Signs of initial onset of toxic psychosis can be vague, but include things such as auditory/visual disturbances, delusions/paranoia....etc....
The tricky thing is, it takes experience, a firm grounding in reality (ie, not prone to psychosis) and keen sense of perceptual toxicology to be able to recognize and discount such symptoms as being toxicological in origin. In acute cases, the individual may only realize such symptoms after the fact or upon discontinuing usage.
There is a pervasive myth that someone experiencing psychosis/delusions cannot express orthe admit that they are psychotic or under delusions. I have seen psychiatric patients with profound psychosis freely admit that they are psychotic or "insane". This is not just limited to those who are suffering with organic schizophreniform or other transient psychosis; schizophrenics can also acknowledged their lack of sanity. However, toxic psychosis, especially in its acute form, is rather tricky, particularly in individuals who are otherwise sane and not prone to psychosis. Because of the gradual onset, toxic stimulant psychosis is often highly realistic. The prevailing manifestation is of a paranoid nature. These individuals generally only are able to acknowledge their absurdity of their delusions after stopping or being treated.
Benzodiazepine withdrawal is somewhat different in nature. My first BZD withdrawal caused a distinct delusional parasitosis, without causing any other delusion/psychosis. During this first withdrawal I was rather certain that I was legitimately the host of some parasite (something very closely resembling 'Morgellons'). Eventually, this notion faded and disappeared. Years later, when I was going through BZD withdrawal again, the same exact same delusion appeared, however, I did NOT believe I was truly infested with some parasite. Nonetheless, the feeling persisted, including formication, visual disturbances of parasites, etc. Thus, I was experiencing delusional parasitosis, without actually believing that I was truly being plagued with parasites.
My overly verbose point (again, dictated), is that toxic psychosis is a tricky condition. In a sense, in order to recognize symptoms of toxic psychosis, while experiencing said psychosis, almost requires having had experienced and defeated toxic psychosis in the past. Thus, after using MDPV for around 10 consecutive days at rather high doses, I was able to identify a paranoia that was purely toxicological in origin, and discontinued its use. Again, this is not easy to do without having experienced these symptoms previously, and even then, it takes an inherently strong sense of reality to be able to differentiate accordingly....
