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Trileptal (Oxcarbazepine) - Earth shattering depersonalization / derealization event

Soap MacTavish

Bluelighter
Joined
Jul 12, 2010
Messages
293
Introduction:
First off, I would explain a little about me. I take too much Adderall and I stay awake too late too often. Fine. Basically I can do 2 days but at 3 I have to stop and sleep. I have been on a series of different medications these days finding what is right for me. I am currently prescribed Lexapro(SSRI anti-depressant), Adderall(stimulant for ADD), and Imaprimine(tricyclic anti-depressant).

So recently because I was having some outburts of.... "rage" I guess you could say, my shrink - who I see 4 to 5 times a month - put me on a mood stabilizer/anti-epileptic psychiatric drug called Trileptal. Boy it was fun for a week then I was scheduled to up my dose yesterday and all hell broke loose...

So I didn't sleep the night before. No biggie. I have had much worse sleep deprivation in the past. Nothing to worry about. Well I was just going about my day like normal, minding my own business, and I titrated myself up to 300mg Trileptal. Took my dose in the morning and went to work. Everything was fine until around 10:30am when I noticed my depth perception was askew. My laptop screen looked slightly unfamiliar and I just could not adjust it to look right. I dismissed this as an Adderall effect and tried to go about my business.

By 11:00am I was having real difficulty concentrating or thinking straight and my depth perception continued to get worse. By now the actual perspective of all the objects and everything around me was looking "wrong". I did my best to go in the bathroom and take a breather and splash a little cold water on my face to snap out of whatever was beginning to happen. I have been on hundreds of psychadelic trips in my life, including Salvia so I was not panicking. I have been much worse off and I was prepared to just wait it out.

By 11:30am I am unable to keep from going automatically into a deep deep trance where my eyes are focused 50 feet in front of me and I can't focus on anything close, then a thick gray veil starts to surround and settle on all the surfaces in the corner of my eyes like fog and "erases" them like an endless gray silken curtain.

By 12:00 noon I was unable to function in any productive capacity and I was growing concerned about my panic threshold. I was slowing falling down into a trance-like abyss of distortion and psychic disconnection and disassociation from my environment, thoughts, feelings, and my very identity. The walls were completely strange and unfamiliar, like I was in some museum somewhere I had never seen before. But these were not hallucinations in the classic sense. They did not "move" or have any active vibrance. What was actually happening was I was seeing the walls like usual but my recognition of the walls and environment around me was faltering. This was far deeper already than any bad acid trip had taken me.

I decided it was best to get the hell out and go for a walk, maybe that would clear things up. As I walked down my usual lunch route it truly started to feel like I was walking on a movie set. The overpowering feeling was that nothing I saw was "real" including myself. It felt like I was looking out at this strange world through a cardboard cutout(my body). None of these familiar objects and people had any meaning to me anymore and it was like I was acting out this life and walking in this body but I had no feeling or connection to any of it whatsoever. I truly felt disturbingly untethered from what I thought was my life. This disturbing feeling became more and more intense and I remember becoming angry at the people walking around for taking part in this fictitious construct. Even though I was functioning on basic survival levels, I can't explain with words how terrifying this was. The thought that I might possibly remain in this state permanently.

As I continued down the street everything about the world seemed more and more fake like this was my own personal matrix and I felt like I was about to be rudely awakened at any moment. All the time I was still understanding that this was possibly a side effect that and it would eventually end so I clung on to that hope as I teetered on the edge to keep from panicking. Nonethless, at this point my audio perception began to be "chopped" as if by a digital stuttering comb filter and this further fractured my mental state and made me more convinced that at any moment the lights were going down and the show was over. I felt the facade of my "life" was going to be obliterated and smashed in a cosmic explosion and I would be reassembled somewhere else in some other alien unknown form.

To add to the chaos, as I was walking and I would look from one direction to another, whatever was no longer in my line of site instantly ceased to exist in my mind and perceptual space. Any space that was not in my direct line of vision my brain could not make sense of at all, it was like whatever was in my peripheral vision is in a black hole. And not just a black hole of space, but a black hole of memory as well, I mean not only did anything not in my direct line of visions cease to exist but I was also unable to recall anything about it.

All of this was beginning to be accompanied by a low-level panicky feeling. I felt like whatever was about to happen, needed to happen already. I accepted my death and my fate and the fact that I never really existed and that all life is just an endless cycle of the passage and rebirth of energetic vibrations in the dark heart of a strange and pointless universe, and theoretical quantum mechanics were no longer a theory...they were here and now manifesting before me.

My shrinks office is close to where I work. About 3 miles. So still some part of me was still understanding and hoping this was delusion and decided to walk all the way there. I had to strain to remember what I was doing and where I was going. The biggest problem was the highly disturbing unfamiliarity of what was supposed to be familiar.

I must have looked like a freak when I burst into that waiting room. My shrink saw me right away. She looked totally different. Nothing felt right. To make a long story short my wife arrived and my shrink was looking at me like a diamond cutter with a lupe in her eye. She was trying to see if I was, or going to become, violent. Which I was not. I was simply lost and completely divorced from this world. I went home with a klonopin prescription and orders to rest. I was calmed down by my shrink who agreed it was an adverse reaction to Trileptal. From the look in her eye she had seen this once or twice before.

That evening the effect wore off and I settled back into this world once again. My shrink called and we discussed it for some time and she and I both agree it was a depersonalization / derealization event induced by the Trileptal. Amazingly, for some people, it is a permanent disorder. I can tell you without question I would kill myself if I had to live like that.

And also not-so-strangely is that in my research I found that Trileptal is actually a frontline treatment for dissociative disorders such as depersonalization. In one form or another this drug can function as a teleporter to hell:

Oxcarbazepine (Trileptal) is also very effective as a primary agent or as an adjunctive agent in the treatment of dissociative disorders. Initiation at 150 mg PO every morning and 300 mg PO every evening is usually sufficient over time to suppress dissociative symptoms.
http://www.depersonalization-home.com/forums/viewtopic.php?f=29&t=31

Now I know something about myself that has always been a mystery, this is theoretical but I truly believe it the case now. For my whole life I would always get carsick or seasick and feel a motion-related vertigo and nausea at times unexplained. I never knew why, just accepted it, and I go into trances a lot, this is especially due to my ADD. I have always gone in to these trances for as far back as I can remember. This is because I now believe I was always on the very outside of this alternate reality and in some rare instances I glimpse it, this is when I feel motion sickness, any time the 2 realities with conflicting motion patterns come in to close "contact". Meaning I can probably find this horrible place again if I go into a trance state.

By all outward appearance and evidence this was brought on by the Trileptal and that's the only thing keeping me sane and in control today. Thats bhe best I can describe it, it was beyond and worse than any psychosis I've ever had. And I've had them.

Here is an interesting adverse responses list to trileptal which further supports my (as-yet unrefined)theory on my trances and motion sickness. As you can see below, these people who experienced motion-related side effects were actually on the edge of this inverse reality but they never stepped in. If they had stepped further in they would have founf the hell world of a true depersonalization / derealization event like I did. I hope I never go back.

Special Senses
Diplopia 14 30 40 5
Vertigo 6 12 15 2
Vision Abnormal 6 14 13 4
Agitation 1 1 2 1
Coordination Abnormal 1 3 2 1
EEG Abnormal 0 0 2 0
Speech Disorder 1 1 3 0
Confusion 1 1 2 1
Dysmetria 1 2 3 0
Thinking Abnormal 0 2 4 0

From rxlist.com adverse side effects:
Nervous System: Aggressive reaction, amnesia, anguish, anxiety, apathy, aphasia, aura, convulsions aggravated, delirium, delusion, depressed level of consciousness, dysphonia, dystonia, emotional lability, euphoria, extrapyramidal disorder, feeling drunk, hemiplegia, hyperkinesia, hyperreflexia, hypoesthesia, hypokinesia, hyporeflexia, hypotonia, hysteria, libido decreased, libido increased, manic reaction, migraine, muscle contractions involuntary, nervousness, neuralgia, oculogyric crisis, panic disorder, paralysis, paroniria, personality disorder, psychosis, ptosis, stupor, tetany.

So I think it's safe to say I'm discontinuing Trileptal for now...
 
This might not fit into a the usual trip report mold, it wasn't intentional. I did more research and found 3 main factors that contribute to this event occuring, and i hit all 3 by coincidence this day..

#1 sleep deprivation
#2 intense self monitoring
#3 stress (induced by amphetamine)
 
Yikes dude. That sounds scary, and I'm glad it went away. I would definitely agree that amphetamine stress and sleep deprivation could have exacerbated/potentiated this adverse effect.
 
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