Alcohol psychosis or depressive psychosis?

[Hedgehunter]

Hi all, I'm not new to new to this forum, but it's my first post here, will try to keep it brief... Until recently I drank almost daily since I was 18 (I am 32). I would go to the pub for 2 or 3 pints (or sometimes 4 or 5…) each night after work, heavily on weekends, usually had Sundays off. Also sometimes drank in afternoons more recently. Then 2 years ago, when very worried about an ill relative going for an operation, and while taking ibruprofen (NSAID) for an odd sharp pain in my lower right abdomen, I drank a lot of white wine over 3 afternoons and nights, & the next day hallucinated smells on myself & became delusional, and spent 3 weeks in a psychiatric ward (I played down my drinking when they asked me). I woke early morning after the drinking smelling an odd smell on myself, & with deluded ideas of stopping the relative going to the hospital. My pain was getting worse, and later that day I became completely ‘mad’, heart rate going through the roof, smelling the odd smell all over, clouding of consciousness, difficulty speaking & walking, became suicidal, lost so much weight my trousers fell down, hair greasy and flat, became terribly paranoid & seriously deluded, needed watching over by family. Doctor prescribed risperidone (antipsychotic) which made me feel terrible, didn’t help at all really. I went into the psych unit and they gave me olanzapine (antipsych & tranquiliser) which almost immediately stopped the smell hallucinations, heart rate etc. This was almost 2 weeks into the episode. I gradually got better, craved sugary food, put on 2 stone. Their official diagnosis was an acute polymorphic psychotic episode with no signs of schizophrenia. It was a truly awful experience, I believe I nearly died and coming out of it was like waking from a living nightmare. I stopped the meds, and went back to work with a calm & confidence I’d never known before. I never thought at that point that any of it was caused by alcohol… I haven’t taken up regular drinking since though because after I started again it brought back anxiety, fast heart rate, and it’s sometimes hard to stop; my body also sometimes ‘jerks’ during the following couple of nights, which made me think it was alcohol all along, but I was blind to it. Also seem to get drunk quickly. I wondered whether anyone has been through a similar experience? I don’t know if I had an alcohol psychosis or a depressive psychosis? I am thinking that as it took the tranquiliser to cure me my nervous system must have been in overdrive because of alcohol. Sorry for going on & many thanks for reading.

[boogieman]

hi. the thing that concerns me the most is the possibility of liver or pancreas damage. damage to these organs will cause the pain you describe, a lowered perceived tolerance for etoh and the symptoms of a condition found in diabetics and alcoholics called ketoacidosis. it also sounds like you may have done some neurological damage as well. these specific conditions were likely not checked for if you were not honest about your consumption. if there is damage, it is likely reversible, but not if you continue to drink. it would be wise to have lab panels done for your liver and pancreas to determine if they have been compromised, and to take action to stay sober. nsaid pain relievers are also toxic to folks with this type organ damage, so be careful with them as well. hope this is helpful---gm

[boogieman]

hi again. another concern is the possibility of wernicke-korsakoff's syndrome, of which korsakoff's psychosis is a condition which could cause your neurological symptoms. treatment of such is usually mass doses of thiamine. this condition as ketoacidosis , is caused by the poor nutritional intake that frequently accompanies excessive alcohol use. take care, gm

[ibizan]

Did any of the health care personnel there while taking your history ASK you about your alcohol intake or history?some do not ask and as we know many will not offer it which as u have seen did not assist you in gettting the right diagnosis!Please heed what boogie advises...he is a wise sage here and knows what he is talking about!:)

[Hedgehunter]

Thanks Boogieman. The work you do on here is great by the way. I wondered about ketoacidosis just after the episode. I don't think it was korsakoff''s psychosis, because there was none of the memory loss, well there was some actually - I was losing track of time, but no confabulations associated with it. I've done some research, and it seems alcohol can cause a plain psychosis, same as a drug induced psychosis. Interestingly enough, they say a drug induced psychosis is indistinguishable from an acute polymorphic psychotic episode, which was my diagnosis. I also wondered whether it was the DTs, possibly brought on by the NSAIDs on an already taxed liver and my worried mental state (and alcohol of course!). You have certainly given me food for thought regarding NSAIDs being toxic to folk with organ damage. Thanks.

Ibizan - Yes, they asked me about my alcohol intake and history, but I was so delusional, thought the authorities were after me etc, that I said whatever I thought I needed to say to 'escape'! (saying I rarely drank, but drank a lot the day or two before the episode) It was only many weeks after the episode, when I gradually started drinking again, that I thought drink could be involved - that's how blind people can be to it!

[boogieman]

hi. chemical dependency is the only sickness i know of that will convince the sufferer that they are well, when the truth is quite the opposite. i hope you can use this information to improve your situation in a safe, progressive manner and please keep us posted on how you're doing. take care,    gm