"Getting tilted" is a term that is use mainly in a competitive environment that requires concentration (video games, poker, chess, etc.). What it means is to suffer a setback, get frustrated about it, and have it go to your head. When you go tilt, you're not thinking straight and are more prone to making mistakes. That's the best way I can describe it. Hope that clarifies it.

Like Susan said, and most of us over 35 can vouch for, we used to tilt pinball machines to prevent the ball from getting away between or behind the flippers. Unfortunately, there was an anti-tilt sensor so you had to develop a sense of how much you can abuse each machine before getting locked out. However, I doubt that this is the context for this conversation. Is it possible that this game involves horsemen dueling with lances? I think if you were thrown off your horse that would be considered getting tilted. Otherwise, I think it's just losing your cool and screaming at the computer screen!

In the context of an arcade game, it means the game stops, usually because the player shook the machine too hard. See this definition: http://www.urbandictionary.com/define.php?term=tilt

This person was playing video games, so he is asking if he gets tilted for playing a long period of time, in this context does it means something like "getting dizzy" or is it always has a drugs/drinks connotation?

Ah, I had forgotten what happens when you look up "tilt" on Google. :D