled off by the police. I don't know how it ended or if she was psychotic before the MDMA.
 
(I have a level of paranoia involved around how much noise we’re making and whether we’re possibly offending or annoying people because we do talk some shit joking around and can be pretty loud late into the night).
i'm diagnosed with schizophrenia and this is totally what happens to me.

if you don't like the voices, i would probably recommend not doing any recreational drugs, but that's not what i do. i actually get a kick out of most of my voices. i read reddit's schizophrenia page and a lot of people hate having them. most people experience a rise in voices when they use any drugs if they are schizophrenic, but the funny thing is one of my schizo friends will actually totally trip out from eating fake blank acid or like a .1 g piece of mushroom. it's crazy cause he'll get worked up and cry and stuff too. no way is it even the drugs, just taking what he thinks are drugs makes his mind go crazy.

sounds like you are pretty grounded though, which is something that i don't always read on the internet when people experience voices.
 
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