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 unconscious 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