Citation: Tay. "An Epileptic Takes Psychedelics: An Experience with 4-AcO-DMT & Phenytoin (exp112314)". Erowid.org. Sep 4, 2018. erowid.org/exp/112314
This report is in 4 parts:
1. Short TL;DR answers to questions that were burning in my mind before I actually tripped,
2. A short history of my diagnosis of epilepsy and give an account of what a temporal lobe seizure feels like,
3. How I connected my seizures to the psychedelic experience,
4. An account of my actual trip on 4-AcO-DMT, and comparisons with temporal lobe seizures.
I - Quick Answers
To any epileptics out there:
You probably have a couple of burning questions that havenít been answered with much certainty or with any first-person evidence. I know that I wanted to know two things very badly and Iím betting yours are similar, so to save you time, Iíll answer them clearly right here.
1. Do temporal lobe seizures resemble an experience with psychedelics?
a. For me, yes. Although itís not exactly the same, the come-up of 4-AcO-DMT felt similar to the come-up of a temporal lobe seizure but stretched over a longer period of time.
2. Are psychedelics a risk factor for seizures, or interact with seizure medication?
a. Some of them are bigger risk factors than others. Psilocybin and its derivatives like 4-AcO-DMT seem to be the safest bet. I am still very careful in what drug I choose to trip with and limit the kinds of psychedelic drugs, and drugs in general, that I use. Ideally, I also make sure that my seizures are in remission for at least a few months before trying psychedelics and make sure I am in good mental health. We are more prone to psychosis than the general population.
II - Temporal Lobe Epilepsy - My Story
In summer of 2015, I was diagnosed with a concussion after I suddenly collapsed to the floor. Because I hit my head so hard, the doctor assumed it was minor head trauma and urged me to take it easy for a little while. I kept having these moments every few months where I suddenly ďfelt strangeĒ and lost consciousness
I kept having these moments every few months where I suddenly ďfelt strangeĒ and lost consciousness
, and that definitely didnít seem related to concussion symptoms, so I made an appointment with a neurologist and got an MRI.
He confirmed that there was a scarred area of my brain in the middle of the left temporal lobe, partly in the hippocampus: Mesial Temporal Sclerosis. I had temporal lobe epilepsy. He prescribed me the anti-convulsant phenytoin. After months of experimentation, we found the proper dosage to keep me seizure-free, although it took me a while to get used to taking medication on a regular basis because Iíd never done it before. Ever since then, Iíve been taking 400mg of phenytoin every single day and have been mostly seizure-free, other than on days I forget or days that Iím irresponsible and drink too much. Too much in this case is only a couple of drinks. Alcohol reacts with phenytoin quite strongly.
Whenever I forget a dose, there's a seizure about 24-36 hours later. Otherwise, the phenytoin is successful. Itís the first line of defense when trying to curb seizures, and I'm glad it works. If it didn't I'd be looking at a lobectomy where the troubled area of the brain is removed, or a corpus callostomy that severs the two halves of the brain in an effort to prevent the seizures from spreading to the entire brain.
There was always something strange about my seizures. For the most part, they were terrible and physically uncomfortable, and would keep me exhausted for hours afterward. The fact that I might lose control of my body and consciousness due to some electrical misfiring in my head at virtually any time continued to send me spiraling into a deep depression that I had a hard time breaking out of. My life conditions were rather poor as well and I was suffering from burnout and mental exhaustion that only exacerbated my condition. Meanwhile, I searched for answers into what this feeling that accompanied my seizures could be. It was like nothing else I had felt before.
Iíll try my best to describe it in simple terms: My seizures start with a feeling of intense dťjŗ vu. Then, I feel flighty in the stomach like Iím about to have an anxiety attack. I feel dizzy. I shake, shiver, and sweat. If Iím lucky, the seizure stops there, but sometimes it crosses the threshold even further and enters a psychedelic space where over the course of about 90 seconds, the brain feels like it is slowly opening itself up to me. Itís as though I am on the verge of grasping some kind of cosmic understanding. At its most psychedelic, I feel my sense of self and my consciousness gradually stretching out to envelop the universe, and near the point of ego death, I lose consciousness and slip into a grand mal seizure.
Based on people whoíve seen it happen, I stay unconscious for about 30 seconds to a minute. Theyíve told me that I have some muscle contractions, but I donít act like a fish out of water. Itís mainly that my arms and legs contract. I bend my elbows and knees and different pulsating intervals, but Iím not conscious or aware of it.
After about a minute, I regain consciousness. Usually my arms are held up near my chin with my biceps tightly flexed. I start realizing that Iím holding myself this way, and that I can slowly relax the muscles. I gradually regain awareness, and then control, of my whole body. In more severe seizures, nausea and vomiting can occur. In lighter seizures, I donít reach the point of losing consciousness, and there is less of a mystical, psychedelic feeling to the experience.
III Ė Entry Into Psychedelics
These experiences were the origin of my dive into the psychedelic experience. I read as much as I could about temporal lobe epilepsy. I discovered artists and other well-known people who suffered from it. Fyodor Dostoevsky, Vincent van Gogh, and Lewis Carroll were common examples, but each list floated some more controversial, retrospective diagnoses that caught my interest: Socrates, Alexander the Great, or even religious figures like Moses or Gautama Buddha. There have been accounts of mystical experiences associated with seizures for millennia, although the evidence for many of the religious or spiritual figures are reinterpretations of their lives and are frequently disputed.
Despite its tenuous connection with religious figures, one thing came through with absolute clarity: there is an association between temporal lobe seizures and mystical or religious experiences. As I involved myself with Dostoevskyís work, I found Jordan Petersonís lectures since he often cited Dostoevskyís epilepsy and its involvement in his writing. Through Peterson, I discovered Carl Jungís work, and later on, Terrence McKenna, as he bridged the gap between Jungís Archetypes (and his idea of the collective unconscious) with psychedelic drugs and plants. His first-hand descriptions of psychedelic experiences captivated me because it felt as though he was speaking the knowledge that I had only been getting hints of through seizures.
As I continued watching, reading, and learning, I found greater meaning in religious writing, world literature, depth psychology, and psychedelics. It was as though my inner monologue was screaming at me that the path towards the most interesting, meaningful, and impactful life would somehow incorporate these things. I chased whatever gave me that same feeling of pure presence that was only felt in the body through my seizures.
I generally found that psilocin-based psychedelics like psilocybin and 4-AcO-DMT were a lower risk factor for seizures than other psychedelics such as LSD. There were also very clear risk factors for dissociative drugs like Ketamine. If there was some way to experience these feelings without having a seizure, I wanted to see for myself what it was like. I was lucky enough to run into a friend who had recently acquired 4-ACO-DMT. Due to its similarity to psilocybin and thus less of a risk to my health, I decided to try it.
The first time was a microdose, ~5mg. I didnít feel much, but that might also have been because I didnít know what to expect. My body felt a bit looser. Maybe some things popped out in my peripheral vision a little more brightly. Other than that, there was nothing I could really measure. The next time, we took ~15mg each, and that was enough to send me into the psychedelic space proper.
IV - The Trip
My friend and I began our trip with a singing bowl ritual as a way of cleansing the space and marking the beginning. We each licked up a small pile of about 15 milligrams of powder and waited. It took about 30 minutes for me to feel the effects. We were lying on my bed and looking up at the ceiling when I first started noticing subtle distortions in my vision. After that, I felt some familiar body sensations.
Many physical aspects of the come-up were similar to the ďauraĒ I get when Iím about to have a seizure.
Many physical aspects of the come-up were similar to the ďauraĒ I get when Iím about to have a seizure.
The butterflies in the stomach. The mild dizziness. The shaking, shivering, and sweating. But it didnít feel like I was going to have a seizure. I kept control of my consciousness as the feeling escalated further and then reached that point of cosmic understanding that up until then had only ever ended with a seizure. But the seizure didnít happen. It took me right up over the edge and into ego death. For the first time I could stay in this space and stay conscious. Rather than lasting for 90 seconds, it lasted for several hours. I reached my peak at about 2 hours post-drop.
The next three hours were a highly embodied experience. I felt a need to languidly stretch out my body and to touch everything around me like I was a singular nerve ending of a cosmic body. I did this for nearly the entire trip. My mind was too occupied with ideas and conversation to notice or really care about what my body was doing. I was simply doing what ďfelt rightĒ, which mostly consisted of long, slow, cat-like stretching.
There were some low-level visual distortions as I looked up at the stucco ceiling and watched the rough terrain bend, warp, and arrange itself into different patterns. Conversations tended towards our relationship with primates and other close relatives on the tree of life. I was filled with laughter as I thought about how weíre not that far away from them and said things like:
ďUp until recently all we could do to communicate was grunt, fling poop, and fuck.Ē
ďWeíre just monkeys wearing clothes!Ē
My friend and I went back and forth exchanging similar utterances. Despite their silliness they filled me with immense gratitude at the fundamental building blocks of humanity. I felt grateful for language, as it allowed us to slowly move out of our primitive ways and communicate with more complexity. Grateful for the plants and vegetables that evolved with us and allowed us both to thrive. Grateful that evolution had led to this body that my consciousness occupied, despite its electrical faults. We kept talking in this manner for the next few hours, and I simply enjoyed the feeling of being in my body at that time and place. As the drug began to wear off about 5 hours in, the need to move around and stretch faded and I settled into stillness and gained more control over my thoughts.
It was a trip through potentials. I was able to think through possible futures for myself if I continued doing or not doing certain things. The best way I can describe the image I pictured in my head is by comparing it to the old Atari game Tempest. Each of the sections of the ďwallĒ led to a slightly different future, and my awareness was circling around the wall and taking in the view.
The entire experience was positive. If I had kept along a line of thought associated with a particularly bad future and wasnít able to pull myself out, I can easily see how a bad trip might happen. Thankfully I was able to stay a passive observer rather than get caught up in any particular thought or idea.
Based on the accounts of other trip reports and stories from friends, I seem to have had a fairly standard reaction to the drug in line with the effects expected at that dose for someone of my size (5í10Ē, 215 lbs). I was concerned that the anti-convulsant properties of phenytoin may have dampened the effect of the psychedelic, but that didnít seem to be the case.
I had a positive experience on 4-AcO-DMT that was fairly clear-headed and didnít cause a seizure, although it felt familiar. I also tripped with someone who was much more experienced in psychedelics so in case a seizure did happen, I would have someone to help me out. This isnít to say 4-AcO-DMT wonít cause a seizure in others with this condition. I want to urge anyone with TLE to exercise some caution around doing this, because we are at a higher risk of psychosis than the general population. Make sure to be careful and precise with dosing and taking things slowly.
Iím more convinced than ever that thereís something valuable to be discovered about the relationship between epilepsy and the psychedelic experience.
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