Pharmacological cause of opiate nightmares?

[Zombie Pharmacist]

Does anyone know the pharmacological cause of opiate induced nightmares? I've heard many stories of individuals taking varying amounts of opiates and suffering from horrific nightmares when they do finally attempt to sleep. I'm personally able to attest to such occurrences, having suffered through 4 hours of nightmares and sleep paralysis attacks every few minutes when I last took oxycodone (12 hours before going to bed and taking 100mg quetiapine, which stopped me from waking up completely). I imagine it has something to do with the κ-opioid receptors, but I'm not entirely sure.

 

[Hammilton]

This is what is usually described as the nods. Generally a sought after effect.

Quetiapine will probably knock you out whether you had the opiate or not. Benadryl would do the same.

You may not wake up, though. Quetiapine with methadone left me unable to feel my skin for a day, and quite afraid to fall asleep, though maintaining consciousness was very difficult (with a quetiapine dose that would not normally produce any notable effects).

 

[f33lg00d]

I attribute it not to the high/nod but the rebound effect. The low following the high manifests itself in nightmares as you try to sleep through it. Do you feel any negative effects after you comedown but before you sleep?

 

[AlphaMethylPhenyl]

I don't know if this is what you experienced, but I've noticed a curious, ephemeral effect whenever I take an addictive drug so habitually that I'm in danger of becoming addicted if I continue to do so: I seem to catch an early glimpse of intense withdrawal. This effect only started manifesting after I had reccovered from several addictions.

For instance, when I first started smoking I would have mood swings and became extremely restless, though one would expect polar effects, and upon quitting I experienced the same symptoms, just with increased intensity and for a longer duration.

I seem to have a psychosomatic safety-catch, or warning, against addiction.

Opiates are strange in that they're not definitively pro- or anti-psychotic for the general population. It varies a lot. So maybe you were just experiencing a psychotic reaction.

Have you ever smoked salvia? Intoxication from a kappa-agonist could produce nightmares, but from what I've read and learned the experience is so other-worldly/different that it really bears no relevance to strict emotion and is not really bad or good in most users; its a hallucinogen though so I'd expect chronic use would lead to either a compromise of mental integrity and/or a bad trip. I would expect mu and delta activation to overpower any kappa activation for oxycodone. Someone with more knowledge might have a better guess (enter E.A., Sekio, Ebola, etc.).

 

[alovesupreme]

i've heard salvia best characterized as a "dissociative deliriant". it is definitely emotionally neutral in the sense that it does not induce euphoria, nor does it really blunt emotion outright, but that said it is a very strong invoker of both fear and awe, usually in the same trip, at different stages. but i never found it nightmarish and never experienced nightmares even after breakthrough salvia trips... i was always back to baseline within 60 minutes, like nothing ever happened.