Formication - Sensation Of Bugs Crawling And Pinching Under Skin

quinnGoes

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Formication is a common trait of drug withdrawal. I am very curious to learn more of the neurology and pharmokinetics related to this condition. What is its cause and what substances would best treat it?
 

DL-ark

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Aw, perfect. Anti histamines are sedative too, although if you need to much to stop the itching those bugs will likely be seen outside of your skin rather than inside. Benadryl could literally push the bugs out
 

Solipsis

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It seems to be a result of (prolonged) high dopamine levels, dopamine antagonists would be my suggestion although it is not recommended to randomly start taking (psychiatric) medications that have this mode of action without supervision.

Sedatives can indirectly attenuate stimulation effects and seem like a proper first choice.
 

endotropic

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I was thinking more of a peripherally selective anti-histamine (cetirizine is my favorite). I don't see how that could be dangerous, then again I don't see a lot of things.
 

Solipsis

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But, it's not itch is it? Or else how do things like amphetamines or coke cause histamine issues that explain it? Clearly my knowledge is limited :)
 

endotropic

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Isn't it an itch though? The relation to histamine is just a guess on my part, based on how I've personally experienced that phenomenon.

Severe stress can activate mast cells causing histamine release. Stimulant abuse followed by withdrawal seems like a pretty severe stress to me.


There's not much written about this specifically, here's what I've found so far though: http://www.ncbi.nlm.nih.gov/pubmed/21803215

They say:
Along with abstinence from drug usage, dopamine antagonists
have been shown to help patients with drug-induced formication.57
And here's that reference #57: http://www.ncbi.nlm.nih.gov/pubmed/1555406

They say:
In Skott’s sample, half of the patients complained of pruritus at the onset of the delusion.’
 

SeenSoFar

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From what I've read about formication and factors known to trigger it, a histamine-based mechanism seems likely to be secondary, if it is involved at all. It seems more likely to be caused by some dysfunction in the tactile sensory system, either by nerve damage or by a misinterpretation of tactile sensory data. The reason I say this is that it can be triggered by mercury or pesticide poisoning, among other things that are known to cause nerve damage, in addition to things like alcohol withdrawal and drug-induced psychosis, things that are known to cause hallucinations, which could be considered a misinterpretation of sensory data.

In addition, as someone who loves my opiates, and loves to IV them, I have experienced more than my fair share of histamine bursts. Never has this ever felt like insects crawling on, nor under, my skin. It always just feels like an intense, spontaneous, itch. In fact, I'm planning to do a nice big smash later on tonight, so I'll pay extra close attention to the initial rush of itching to look for any feeling of formication.
 

neversickanymore

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occurrences like this, stimulant psycoses like reactions, could be hard or impossible to attribute to a generic specific chemical state. I feal we may benefit more from looking at previously existing fears manifested through the chemicals introduced rather than trying to identify little understood chemical processes that cause them. Maybe it comes down to some adrenal spike, which may combine with the pattern seeking nature and sometime pattern creating properties of elevated dopamine, resulting to create a manifestation of ones own fears?

Whatever it is people tend to experience what they are most concerned or fearful of when these occurrences happen.. if people fear the government and the law then they experience this. if a woman fears another woman sleeping with their man than they seem to experience this, if people fear rats or bugs then the seem to experience this..

I wonder if we looked at the manifestations if we could attribute specific emotions to them?


So could this be just another stimulant or mental health induced amplification of a manifestation of a persons own fears?

What really captivates me about stimulant psycoses is why people from all over the world and from all walks of life see the exact same figures.. the shadow people, the hooded man, and the hat man. Its utterly astonishing and mystifying, especially on attempting a scientific examination, as the utter lack of influencing variables leads to interesting thought to say the least .:?

NSFW:








So I think as previously stated antagonizing the dopamine and possibly adding an adrenal antagonist , combined with a benzo if needed, would likely be a therapeutic path to explore to treat this.
 
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crOOk

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I get it on high doses of amphetamine, like now after IV'ing roughly 200mg amphetamine sulphate throughout the last 15h (no tolerance).

It's very annoying, but not as unsettling as I would've imagined when I had first heard of it. It's very similar to the sensation you get when a drop of sweat forms and runs down your skin.

I suppose everyone knows the feeling - You're not sure whether there was an insect on your skin or a drop of sweat has formed. Now imagine that randomly popping up everywhere at varying frequencies. It's sorta itchy, but only for a very brief moment, it won't persist like actual pruritus.

I wouldn't necessarily say it feels as if the insects were underneith my skin. To me it's always been apparent that it's a form of paresthesia, someone less educated who's in the middle of a full-blown stimulant psychosis might not be so well reflected. In that case, it's more likely a person would assume it's caused by bugs moving around underneith his skin, especially if he is experiencing visual hallucinations which often play on top of the cues given by your sensory input.

Since this has only happened on very high amphetamine doses (nothing I'd even dare to leave the house on), it has initially worried me quite a bit in that I was afraid to have done some damage to my nervous system or am otherwise experiencing symptoms of organic damage related to an overdose or dehydration. I left out that I'm usually very dehydrated when it happens, but that might just coincidide with the formication due to high amphetamine doses causing me to lose a lot of water.

There is a fluent transition to other manifestations of paresthesia for me, electrifying sensations that cover larger areas than the pin-point sensations in formication. These larger forms of paresthesia in turn feel very much as if there were goose bumps on my skin. Now we have all seen that happen on stimulants.

To be honest, the formications I've experienced have actually been slightly pleasant in some twisted way at times, as long as I was aware of their non-threatening nature that is.

EDIT: I should add that I am not playing this down. I have actually suffered a severe case of stimulant psychosis before, have been kicked out of a dermatologist's praxis due to delusional parasitosis, have picked at my skin for hours and days and weeks on end and have also experienced visual hallucinations of being infected which a large fungal organism that was eating away at me, macerating my tissue to a white pulp before consuming it. The paresthetic sensations were also present back then, without being very prominent though. At one point I explained them to myself with the fungus altering my skin so it would let water through lol. It was more one of many curious phenomena rather than the central oh-so-significant symptom that had me go nuts over it.
 
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Euphorogenesis

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It seems to be a result of (prolonged) high dopamine levels, dopamine antagonists would be my suggestion although it is not recommended to randomly start taking (psychiatric) medications that have this mode of action without supervision.

Sedatives can indirectly attenuate stimulation effects and seem like a proper first choice.
I don't quite follow your logic, the OP stated that this sensation would occur during withdrawal. So either, you are implying dopamine levels are elevated during times of withdrawal(Which is a pretty broad assumption since not all drugs affect the DA systems directly) or you've missed the part where the OP said that the symptoms occur in WD.

Suggesting the use of DA antagonists during WD seems to me like a pretty good way to make someone feel even worse during a bad time.

I'm going to go with the flow here and say antihistamine treatment for this particular brand of bodily nuisance. Cetrizine is relatively potent and OTC at least where i am at so that'd be a good start.
 

serotonin2A

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I'm going to go with the flow here and say antihistamine treatment for this particular brand of bodily nuisance. Cetrizine is relatively potent and OTC at least where i am at so that'd be a good start.
That doesn't make any sense. Formication is a tactile hallucination. It isn't caused by an allergic reaction. The only reason an antihistamine would be indicated is if someone was having an allergic reaction to actual insects. Formication in the context of stimulant abuse and withdrawal is centrally mediated.
 

JBrandon

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Bumping this thread to ask a question:

Isn't the presentation of formication wider than simply the classic "meth bug" presentation?

I'm having a very weird reaction which I believe is directly tied to dopamine levels and has nothing to do with hallucinations based on "fear of bugs" or some nonsense.

I was prescribed Xyrem and started at a dose that I, as a previous recreational GHB user, felt was too high. Nonetheless, I listened to the doc. 4.5g x 2 a night right off the bat, no taper up. Sure enough, after a few days I found myself waking up feeling as if the skin all over my body was sunburned, or about to rip about in a million molecules exploding everywhere, or it was extremely hot / cold, etc. It would last for an entire day. I dropped the dose down to 2g a night and tapered up slowly - no problems.

I was very hydrated. I am assuming this was dopamine rebound presenting itself.

I've only experienced it one other time - I failed to fill my script in time and bought some shitty street meth - same fucking feeling.

In neither case was I awake for days beforehand, sleep-deprived, delusional, or thinking anything about my skin other than "fuck, this is annoying".

There's absolutely a dopamine mechanism at play here.
 

crOOk

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It's basically a form of paresthesia that some people interprete as bugs under the skin, especially in the midst of a stimulant psychosis. It's usually just a delusion, not hallucinations eventhough patients can present with those as well, not at all uncommon. I+f you've only experienced this once, why did you have medication prescribed? I've been suffering a pretty severe case of polyneuropathia that would have me wake up wailing and yammering like a little girl. It seems to have been caused by 3-Fluoro-Phenmetrazine neurotoxicity. Even those will usually dissipate once the toxic influence is gone. It's possible that your meth contained neurotoxic impurities, but this alone wouldn't cause polyneuropathia alone. I wouldn't worry about it. You'll find good articles on this topic on pubmed, just perform a search. If you are interested in an article, but can not access it drop me a line and I'll see if I can get it for you!
 
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5HToInfinity

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I realize this is an old thread. I just wanted to add a report to this discussion.

I was prescribed low doses of Vyvanse for a while. Probably took between 20-30mg a day for about two weeks. Toward the end of this period I began waking up with extremely severe pain in my toes, like someone was repeatedly jabbing needles into my skin. I've used plenty of stimulants before, and never had this happen until now. What's weird is that I didn't take the high doses that other users are claiming to be necessary for this symptom to occur.

The stinging sensation comes back a little every time I take a single low dose of Vyvanse, and persists for a couple of days after. It's incredibly disturbing. I'm thinking of switching to methylphenidate to see if this also happens. If it does, it's likely due to dopamine receptor activation. If not, then there's something special about amphetamine induced monoamine release that's making this happen.
 

Limpet_Chicken

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Adrenergic agents, or removal of long used adrenolytics like clonidine, tizanidine, if I delay taking either of those too long and long enough for any symptoms to show as a result, seem strongly correlated with skin-crawling sensations, although I am definitely aware that it is a sensation, albeit an undesirable one, and not a result of any entomological cause. Its just that, a nasty sensation, but one I primarily associate with adrenergic entities.
 
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