Can you ease my neurological freak-out?
May 27, 2015 7:18 AM   Subscribe

I've had some very upsetting neurological symptoms last night possibly related to a medication change, and I'd like to get some input from the hive mind while I wait to talk to my doctor. Lengthy snowflake details inside...

As I've noted here in various answers in the past, I'm bipolar. Although my meds have varied over the years, I've been on a pretty stable cocktail for the past several years of Lamictal, Buspar, and Welbutrin. Recently, I've been having some fairly serious depression symptoms, so much so that I made an urgent appointment with my psychiatrist to talk to her about it.

It's worth noting that along with the emotional aspects, I've been having various other symptoms that mostly seemed sub-migraine. I've never had major migraine issues, but have had enough over the years to know the aura around them. I've always had a little visual snow -- which I only realized recently isn't something everyone has -- but it's gotten worse recently. I've had on and off tinnitus in my right ear, and occasional bouts of mild depersonalization.

I discussed this with my doctor when I saw her, and she said it may all be related to the increasing chemical imbalance. She doubled my dosage of Welbutrin from 150, near the minimum therpeutic does, to 300. That was roughly a week ago.

Nothing much seemed to change until yesterday. Around mid-afternoon I noticed my visual snow getting worse, to where it was very noticable against both bright and dark objects. I began to feel increasingly depersonalized. Then there began a three-hour stretch, from about 5 to 8, which was very worrying for me. I started having vertigo. On the train home, I kept nodding off even though I wasn't really tired. I had a minor panic attack, which was probably related to the other increasing symptoms. I noticed that the visual snow had progressed to the point where in addition to the usual static I was seeing small bursts of light. When I got off the train, I began to feel as though the earth was falling away from me and having to pay attention to my walk. I got really worried when I got into my car and starting feeling like it wasn't safe for me to be driving; I even had difficulty turning into a couple busy streets because my perception of time and distance seemed totally screwed; I had to wait for large enough holes in traffic to feel safe pulling out, and I'm usually a very confident driver, I've done track racing in the past and have lots of comfort with my car and my personal abilities.

When I got home from work, I began having short-term amnesia. I lost my phone twice in the space of about 15 minutes. I forgot I let our dog out, then forgot I let him back in. When my wife got home from picking our kid up from day care, she noticed me distinctly out of sorts, and as I was telling her about it I began to have difficulty keeping a coherent train of thought long enough to form full sentences. She said at one point I told her that "I almost fell up the stairs", and I had to pay close attention to what she and my daughter were saying to follow it.

I began to debate out loud whether or not I should call my doctor, which in retrospect seems very silly. I was demonstrating both mental and physical symptoms and even feeling unsafe with basic physical activities like walking. The wife talked some sense in to me, and I called my doctor and left a message with the answering service asking for a call back today so I can talk to her.

After about three hours it passed, and though I felt off for the rest of the night the acute symptoms left; it actually felt almost as though a strange veil had lifted from my mind. This morning, I'm still not right -- I'm still feeling vaguely depersonalized, and having trouble concentrating, but the amnesia and cognitive and physical difficulties have passed. Now I'm waiting for the call from my doctor, but I'm very concerned about what's happening. I was doing reading about various neurological symptoms on the internet -- a bad idea, I know -- and a lot of what happened seemed to match the description of various minor seizures, but I'm no doctor. It's all upsetting though, and it's gnawing at me.

While I wait to talk to the doc, can anyone tell me if they've ever had anything like this without any real history of it? Was it related in particular to an increase in psychotropic medication? YANMD, but does this sound like something of serious concern that may end up with me on an EEG and "Congratulations, you're epileptic!", or is it more likely to be something transient?

Basically, anything that can be given to either ease my mind a little, or brace me for what might be coming up, would be appreciated.

Sorry for the length of this, but I wanted to be thorough -- and help get it all straight in my head for when I talk to the doctor. Thanks.
posted by jammer to Health & Fitness (12 answers total)
Yes. A doctor gave me antidepressants in college. What a crazy, scary day! I was so incoherent I couldn't understand basic words like my own name, "no", "yes". A relative taking the same medication thought the devil was speaking to him and he'd never had any hallucinations before, nor did he believe the devil existed.
It all stopped once we were off the medication.

So, yes, our bodies can have weird, unexpected side-effects to any drug. No big surprise if it happens with a psychiatric drug.
posted by Neekee at 7:40 AM on May 27, 2015

Best answer: My best guess is that you were having a lot of anxiety and possibly a prolonged panic attack. This is definitely a side effect of Wellbutrin and it is a very serious one. I hope that it does not sound like I am dismissing your symptoms. In my experience, these kinds of diverse neurological seeming symptoms are typically anxiety, not neurological. There's a lot of overlap, of course, but my guess is that you do not have epilepsy.
posted by internet fraud detective squad, station number 9 at 7:57 AM on May 27, 2015

Best answer: It sounds like migraine aura.
posted by Don Pepino at 8:15 AM on May 27, 2015 [1 favorite]

Best answer: As someone who has both migraines and panic attacks-- yeah, that all sounds really familiar. It actually sounds very much like the first (and worst) migraine I ever had. Did you have any nausea?
posted by palmcorder_yajna at 8:50 AM on May 27, 2015

Yes, I have nightmares like this occasionally. As in dreaming and asleep in bed.
posted by aniola at 9:22 AM on May 27, 2015

Best answer: Standard "not a doctor..." disclaimer, but that sounds 100% migraine to me, mixed with panic over the symptoms. All the visual stuff is classic migraine. You don't need to have a bad headache or nausea for it to be a migraine...I have a friend who gets visual auras only, no headache (though he will generally barf if he doesn't take an ibuprofen at the onset of visual symptoms). Seeing doctors, and letting the doc who prescribed the meds to you know what is going on, is of paramount importance...even if it isn't seizures or something "scarier" than migraine, it's not something you should have to put up with while getting other stuff treated.
posted by aecorwin at 9:25 AM on May 27, 2015

Best answer: I get visual migraines which are a lot like you describe (visual noise is a great way to put it), which bring on terrible panic attacks. The visual weirdness/tiredness you describe begins, and then I become anxious and hyper-focused on it, which affects my memory and thinking, and eventually I can't tell what is migraine and what is anxiety. It's a real good time! I'm sorry you experienced this. It's very scary every time it happens - I think you should tell your doctor for sure, and see what they say. It could be 100% something else, naturally, and they will know what questions to ask you to get to the bottom of it.

If you get a vague answer like "it sounds like a migraine and while it's unpleasant, very common and nothing to worry about," I have had a lot of success asking my doctor "when SHOULD I worry?" instead of being told which symptoms aren't problematic. I stepped through all of the things I feared I was experiencing and panicking over - and they gave me clear indicators of those things (i.e. real stroke symptoms, detached retina symptoms) so that I could use that to help calm the anxiety that having a migraine aura can bring on. Then, I have a checklist I go through when a migraine starts. Can I stick my tongue out? Can I balance on one foot? Can I recite a tongue twister? Etc. Etc. These things both help focus the anxiety and also keep me from spiraling out of control. And Ativan. Once it starts, it's time to take an ativan and sleep it off, for me.

Hang in there, I'm sorry you experienced that!
posted by pazazygeek at 9:48 AM on May 27, 2015 [7 favorites]

pazazygeek, what a great idea. I'm going to ask that question next time I'm at the doctor because it is genius. (You don't necessarily need to automatically freak if one day you can't recite a tongue twister. With some of mine I start to have trouble reading/understanding speech/talking fluently, some not. And a few times I've had full on aphasia--no language left at all. Luckily, knock wood, that part of the thrillride doesn't last long.)
posted by Don Pepino at 10:15 AM on May 27, 2015 [2 favorites]

Response by poster: Thanks for the feedback, guys. I've had panic attacks, and I'm on buspirone daily for anxiety, and have taken ativan in the past, but I'd never had anything nearly this bad. It's "good" to know that this and/or migraines could well explain what's going on.

I spoke to my doctor, who asked me to cut back to the original dose of Wellbutrin for a few days, then call her and let her know how I'm doing (or, of course, call immediately if I have any problems). It's not going to help the depression, but not having my brain explode is more important, I guess.

Then I get to go through the awesome fun of trying to adjust my cocktail without upping the Wellbutrin, or find a new antidepressant, again. Whee! Oh well, so it goes. I'm going to go back to the original dose for now, and just get myself to an ER if it happens again, then tackle the rest.

Thanks again for the support. The "it sounds like a panic attack" didn't remotely feel like it was dismissing my symptoms, it was precisely the sort of thing I was hoping to hear.
posted by jammer at 10:23 AM on May 27, 2015 [2 favorites]

Very similar things happened to me when I had my Wellbutrin dose doubled from 150 to 300. I stopped taking Wellbutrin after that. My doctor at the time didn't have any suggestion as to what happened/caused it, but when I explained my symptoms to my current doctor she agreed with the likelihood of minor absence-type seizures, which triggered a major panic attack.
posted by elsietheeel at 3:36 PM on May 27, 2015

Sounds similar to my symptoms during a complicated migraine, very seizure-like.
posted by tamitang at 7:56 PM on May 27, 2015

My doctor let me cut the tablets in half. If you need to step up again, ask if you can step to 225 before going to 300. I had less severe initial side effects from Wellbutrin, but it was definitely the worst I have ever experienced for any crazy med. Mine took two weeks to resolve. If it seems to be helping the mood and the symptoms aren't dangerous you might want to persevere. Wellbutrin was very effective for me.
posted by crazycanuck at 5:42 AM on May 29, 2015

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