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Safer Using – Deliriants

About Deliriants

Deliriants are a class of hallucinogenic drug characterised by their ability to produce complex delusions and vivid, dream-like hallucinations which integrate seamlessly into waking consciousness.1-4 Unlike psychedelics and dissociatives, the hallucinations produced by deliriants occur at all recreational doses and are often difficult to tell apart from reality.3,4 The experience produced by deliriants is often described as unpleasant and can result in unpredictable effects, distressing hallucinations, and erratic behaviour.3 Excessively high doses of deliriants are dangerous as they can put strain on the heart as well as cause overheating, seizures, and muscle breakdown  (rhabdomyolysis).1,5 People with existing heart conditions should avoid deliriants.

Some over-the-counter medications are taken at high doses—much higher than the recommended medicinal doses—to produce deliriant effects.3,4 Examples of these include the antihistamines diphenhydramine (a.k.a. DPH) and dimenhydrinate, the motion sickness drug hyoscine (a.k.a. scopolamine or devil’s breath), and the anti-inflammatory drug benzydamine.1,3,6 Other pharmaceutical drugs are reported to have deliriant effects including the antidepressant mirtazapine as well as several antihistamines and drugs used to treat tremors.1,3

Common deliriant substances found in pharmaceutical drugs and/or plants.

Some plant species are consumed for their deliriant effects.1 For example, plants in the genus Brugmansia(a.k.a. angel’s trumpet) and Datura (a.k.a. common thorn-apple, devil’s trumpet, moonflower, jimsonweed or hell’s bells) contain the naturally-occurring deliriant chemicals hyoscine, atropine and hyoscyamine (a.k.a daturine).1 Datura seeds have long been used for medicinal purposes in South Asia and South America.7 Nutmeg also contains the deliriant substance myristicin.8 One should exercise extreme caution if consuming deliriant plants since their potency is often unpredictable and they can be physically harmful at high doses.7,9 Deaths and hospitalisations have resulted from consuming high doses of Datura species as well as nutmeg.7-9

Datura stramonium, the seeds of which contain several deliriant substances. Source: https://commons.wikimedia.org/wiki/Datura_stramonium

Effects of Deliriants

The subjective effects of deliriants are highly varied and unpredictable.3 The effects also depend on the dose and the specific deliriant ingested, but they broadly include:1-4

  • Dream-like hallucinations and delusions.
  • Vision disturbances (e.g. double vision, vibrating vision).
  • Auditory hallucinations.
  • Impaired attention.
  • Drowsiness, sedation.
  • Confusion.
  • Unease, dissatisfaction, dysphoria.
  • Anxiety.
  • Agitation.
  • Dizziness.
  • Dilated pupils (mydriasis).
  • Increased heart rate.
  • Increased body temperature.
  • Increased blood pressure.
  • Paranoia.
  • Depressed mood.

The duration of the effects differs between deliriants. Typically, the peak effects last 5-12 hours for hyoscine/Datura, 1-4 hours for DPH/dimenhydrinate, and 3-6 hours for benzydamine.7,10,11 Some people who use hyoscine/Datura report vision disturbances (e.g. difficulty reading) the day(s) after a trip.7,12

Dosing Deliriants

Deliriants can have very unpredictable and unpleasant effects.3 Hence, it is strongly recommended to start at a low dose and wait before redosing deliriants (start low and go slow).

DPH/Dimenhydrinate

The following is a rough dosage guide for DPH(sold as Benadryl among others):3

LOW DOSE – 100-200 mg

MODERATE DOSE – 200-400 mg

STRONG DOSE – 400-700 mg

HEAVY, POSSIBLE OVERDOSE – 700+ mg

Dimenhydrinate (sold as Dramamine, Gravol among others) is a combination of DPH with the stimulant 8-chlorotheophylline, chemically related to caffeine.13 The combination may increase the strain on the heart, and may produce more restlessness and dysphoria.11

It is important to note that, in Australia, Benadryl no longer contains DPH.14 The formulations of DPH/dimenhydrinate commonly sold in Australia (e.g., Paedamin and Travacalm Original) contain other drugs including caffeine, hyoscine, and decongestants.15 These combinations may increase the risk of dangerous and unpredictable side-effects. Excessive caffeine intake may put strain on the heart. The night time pain relief drug “MersynoNight” should not be taken as a deliriant because it contains paracetamol, and thus carries a high risk of toxicity.16

Hyoscine

There are two forms of hyoscine sold in Australia: hyoscine hydrobromide (a.k.a. hyoscine HBr) under the brand names Kwells and TravaCalm HO, and hyoscine butylbromide (a.k.a. hyoscine BuBr) under the brand name Buscopan and Stomach Ease.15

There is very little information available for dosing hyoscine HBr. Some users advise against taking greater than 2-3 mg (=7-10 Kwells/TravaCalm HO tablets) due to the high risk of a bad trip, blackout, and injury.12,17 In the absence of accurate dosage information, it is recommended to start with a low dose (e.g., 1-2 tablets) and slowly work your way up to the desired intensity of effects.

Hyoscine BuBr (in Buscopan and Stomach Ease) is not orally active as a deliriant because it does not enter the brain.18

Benzydamine

The following is a rough dosage guide for benzydamine(sold as Difflam among others):10

LOW DOSE – 300-500 mg

MODERATE DOSE – 500-1000 mg

STRONG DOSE – 1000-2000 mg

HEAVY, POSSIBLE OVERDOSE – 2000+ mg

In Australia, medications containing benzydamine often contain other drugs, such as the topical anaesthetic lidocaine and the antiseptics dichlorobenzyl alcohol and cetylpyridinium.15 These drugs have toxic effects when ingested at high doses. In severe cases, lidocaine overdose can cause heart failure.19 If consuming benzydamine for deliriant effects, choose a formulation that contains only benzydamine, usually indicated by the inclusion of “Forte” in the name.

Datura

Deliriant plants such as Datura species can be extremely difficult to dose accurately because the plants can vary in potency.7 Most of the Datura plant contains deliriant substances, but the seeds are the most common part of the plant consumed.9 If you choose to ingest Datura, try beginning at the lowest possible dose (one user reports 1-10 seeds) and slowly working your way up to the desired intensity of effects.7,20

Nutmeg

Nutmeg is responsible for multiple fatal overdoses.8 Exercise extreme caution if choosing to dose nutmeg. Generally, the fresher the nutmeg, the higher the potency.21 The following is a rough dosage guide for whole nutmeg:21

LOW DOSE – 2-5 g

MODERATE DOSE – 5-15 g

STRONG DOSE – 15-20 g

HEAVY, POSSIBLE OVERDOSE – 20+ g

Deliriant Overdose

A deliriant overdose can be life-threatening. The symptoms of an overdose can include:5

  • Agitated delirium.
  • Fast heart rate (tachycardia).
  • High blood pressure (hypertension).
  • High body temperature (hyperthermia).
  • Flushed face.
  • Dilated pupils (mydriasis).
  • Inability to urinate.

If a person experiences any of the above symptoms or is concerned, consider seeking medical attention. Additionally, if a person experiences any of the following:

  • Loss of consciousness.
  • Seizures.
  • Chest pain.
  • Sudden drop in blood pressure (hypotension/shock).

Call 000 and wait with them until they recover.

There is some information online regarding “Deliriant antidotes” including nicotine and physostigmine, however, there is little evidence for their effectiveness.22 Don’t try to administer an antidote instead of seeking medical help.

Mixing deliriants with other drugs can increase the risk of overdose. For example, mixing deliriants with stimulants or anticholinergics can increase the strain on the heart, and mixing deliriants with depressants can increase the risk of blackout and respiratory depression.7,10,11

References

[1] http://dx.doi.org/10.1021/acschemneuro.8b00433

[2] https://doi.org/10.3389/fnins.2018.00007

[3] https://psychonautwiki.org/wiki/Deliriant

[4] https://wiki.tripsit.me/wiki/Deliriants

[5] https://www.rch.org.au/clinicalguide/guideline_index/Anticholinergic_Syndrome/

[6] Pharmacology for Health Professionals by Bronwen Bryant and Kathleen Knights, Fourth Edition

[7] https://psychonautwiki.org/wiki/Datura

[8] https://doi.org/10.1007/s11419-012-0151-8

[9] https://doi.org/10.3736/jintegrmed2013016

[10] https://psychonautwiki.org/wiki/Benzydamine

[11] https://psychonautwiki.org/wiki/Diphenhydramine

[12] https://www.erowid.org/chemicals/scopolamine/scopolamine.shtml

[13] https://doi.org/10.1016/s0149-7634(01)00038-0

[14] https://www.benadryl.com.au/

[15] https://www.chemistwarehouse.com.au/

[16] https://www.nps.org.au/medicine-finder/mersyno-night-night-time-pain-relief

[17] https://www.reddit.com/r/Deliriants/comments/1ddj6d7/anyone_ever_mixed_dxm_and_otc_scopolamine/

[18] Oxford Textbook of Palliative Medicine (4th ed.) by Geoffrey W. C. Hanks

[19] https://www.verywellhealth.com/lidocaine-overdose-4582418

[20] https://www.reddit.com/r/Datura/comments/149cooh/guide_to_datura_consumption/

[21] https://psychonautwiki.org/wiki/Myristicin

[22] https://psychonautwiki.org/wiki/Deliriant_antidotes

Written by Darcy Lynch

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