narcolepsy/seizure/depression

[allegro]

After having a sleep study 2 years ago I was put on 100 mg of provigil to combat day time sleepiness/narcolepsy.  Months later I was given Ambien to correct vast awakenings shown in the eeg. Ambien only kept me asleep for 1-2 hours and so I was eventually put on 15 - 30 mg of Restoril (per night).  After 2 years Provigil stopped working and an increased dosage of 200mg caused rage and no improvement of my day time wake state.  3 months ago my medication was changed by my sleep doctor to Adderall at 25mg which improved my attention and worked fabulously at keeping me awake.

6 months ago I went to a psychiatrist who put me on 30mg per day of lexapro after a severe episode of depression (taken at night).  At the time I was hopeful that the day time sleepiness and nightmares may be due to obvious depressive cycles thoughout the years.  Lexapro has continued to help a lot with my mood and initially the daytime sleepiness and nightmares (about 3 weeks - maybe psycological?).

Shortly afterward I was finding depression returning because of severe anxiety and work pressures.  My psychiatrist put me on 0.25mg of respirdol (at night) to alleviate negative thought patterns.  I had a slightly better sense of well being and the vivid nightmares were reeduced.

6 days after being put on the risperdal, however, I had a grand mal seizure at work whilst teaching.   I had taken 25mg of adderall that day.  The night before I had taken 15mg restoril, 30mg lexapro and 0.25mg risperdal.  MY stress level was extremely high that day with general feelings of being out of control and unable to keep up during the general time frame of a few weeks.

I have quit work for 3 months to lower my stress and reduced adderall to 15mg a day.  My GP and my sleep doctor have suggested Neurontin as a replacement to risperdal.  I am scared that I will lose those feelings of general well being and worried about the level of drugs I am taking.  I also feel like my brain is not focussed and that my memory is very bad.  As an educator I know the signs of ADD and I certainly fit the bill, (Hence I liked the sense of adderall keeping me focussed).  however now I am extremely forgetful and "foggy" with both long and shoret term memory.  

I am hopeing you may have some input on what may have caused the seizure, how my syptoms may relate to each other and whether I should change my medications.

Thanks for your help

[Roger Gould, M.D.]

You have asked the right question and I will give you a candid answer.   All of the drugs you are taking have a powerful effect on the cns, so any combination could have caused the seizure, and coming off some of them will have to be done carefully, because coming off can also cause seizures.

Neurontin, in this case, may be a good choice as a both a mood stabilizer and a seizure control medication.

If I were you, and would make myself less dependent on the magical pill combination and work closely with a psychotherapist to understand your stress, anxiety and depression response to the challenges in your life.   That will help you more than anything.  If you are hesistant, or can't afford a therapist, you can start your work inexpensively on my online therapy program at www.masteringstress.com.

[allegro]

Thank you for your help - I am familiar with your website and love it!  I have also been in intensive therapy for 6 years.  Q. I have an eeg coming up tomorrow, should I remain on all medication when I have it to see what my day to day state is like (i.e. should I take my adderall dosage that day), or should I try to go in un-medicated?