REM sleep disorder - caused by dissociatives? morphine / venlafaxine

[plumbus-nine]

It's about this, technically sleepwalking but I only have it partially. I don't move but brabble around, sometimes violent screaming which of course heavily disturbs anybody close to me. It developed gradually (granted, many years I never had anybody around so I don't know for sure but I was on venlafaxine for years before without this condition. Then I began abusing dissociatives, mostly O-PCM, sometimes together with opioids and this disorder began. Morphine acerbates it, methadone much less but apparently I was screaming on bupe too. Always together w/ venlafaxine 150mg-300mg. Quit any recreative drugs 18 months ago and only venla + morphine XR. Every single night these violent dreams.
Need to say that in the disso times I did many many 2-3 nighters and then sleep like 12-16h, rinse, repeat ... will not have helped I guess but never heard stimheads get this sort of problem..?

Clonazepam didn't help, neither did quetiapine, mirtazapine, risperidone, (enter your favorite toxic antipsychotic). Got on pregabalin, this helped me to heavily cut down on morphine, but no improvement. Recently switched to paroxetine 20mg 1-0-1 (doc recommended me to take it like this instead of all in morning, I question it but for the moment I'm using it like this) + valproate magnesium 200mg 1-0-1 + pregabalin 150mg 2-0-1 (sometimes like 4-2-4) - the violence is gone but still brabbling. Now I am changing the remaining like 30-60mg or morphine (I could just quit but of course like it too much) to kratom.

Anything known about whether this REM disorder develops gradually and will become chronic? Or need long time to go again?
What could I do to get rid of it - melatonin megadoses for example to throw something into the balance against the heavily increased and in me certainly wakefulness promoting serotonin? Mulungu? Antihistamines don't do nothing to the problems.. Or even use some psychedelic therapy for the growth factors and stuff?

Side question, the doc recommended me to add paroxetine 20mg in the evening to the 300mg venlafaxine in morning instead of switching completely. This felt like overkill and as the venla messes with my heart, I want to get rid of it anyways, but is it just some decision of a random doc who was cautious about changing too much or is there something about combining S/NRIs, will they compete and the stronger affinity win or add to each other?

Would ceasing the antidepressants help? I could try with 5-htp, worked in past, but also I was for years on venla, citalo and sertralin (this one did shit beyond making me slightly psychotic) without any violent / problematic dreams.

Thanks. Much appreciated.

 

[Nagelfar]

I was on des-venlafaxine, mirtazapine, lamotrigine, bupropion & buprenorphine and it was the absolute worst for sleep paralysis. They were horribly disturbing dreams which kept you shaken and brought an ineffable, dark, lingering feeling through the entire next day and somehow managed to even drain the meaning out of waking life.

Most surprising of all was being shocked awake while drifting off; what's called "Exploding Head Syndrome", so violently in fact my hand would involuntarily swing and scratch by my eye in a spasm or twitch, and leave a cut, I would think "did I just dream I punched myself in the face laying here?" until I got up and checked and mirror and saw the marks.

Getting off bupropion helped, then mirtazapine & lamotrigine, and finally desvenlafaxine; now at least I don't remember the dreams.

Effexor & Pristiq, also Remeron, are known for making vivid, terrifying dreams. They gave me dreams where I dreamt I woke up, laying in bed, and I didn't know where I was. I would see other things besides what there actually was, around me furnishing my room, and I'd have to actually get up to get out of that dreamlike state; to notice there was no such table or nightstand in the room with me, etc.

 

[plumbus-nine]

Oh yeah, forgot to mention the dreams themselves. They are like the reality here and now, completely vivid and often enough I would remember that I were dreaming and begin to change the contents of the dream story, interact with things and people, even fly above endless landscapes and cities.. Getting killed by electrical shock zapping down from wires only to wake up in the next dream..

This was funny at first and it still is, but more and more it would contain flashback like stuff like being trapped in the apartment of my childhood or being bullied by these at school etc and then me acting more and more violent..indeed very pricey on the next day too and many times I would need to sleep off the stuff, like bring more awake with little sleep w/o dreams than more hours with lucidity in between..

But the weirdest at all was trazodone. I would consciously sink into the mattress, turn around into it and beginning to fly.. Or seeing a dead person next to my bed, staring at me.

Exploding head syndrome, too, I think it was from added antipsychotics.

OK, I will wear off the venlafaxine and add melatonin as Wikipedia suggests and hope.

But anybody knows whetrer this can build up or cause sort of learning effect and become chronic?

 

[sekio]

But anybody knows whetrer this can build up or cause sort of learning effect and become chronic?

usually chemically-induced dreams stop when you stop taking the drugs in question

 

[plumbus-nine]

Something's really weird about this, things get better by changing agents but I was on the same combo before (venla + morphine) and did not get these symptoms. Melatonin as expected does nothing at all. Paroxetine in evening strangely seems to improve sleep a lot, now I am fully rested after 6h instead of being still tired after 9h. Less dreams but still talking in sleep. Switching morphine to kratom was long needed and improves much in daytime but sleep disturbances continue. Of course, weaning off all psychoactives would be necessary to get baseline data but I don't feel like this at the moment...

Any hunch if this might be related to glutamatergic excitotoxicity from dissociatives (afaik they can hurt or kill GABAergic interneurons)?

 

[Nagelfar]

Any hunch if this might be related to glutamatergic excitotoxicity from dissociatives (afaik they can hurt or kill GABAergic interneurons)?

Unsure about this personally. Wouldn't GABAergic neuron death and excitotoxicity be somewhat opposite, e.g. if a neuron is destroyed it can't be activated - whereas the excitotoxicity comes from over activation.

Reading back over my post (correcting some very ill-written paragraph structuring and misspellings, which I don't know how escaped my attention) and seeing your responses; I did indeed have much of the same sleep problems on my combination of drugs as you seem to explain having yourself. Especially those dreams that are lucid, slightly controlled, and followed by another dream where the logic is unable to follow from the previous one. For instance 'dying', immediately takes you into another scenario.

 

[plumbus-nine]

Unsure about this personally. Wouldn't GABAergic neuron death and excitotoxicity be somewhat opposite, e.g. if a neuron is destroyed it can't be activated - whereas the excitotoxicity comes from over activation.

I really don't understand a single bit about dissociative excitotoxity. They say NMDA doesn't up-regulate but then it does (see thread about permanent downregulation). That this up-regulation, which doesn't happen, is toxic by itself or not. Whether it's a rebound, a tolerance buildup or real toxicity or altogether.
Just that dissociatives do -temporarily- solve A LOT for me. Recently just an accidental "overdose" on memantine (by which I mean hitting dissociative amounts, which can be as low as 60mg) made me believe that all my dependencies were gone. I was normal for two and a half days, without taking anything. No brain zaps, no nothing. But then when the memantine had worn off, things came back full force unfortunately. I'm still hooked on venlafaxine, and this weird REM sleep disorder is somewhat wickedly intertwined with this drug.

Remembered that somebody told me I was speaking in night, 5 years ago, when the only drugs I was taking were valproic acid and occasional lorazepam.
Also memantine makes the phenomenon to cease, the only agent so far (clonazepam, melatonin, paroxetine, mirtazapine, quetiapine XR and IR, clonidine, pregabalin all failed) but it's still a hit or miss between insomnia from too much and REM disorder from too less. Guess any dissociative would do it, but I was mentally addicted to O-PCM and somehow developed an adverse feeling to dissociation..

Also note that this speaking in night 5 years ago was actually before my period of heavy disso abuse.
Had a weird manic reaction to 3-MeO-PCP like 6 years ago which brought me into ER and jail for some times, was indeed a bit like demonic possession. They injected me like 7mg lorazepam and I was still agitated.. without actually having a reason for it. Came out of nothing, and I suspect the 3-MeO-PCP to have been adulterated but who knows, my ex flushed it down to the rats.

 

[plumbus-nine]

I found it to be the morphine, quitting opiates reduced the symptoms by maybe 75 percent but shit's still here, in two out of three nights I babble some stuff or move during dreaming, dream of stuff I wanna forget etc. but the REM disorder is more embarrassing, Weird because I couldn't find a single similar report and the docs didn't believe me either. But it seems to be some sort of damage, which needs time to (hopefully) heal.

Anybody having any similar experiences with opiates? I know that opium seems to cause vivid dreams but nobody talks or shouts while dreaming ... :/