The term for what happens when high doses of mind-altering substances meet latent mental illness, although in certain cases no preexisting condition is required. Drugs have a tendency to aggravate whatever problems may already exist among your neurons, and cause a psychotic episode. These events are usually characterized by the subject going completely out of their gourd.

Here's a little snippet from the DXM FAQ( on what to do if you're required to deal with someone in this condition.

6.12.17 - Psychotic Breaks

This section is probably of no use to you if you're the one experiencing the psychotic break, and is primarily intended for trip-sitters. First verify that the tripper is actually out of his gourd and not just playing games (incidentally, this is a good reason to use a "safeword" when tripping; when the safeword is spoken, take everything seriously until further notice). Delusions on DXM, especially upper plateaus, are common and not usually something to worry about since people aren't usually motivated to act upon them.

If you've got a real problem on your hands, call the hospital and explain the situation. Again, since DXM isn't a commonly known drug, you can tell them it's similar to ketamine and PCP (an oversimplification, I know). Be very careful in trying to restrain the tripper, since she or he may perceive this as a threat, and will probably be mostly immune to pain. Unless you can safely restrain someone (and unless you've had training in this sort of thing, you probably can't), the tripper, like a cornered animal, could beat the living shit out of you without thinking twice.

Instead of restraint, try talking him or her down. Be calm, soothing, and repeatedly remind the tripper that they have taken a drug which has critically impaired their perceptions. Remind them of who they are and how they got here, and that the experience will end.
Portions of this node from

It should be noted that a psychotic break can happen with any psychedelic given the wrong circumstances and individual, and although rare, is a serious problem for all involved. Since you are not in control of your mind, it is possible and probable to commit acts that you would normally not even consider. If one wants to know what a psychotic break is like, I can relate my experience.

A psychotic break is not something most people remember. You will probably be astounded if and when you come to and you're told what you were doing. In my case, I took a quarter-ounce of psilocybe mushrooms and in about a half hour I had a screaming-like-a-banshee psychosis in which I repeatedly threatened to murder the person I was tripping with for hours on end, just like in the movies. I had to be physically restrained, and after a while, I simply lapsed into a thought loop in which I believed I was unable to escape a circular thought pattern and that I would be stuck in that hell for all eternity. I screamed for hours on end; the experienced trip sitter, someone who has tripped hundreds of times in his life, could do nothing to console me. My vocal output, when not primal screams, was a random stream of half-sentences which contained heavy use of the words "fuck" and "kill". What little I consciously remember doing in that state had nothing to do with what I was actually doing. I pissed myself at one point, likely in terror. Perhaps most psychotic breaks don't involve homicidal ideation, but I can assure you that it happens and that mine did.

If you are going to be tripping, don't assume that a psychotic break can't happen to you or whoever you're tripping with. It can, especially if you have underlying emotional issues, and is an urgent problem if it occurs. Keep in mind: if precautions are not taken to deal with someone having one, the worst case scenario is a very bad scenario indeed. At the very least, keep anything that someone could easily hurt someone with away from those tripping.

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