Synthetic marijuana and DS's psychotic episode

[daylily]

Hello, I know I haven't posted in a long time, but I need to reach out for help.

My son turned 20 last week.  He is a college student and was living at school in another state.  We went to see him a few weeks ago and found him to be psychotic.  He was paranoid, angry, had not slept in days.  We took him to the emergency room and he was admitted to a psych unit for 11 days.  Now he is back home with us.

A lot of scary things are happening, and I'm still not sure what exactly is wrong with my son.  Here are the facts:

1. He had never been psychotic or manic prior to this episode, although he has had issues with anxiety and depression.

2. He was a heavy and frequent user of synthetic marijuana.

3. He was also tripping on shrooms, and smoked regular marijuana as well as dabbled in other drugs and alcohol.

From what he tells us, he had an intense mushroom trip and was psychotic for a period of time, then suddenly became aware of his psychosis, which triggered severe anxiety which led to insomnia, which led to paranoia and the psychotic state we found him in.  He was also experiencing outside stressors at school--not getting along with his roommate, freaking out about money, etc.

He was discharged with a diagnosis of "drug induced psychosis" on a heavy dose of Abilify.  We took him to see a doctor here in Virginia.  This doctor is in the psychiatry department at the University of Virginia, although technically he's an internal medicine doctor and not a psychiatrist.  He specializes in drug abuse and is very knowledgable about the drugs my son was taking.  He immediately told my son to halve his dose of Abilify--it was obvious that he was overmedicated, as he was like a walking zombie.  The next day he told my son to stop taking the Abilify altogether.  This doctor gave us a hopeful prognosis for our son.  He said that these drugs have basically messed up the receptors in our son's brain, but that with time he should recover.  

I am frightened though, because last night DS slept for only one hour.  He was having sleep disturbances while on the abilify, so I don't think going off the drug is causing this, but he seems to be having cycling, possibly psychotic or manic thoughts again.  It's very hard to describe.  His actions and behavior and his speech are appropriate, but it's like he needs to make an effort to be normal.  He was up all night sending facebook messages to his aunt--which he asked me to read.  In them, he's kind of rationalizing himself out of an anxiety attack that started some time last night.  Also, because I am his mother and really *want* him to be OK, I am ready to rationalize almost anything he says.

He is scheduled to see a therapist on Friday.  This therapist is supposed to help him deal with his anxiety and is also knowledgable about drug-induced psychosis.

I'm terrified that my son will never be normal again.  I'm worried that the drugs triggered a latent bipolar disorder.  The doctor here wants him to manage his anxiety with therapy rather than drugs like SSRIs--prozac or zoloft, etc--and my son is happy with that.  My son is also saying he never wants to take Abilify again, but from the change in his thoughts since he stopped the Abilify, I'm thinking it might be helpful right now--in a lower dose than he was taking in the hospital.  They had him on 20 mg/day.  I'm thinking 5 or 10mg might be more appropriate.  

The thing is, my son is an adult.  He can do what he wants.  If he refuses to take meds, there isn't a lot I can do about it.  Does anyone have experience with this sort of thing?

[nerdmomma6885]

My concerns:

1. Has he realized that he SHOULDN'T use marijuana, and that it messed up his brain? Has he accepted that fact? If not, then he is very likely to go back on the drugs.
2. He should stay home for awhile- obviously he is using poor judgement in his personal choices, and he also needs to be placed under constant supervision so if he has an episode, then someone can help him immediately instead of not seeing the signs for days or weeks. At college, they simply do not have the time or the capability to deal with such needs, and I doubt his roommate would be willing to help him out. Also, he needs to see a therapist probably once a week. That way, you can make sure he is meeting his doctor's requirements, since he seems to not be stable right now.
3. Meds- I would have a talk with him and ask whether he has any significant complaints that you might want to consider before making any decisions. I agree with you that a low dosage of the medication would probably work, although ask your doctor if it will still be effective at low levels.
4. Make sure your DS is having AT LEAST eight hours of sleep every night. It's actually necessary, because if they go even an hour off schedule, they are very irritable and anxious. Make sure he is not doing anything that could cause him anxiety. Watching news, going online, worrying about college or money are all things that will have to be eliminated later. If he refuses, tell him that you're worried that he will become paranoid again, and you don't think he needs to think about that yet. But don't remove him from society COMPLETELY. Bring him to the park for a walk, have him enroll in some fun classes at community college, let him see some friends from childhood (good ones, that is), bring him to church, etc. If they don't work in relaxing him, then if he has issues sleeping, use melatonin. It's a sleep medicine- a natural one, I might add. It will work, but for only as much as he wants to. If he refuses to let himself sleep, it won't work. have a gentle talk with him- tell him how much you love him, that he can still achieve his dreams, etc. It can be very reassuring as he falls asleep, or a massage.
5. I think your DS realizes that he is simply not at a good time to be an adult, that he feels very scared and w

[mumkimum]

Not exactly experienced at something like this, but  and a few thoughts.  Sounds like quite an overwhelming time for you right now.

I know that uses change among practitioners - and you might try posting in mental health for more specific advice too - but I've understood Abilify to specifically end up getting used to augment another psych med.  And not always to end up getting used on its own (or not to be used on its own for much of a duration).  I wouldn't jump to the conclusion, based on my knowledge of it (knowing others who do or have taken it) that a maintenance dose of that particular med will be helpful.  In fact, your ds getting weaned off of it sounds about right.  It actually can be a pretty intense med.

If sleeping is currently difficult, helping him find other also relaxing alternatives (baths, yoga, walks together at night with you, music to listen to) that may at least ease him close to sleep might really help.  If he isn't immediately into it, keep it around and easy to access.  Did he ever paint, play music?  Think of repetitive actions that he might be able to focus on and help re-learn how to calm down in the moment.  Sleep is rarely something you can 'just do' even if you want to, so you won't really able to 'make him sleep'.  I'd be cautions about natural remedies without speaking to a medical professional, just based on the circumstances (make sure melatonin is okay - don't just give it right now.).  Rescue Remedy, however, would probably be fine if he'd take it.  

Can you help him tackle some of the other outside stressors right now?  A lot of what's going on with his mental state you're really not going to be able to do much about.  Helping with the other aspects of his situation (gently, of course) there will simply be more you can do.  

[nerdmomma6885]

1. I think your DS realizes that he is simply not at a good time to be an adult, that he feels very scared and wants to feel safe and at home, so that would be his home. I don't think you would have any issues bringing him home.
2. As for bipolar disorder.... nope. He doesn't have it. Remember, bipolar disorder has episodes of anger, mania, and depression. I only see the depression, so I doubt it. My father had it, so I know what to look for. I think he's just stressed out about his situation and embarrassed and angry that it happened to him of all times in college with a roommate to witness it.

Sorry about that weird ending to my post yesterday. My computer shut down unexpectedly, so I had to stop and get it fixed. YAY my computer got fixed today!!!

[nextcommercial]

I don't know much about synthetic marijuana.  I had to look it up.  But, it does say that the stuff leads to mental illness and hospitalization for symptoms of mental illness.  (this is according to blogs, and reports, not scientific evidence) 

I haven't seen anybody say they thought it brought out what was already in him.... rather that they think it's the actual cause.  Not a trigger.

Not that it makes it better or anything, but it seems more hopeful.  If indeed all of this was caused by the synthetic marijuana, Perhaps he just needs a lot of time to let it get out of his system and he will improve.   (I am just looking at the bright side, I have no idea.)  I hope he can put himself back together.  It sounds like he's miserable.

[trekkingirl]

Dr drew has a show on tv that covered synthetic marijuana and it is actually not ment to be smoked because it causes serious mental health problems. There were a few parents on the show sharing how their normal child actually committed suicide while high on the drug. Sounds like your son is really lucky you are there to support him through this. Hugs mama I'm so glad that he is with you. If you have comcast cable tv the show is on demand right now

[To The Maximus]

To The Maximus Foundation is an organization dedicated to activism and education about Synthetic Marijuana.  We have been contacted over and over again about teens and young adults with severe mental health problems brought upon by the use of synthetic marijuana.  

Unfortunately, there isn't any significant research about the damage that these drugs can do.  We don't know if the damage is permanent or not.  The problem is that every single little bag of synthetic marijuana may contain something different and at a different concentration than every other little bag of synthetic marijuana.  Because these manufacturers are trying to stay one step ahead of the law, they are synthesizing a new drug at an average of one every two weeks, according to the European Monitoring Center for Drugs and Drug Abuse (EMCDDA).

However, we do know that the paranoia, anxiety, and crushing depression brought on by the use of the drug can lead to suicide.  Watch your son carefully.  We also know that these drugs are extremely addictive and easy to find--he can purchase them on the internet and from almost any corner gas station.  

The most obvious sign of active synthetic marijuana use is prolonged vomiting.  Here are the other signs:  

Reported Side Effects

• Increased Agitation
• Vomiting
• Increased Blood Pressure
• Increased Heart Rate
• Partial Paralysis
• Lower Body Temperature
• Temporary Inability to Feel Pain
• Seizures
• Paranoid Delusions
• Depression
• Hallucinations
• Exaggerated Thoughts of Suicide
• Feeling of Impending Doom (Death)
• Tremors
• Panic Attacks

Please educate yourself!  Find To The Maximus Foundation on Facebook, follow us on Twitter at Fakeweed, and find our website at http://www.2themax.org.

Become active.  Fight this drug in your own community.  Together, we can fight synthetic marijuana.

[heartofthorns]

I'm sorry your son is experiencing these problems.  Seven months ago, I was in your shoes, desperately seeking answers and a cure for my son's synthetic marijuana overdose.  My son spent two months in the psych ward after becoming psychotic while using this poison.  I can tell you it's my opinion none of the other drugs or mushrooms your son was using did this to him, it was the spice.  I also feel very strongly that one has to take medications to recover from this.  A lot of people feel differently and that's okay.  I can only tell you what has worked for my son to date. 

I would be glad to discuss this with you further through email.  You can email me at [e-mail] if you like. 

Also, Karen Dobner from To The Maximus Foundation (the post before mine) has a wealth of information on this subject and has a group of people who are a great support system for each other.  Look up her organization or look me up on face book (Marla Swanner Gray) and we can guide you to those groups for more information if you'd like.

In the meantime, I'll keep you and your son in my prayers,  This is not an easy road and there is no quick fix.  My son was in college also and would have graduated with a computer programming degree last month.  Now he can't even remember the password to his email account.

Good luck!

[swmuldrow]

a

[daylily]

Wow, I'm overwhelmed by all the kindness and support here.  I'll definitely be checking out the Maximus foundation.  Before this happened to us, I was barely aware of the existence of synthetic marijuana.  

After I posted the above, my son agreed to go back on the Abilify.  He did sleep that night, about six hours.  His insomnia is really a serious problem.  What happens is, as night approaches, he gets anxious about the fact that he might not be able to sleep and the more worked up he gets over it, the harder it is to sleep.  He saw a therapist today and that was a good experience.  He's also seeing another psychiatrist next week.

He does say that he understands he can never touch drugs again.  Yesterday the Dean of Students from his school called him because he had been sending worrisome emails to one of his professors and she got concerned and told the dean.  The dean was very understanding.  It's also helpful that a good friend of my son's here at home comes to visit him--this friend does not do drugs and has always been a good influence on DS.  It's also good that my son is aware that he is psychotic right now and he is motivated to get well.  That said, he has a lot of delusions about how his psychosis is moving in a "positive direction."  I'm not sure what he means by that.  He also learned that a former high school classmate recently had a psychotic break (not drug-related) and was diagnosed with bipolar 1.  They talk on the phone, and while I'm glad ds has someone he can relate to, he is also now constantly comparing himself to this other boy.  

Right now, my son's symptoms include anxiety, insomnia, delusions, paranoia, and restlessness.  He paces *constantly.*  He might sit down for a minute to send an email but that's it.  He used to love to read, now he can only read about one paragraph at a time.  He can't watch TV.  He can't do anything other than pace and talk.

Heartofthorns, thanks so much for the offer.  I think I will be emailing you. 

[jdsf]

I am so sorry you are going through this. I know someone who was found dead recently, COD unknown at this point but I wonder if it wasn't brought on by synthetic marijuana. I know they were using it in heavy doses and posted numerous things on Facebook that caused people to question their current state of mind, and it could potentially be suicide. I don't know how this stuff is legal but it clearly shouldn't be.

That being said, I know numerous people who have experienced psychotic episodes after heavy drug use and have turned out much better than expected. I don't know what happens with this drug specifically, but there is hope. My father is one of these people and you would never know it to meet him now.

[knatoli]

My son has had a similar experience, 10 days in a crisis stabilization unit and now in a dual program for substance abuse and mental health. He was improving on a strong, broad spectrum, antipsychotic (olanzapine), but the morning dose was discontinued and he is rapidly cycling again.

Does anyone know of a recovery community that addresses this drug of abuse? I met a young man at an AA meeting last week who is recovering from very deep depression and is requiring 24/7 watchfulness. He really needs someone to talk to who has had this experience. I know my son could benefit from having a recovery community available when he is discharged from rehab.

[mkassorla]

My son has been off Synthetic Marijuana for over three months now, and insomnia is a real problem as well.  He went over 5 days with no sleep, then I got the doctor to prescribe something.  I think the stuff rewires their brains in very dangerous ways.

[Alenushka]

My so takes Abilify. It has been great for him. He has Bipolasr disorder. It is not a drug that should be stopped suddenly.

You need to take your son to a Psychiatrist.

Internist is not an appropriate Doctor for it.   

Sometime one need combination of 2-3 drugs to quell a psychotic episode and a drug to help with sleep

yes, you son can and will stabilize but you need to see a professional. Talk therapy is not enough just like drugs by alone, are not enough

[drover8]

I'm glad I found this thread.  First off, how is your son doing in his recovery?

I am going thru the same thing right now with my 19 year old daughter.  Her marijuana was laced, and of course nothing came up on her tox screen but marijuana.  She was in the ER crisis for 4 days until she was transferred to a psych hospital for 3 weeks.  She was discharged home to me, had just completed school 3 hours away and had her own place for a month.

She's been home for 10 days now and it is so horrible for her.  She cycles repeatedly.  She can be silly/giggly in an infantile/toddler way.  She can be super paranoid.  She gets delusional, angry, depressed and confused.  She has tics/spasms.  She did have an EEG at the hospital that came back normal.  One day/minute she can be pretty much her old self and the next she is spaced out.  We've seen her family doctor and had her taken off klonopin given to her at the hospital, it was making her worse.  She's doing better on just her risperidone and lamictal now.  We are waiting for a call back from the psychiatrist and therapist to get those services started and whatever else she may need.

She too can't sit still, needs to constantly do something, but it only holds her attention for a few minutes.  However she has no trouble sleeping, and does quiet frequently.

I've read & heard from doctors that the synthentics can bring out schizophrenia and mental disorders that if the gene is there, it switches it on.  Her symptoms are classic schizophrenic and had a diagnosis at the moment of schizophreniform disorder.  Also that recovery varies from individual.

Good luck all.

d.

[mamarhu]

NAMI, the National Association for Mental Illness, www.nami.org, is a national organization with local offices in every US state, I believe. They offer support for people living with mental illness, and family members. They also might offer classes, support groups and local resources, even social events for individuals and families. Varies by area exactly what is available. Worth checking into in your area.

Daylily, I can only imagine the devastation this sudden experience brought to your whole family. Please care for yourself as you care for your son.

I wish you all the best.
 

[mom2ponygirl]

I'm so sorry, and hope your son is beginning to feel better.  Time heals many things.  Please be kind to yourself and patient with your son's progress.  People really don't understand how dangerous this stuff is. 

I do know a bit about synthetic marijuana as I work with a research group designing testing protocols for synthetic marijuana (and cocaine aka bath salts).  It is not my area but I sit in on group meetings with research updates.  It is seriously scary stuff and the worst part is that no one knows the effect it will have on the brain.  Essentially the people who produce this stuff synthesize a compound that will attach to the same receptors in the brain as THC.  They slightly modify the structure so that it won't show up on current testing.  They don't know what the effect will be.  It could do nothing, it could get you high, it could kill you.  They keep producing new structures in an arms race against the current testing.  So the synthetic marijuana a kid used one month with no ill effects may not be related to the one they try the next month.  The stuff their friends used and didn't kill them won't necessarily be what they get.  

The doctors won't know what he has been exposed to, nor will they know the possible effects.  Please tell your kids that if they mess with these synthetic drugs they are playing Russian roulette.