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Contac cold caps and psychosis?!


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My friend had a psychosis last night with all the classic symptoms. She has never showed any signs of this before. No history of MI. Just mild depression, which has never been treated.

She took a Contac last night for the first time and then the psychosis came late at night. I don't think the two are related, but just wanting to double check.

Can Contac possibly cause or contribute to this?

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While it's tough to say definitively because there may be a minor percentage of the population that reacts to a medication in unexpected ways, I would tend to agree with you. They probably aren't related.

The two active ingredients in contac are Chlorpheniramine Maleate or Diphenhydramine Hydrochloride. Both have been around for some time, and the side effects are pretty well documented. I haven't been able to find anything about psychosis-like symptoms, even in the "rarely occuring" category.

InfoNut

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i have to be very careful with OTC medications. 

i recently had a cold and to stay safe the only thing i started out with was original buckleys for my cough.

i also found a generic version of robitussin for chest congestion that helped get rid of the final stage of my cough, and it was the only thing that didnt make me insane; OR give me crazy, scary nightmares...

i cannot take anything that contains pseudoephedrine or diphenhydramine...

even regular benadryl makes me a wacko, heh.

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I have found some references to "Symptoms of pseudoephedrine hydrochloride overdosage include paranoid psychosis, delusions and hallucinations" in large doses or overdose. Here's one link: http://home.intekom.com/pharm/janssen/sinumax.html.

Maybe your friend is extremely sensitive to pseudoephedrine hydrochloride, to the point where she wouldn't even have to take a heavy dose to have this reaction? Don't know if this occurs, but seems like it might be possible.

A couple things to keep in mind:

1) Pseudoephedrine hydrochloride is an ephedra alkaloid, just like the the herb ephedra. "Chronic use of ephedrine has been associated with cardiac toxicity and a number of incidences of psychosis are reported from high-dose use." http://www.medicalpost.com/mpcontent/artic...T/3727/22B.html

2) "Methamphetamine is structurally similar to methcathinone, amphetamine, and other stimulants, and it may be produced from ephedrine or pseudoephedrine by chemical reduction." http://en.wikipedia.org/wiki/Methamphetamine.

Not saying that your friend was using the equivalent of Meth! But again, maybe she is really sensitive, and for her the stimulent effect was too much. Just speculating.

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2) "Methamphetamine is structurally similar to methcathinone, amphetamine, and other stimulants, and it may be produced from ephedrine or pseudoephedrine by chemical reduction." http://en.wikipedia.org/wiki/Methamphetamine.

Not saying that your friend was using the equivalent of Meth! But again, maybe she is really sensitive, and for her the stimulent effect was too much. Just speculating.

You cannot compare Methamphetamine and Pseudoephidrine. The molecular structure is different. They are different substances. One is not a stonger version of the other. It is not possible for Pseudoephidrine to produce a Meth-like reaction in someone.

Revlow is right though, pseudo does, in rare cases, cause halucinations even at low doses. It's very rare, but it does happen. Perhaps it IS the culprit after all.

InfoNut

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You cannot compare Methamphetamine and Pseudoephidrine. The molecular structure is different. They are different substances. One is not a stonger version of the other.

<{POST_SNAPBACK}>

Just to make certain, I am not suggesting that they are the same. (Thought I stated this when I said "Not saying that your friend was using the equivalent of Meth!") They are certainly not the same. But pseudoephidrine is a precursor to meth (in the sense that meth is manufactured from pseudoephidrine). And though they are not the same, there are some speedy effects to pseudoephidrine, though usually quite mild for most people.
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The primary structural difference between ephedrine/pseudoephredrine,

methcathinone, and methamphetamine is the oxidation state at the beta-carbon

position. The methamphetamine has two hydrogens at that carbon,

ephedrine a hydrogen and a hydroxyl group, and methcathinone

has a ketone group. (Pseudoephedrine is an isomer of ephedrine.

Same atoms, same functional groups, but structurally non-superimposable

mirror images of each other.)

That ain't "completely different".

While that *is* apparently enough difference to let methamphetamine and methcathinone cross the blood-brain barrier and affect mood/cognition, 

and not ephedrine... all three are CNS stimulants and hit adrenergic

receptors outside of the brain.  What cat and speed do inside the brain

is quite a bit different in magnitude but still mostly similar overall.

Whatever side effects list you check for normal usage by average people,  diphenhydramine HCl is a strong enough anticholinergic to allow it to

abused as a hallucinogen (very highly not recommended).

Chlorpheniramine maleate is the Coricidin ingredient that makes

abusing it more potentially deadly than dextromethorphan-only

Robitussin DM. (If you can get it, and if you don't mind vomiting, etc.)

There is lots of info on Erowid about all of the above. A basic organic chemistry

text can show you just how completely different meth and Sudafed aren't.

And of course the DEA will be happy to show you what they do to people

who abuse that difference.

For the original poster, my bet is on the anticholinergics. That does depend on

how sensitive the balance between acetylcholine and dopamine are for her, but

for symptoms of psychosis, dopamine imbalance is more likely to be a culprit

than adrenergic stimulation.  And to hedge the bet - elevated blood pressure

from (not just) pseudoephedrine use can do nasty things if your blood vessels

are slightly blocked, bulging, or weak.

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My personal experience: I can't take pseudoephedrine anymore.  Never really could but I didn't recognize the mania.  This past few weeks while I had a cold I had wild dreams when I took Nyquil at night, and cough syrup with pseudoephredrine during the day made me quite anxious and irritable.  Not psychotic, but I'd submit that some people are more sensitive than others.  At the least, pseudoephredrine is known to make even normies agitated.

Once a PA suggested cutting the pseudoephredrine out I calmed down and slept better.  Of course I've had to substitute Afrin to breath at night, which has its own set of problems, but at least it doesn't wire me up.

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I've been thinking about it and I think it's highly likely the dextromethorphan caused it. Stupid me didn't realize until now they contain dextromethorphan. Some people abuse that under the name of DXM, you know? It can cause psychosis-like, psychedelic effects in very high doses.

She must just be EXTREMELY sensitive.

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I too have issues with cold medicines... Well, NyQuil anyway. It seems to prevent me from sleeping, though it will put me in a drooling, spaced out stupor, and if I take a single drop of the stuff even a half hour before the next allowable dose, I hallucinate.

I have been looking around a little, and apparently they have changed the ingredients of NyQuil, but I don't know if the last time I tried it was on the old or the new formula.

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Hey, yesterday I started to think seriously about using Afrin, which one can get quite dependant on.  I picked up a homeopathic decongestant from the HF store and tried it.  It didn't completely work but improved it enough that I only needed one shot of Afrin up one nostril.  I'm hoping that continuous use will shrink things to where I don't get headaches. 

I do take cough syrup with guifanesin (expectorant) and cough suppressant, and don't have trouble with it.  I'm not sure what the cough suppressant is but it doesn't seem to affect me badly.  That plus a nasal spray takes care of all my serious problems.

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NARS: Don't know if this would help your particular nasal/sinus problem, but you might want to check out this: http://www.neilmed.com/. This is the best delivery method I have found for saline solution, and I've used them all, including the device you use with a WaterPik.

I've had lousy sinuses my whole life, and last year finally had to resort to surgery; I had an extremely deviated septum, bone spurs, polyps, et al. I was a mess.

Anyway, I swear by this product; so does my dad who also has bad sinuses. Simple but incredible well designed for the job. The kit comes with little pre-measured packets of saline/bicarb soda to mix. When I finished the ones that came with the kit, I came up with a mix that works just as well, and saves me that expense (which isn't much, but a hassle for me as I have to drive about an hour to get to a pharmacy that carries these packets). If you're interested in doing your own mix, I'll be happy to tell you how.

Might help, and is certainly not going to hurt.

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Guest ~Aurelie~

The ones she took also contained pseudoephedrine hydrochloride btw.

<{POST_SNAPBACK}>

I have had TERRIBLE experiences with products that have pseudoephedrine as an ingredient. TERRIBLE SCARY experiences. never never will i ever take it ever again!!!

i hope your friend is feeling much better now. it is very scary!

aurelie

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Update on the homeopathic decongestant remedy:

IT WORKS!!
I've been taking it for 2 days and my head is clear, the headaches have gone away, my nose isn't running so much, and I've had no psychiatric (or other) side effects.

It's by a company called Natrabio, and it's their Cold & Sinus nasal spray.  I got it at Wild Oats.  There were other homeopathic nasal sprays with the same ingredients, but the supplements lady said this is the most popular, and they haven't had any returns so far.

I can't recommend it enough.  I generally view homeopathic remedies with some skepticism, but after my Zicam success I was willing to try this stuff; now I'm inclined to try more homeopathic remedies.

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Some people abuse that under the name of DXM, you know? It can cause psychosis-like, psychedelic effects in very high doses.

I have lots of experience with DXM and yes it is a powerful psychedelic. You don't need particularly high doses to trip either - most people will start feeling weird with just 150ml of syrup. The effect is like combining LSD, ketamine, opium and alcohol, so probably not that good for the average psychotic. DXM may well have contributed to my first freaking out back in 1999.

Going back to my school days I remember a friend coming in one morning claiming he'd hallucinated on a single dose of Night Nurse, a UK flu remedy containing DXM. IMO it's perfectly possible to be very sensitive to psychedelics, especially with latent psychosis. Nowadays I find just a tenth of an acid tab very heavy indeed.

BTW if anyone reads this and is inclined to experiment (of course I rather hope not.. think twice then twice again) then make sure your product contains no other active ingredients - pseudoephedrine, paracetamol, diphenhydramine etc. are all extremely bad for you above the recommended dose

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