Nocturnal panic attack
>I was wondering if you had heard of anybody waking up at night (about
>2/3 hours after going to sleep) for about a week, week and a half after
>taking a pill. When waking feeling very hot, sweating, shaking and being
>very frightened (not frightened of the sweating etc, like being
>frightened of aliens or some such thing) The heart beating very fast,
>being very tense, thirsty and the throat being very tight?
Reply by a psychiatrist:
This is a nocturnal panic attack, which is a regrettably common occurence
after E.
There are two possible explanations:
The disturbance in serotonin creates a disrurbance in the mechanism of sleep
which may
have an organic basis, That the event occurs so long after taking tne drugs
does not
discount this hypothesis. We are learning more about the long -term effects
of drugs all the
time. The neuro-toxic effects in animal studies do not commence until at
least three hours
after taking the dose. In fact, they commence when the major psychoactive
effects have passed.
Furthermore, we are increasingly exploring the issue of gene induction by
drugs.
The results of gene induction could be expected to last a very long time,
and recovery from
such induction would produce a variety of effects over a considerable period.
It is worth noting that cocaine addicts can stop for 15 years and , if they
have another dose of
cocaine, immedaitely enter the state which they left 15 years earleir -often
paranoid
psychosis - within a matter of minutes. Th e cocaine effects do NOT revert
to being tne same as
they were when that individual first started to take the drug. This process
of 'carrying on where
you left off' is one of the most remakable things about psychostimulants
and strongly
supports arguments for lasting brain changes.
If you wish to take an organic view, I would recomend a 6 month course of
nefazadone, which
is a relative of Prozac (a serotonin reuptake inhibitor) to restore the
normal architecture
of sleep.
The second explanation is psychological. Even just one E will punch a hole
in the wall
between consciousness and unconsciousness, and lower defences against repressed
psychic
material. As you would expect, this material will start to come through
in dreams.
If a panic attack results, I would recommened psychodynamic psychotherapy
so that you can begin
to discover just what that unconscoius may hold. If you wish to journey
into the valley of sex and death in this manner, you may even wish to take
more substances to punch further holes in the wall.
It may be better to have a panic attack than to live a life where you are
actually asleep in the
daytime, because you do not know the real reason why you do anything, and
awake at night or while on drugs.
Sometimes to wake up, you have to fall asleep.
There is no point painting a house if the foundations are rotten, or not
much point in the long term anyway, although as a short term fix I guess
it has it has its value.
Good luck
Dr. Karl Jansen
The Maudsley Hospital
63 Denmark Hill
London SE5 8AZ
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