Combinations - Psychedelic come-down: Tylenol

[aaronitotheburrito]

SWIM to engage his mind in the Psychedelic experience. He recently did Cocaine, on the come-down he took 2 Tylenol PM. After about an hour "The walls abandon shape, they've got a a Chetshire Cat grin. All blurring into one, this place is on a mission". No it wasn't that intense but it looked like a weak acid trip. SWIM woke up the next morning with nice visuals still, it faded away in my Psychology class though. Anyone ever had this? Or was SWIM just getting great flashbacks.



SWIm about to try it again and see what happens :P

[coelho]

Be careful! Taking too much Tylenol can cause a slow and painful death...

From Wikipedia:

Originally Posted by Wikipedia

Tylenol is a North American brand of drugs for relieving pain, reducing fever, and relieving the symptoms of allergies, cold, cough, and flu. The active ingredient of its original, flagship product, is acetaminophen (called "paracetamol" outside North America)

Originally Posted by Wikipedia

Paracetamol toxicity is caused by excessive use or overdose of the analgesic drug paracetamol (called acetaminophen in the United States). Mainly causing liver injury, paracetamol toxicity is one of the most common causes of poisoning worldwide. In the United States and the United Kingdom it is the most common cause of acute liver failure.

The signs and symptoms of paracetamol toxicity occur in three phases. The first phase begins within hours of overdose, and consists of nausea, vomiting, pallor, and sweating. However, patients often have no specific symptoms or only mild symptoms in the first 24 hours of poisoning. Rarely, after massive overdoses, patients may develop symptoms of metabolic acidosis and coma early in the course of poisoning.

The second phase occurs between 24 and 72 hours following overdose and consists of signs of increasing liver damage. (...) Acute kidney failure may also occur during this phase, typically caused by either hepatorenal syndrome or multiple organ dysfunction syndrome. In some cases, acute kidney failure may be the primary clinical manifestation of toxicity. In these cases, it has been suggested that the toxic metabolite is produced more in the kidneys than in the liver.

The third phase follows at 3 to 5 days, and is marked by complications of massive hepatic necrosis leading to fulminant hepatic failure with complications of coagulation defects, hypoglycemia, kidney failure, hepatic encephalopathy, cerebral edema, sepsis, multiple organ failure, and death.

If the third phase is survived, the hepatic necrosis runs its course, and liver and kidney function typically return to normal in a few weeks. The severity of paracetamol toxicity varies depending on the dose and whether appropriate treatment is received.

Reputation Comments on this post:

	An extreame over reaction, there is no reason at all for such a drastic reaction.
	it takes 4+grams of acetaminophen to be considered deadly in adults...swim understands harm reduction but this post is o...

[Boca Bitch]

^ What? Two Tylenol could never cause hepatotoxicity unless the individual has a sensitive liver, consumed alcohol, or other hepatotoxic drugs (like Kava, and benzos to a far lesser extent).

Tylenol PM contains diphenhydramine, a deliriant antihistamine. It's impossible that acetaminophen could cause any form of psychotropic effect... however diphenhydramine's ability to do so, is well documented. The thing that's bizarre is that it had an effect with only two pills being consumed... usually the threshold psychoactive dose for diphenhydramine is 150mgs. Two pills contains 50mgs... it's strange..

Perhaps upon the psychological withdrawal from cocaine, SWIMs body/brain was more susceptible to described events. Normally such vivid hallucinations would never occur from such a low dose of diphenhydramine.

[coelho]

Well... of course just a couple of pills of Tylenol should not kill anyone... but at the required doses for getting the deleriant effects of the diphenhydramine the ingested amounts of paracetamol starts to get harmful.

The following dosages of diphenhydramine were got at erowid.org. Each pill of Tylenol PM has 25mg of diphenhydramine and 500mg of paracetamol, so we can calcule the ingested doses of paracetamol:

Dose_______Diphenhydramine_____Pills______Paracetamol

Threshold_______10 mg__________0.4________200mg

Light__________25-150 mg_______1-6_______500mg-3g

Common______150-300 mg_______6-12________3-6g

Strong._______250-500 mg______10-20_______5-10g

Heavy________400-700 mg._____ 16-28_______8-14g

Originally Posted by Wikipedia;

The toxic dose of paracetamol is highly variable. In adults, single doses above 10 grams or 200 mg/kg of bodyweight, whichever is lower, have a reasonable likelihood of causing toxicity. Toxicity can also occur when multiple smaller doses within 24 hours exceeds these levels. (...)
In adults, a dose of 6 grams a day over the preceding 48 hours could potentially lead to toxicity (...)
In rare individuals, paracetamol toxicity can result from normal use. This may be due to individual ("idiosyncratic") differences in the expression and activity of certain enzymes in one of the metabolic pathways that handle paracetamol.

So, what can be considered a strong dose of diphenhydramine (500mg), or two common doses (300mg) in two days (48h), if taken as tlyenols could cause paracetamol toxicity. This doesnt mean death, of course, but there were already several people who died from paracetamol poisoning from using such pills, so one must be careful when trying to get high this way.