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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Phidippus on October 28, 2009, at 17:03:06
0. Happy for 4 years on Lithium, then started having mental lapses.
1. March 2008 - I was put on Lamictal and became depressed and psychotic(thought things were wrong with my body or that I was making things go wrong with my body by thinking about it). I was on Lithium at the same time.
2. September 2008 - I stopped Lamictal cold turkey and started experiencing uncomfortable euphorias and dreamy states. I started Vitamin D 50,000 IU weekly.
3. September 2008 - I developed chronic daily headaches. Headaches made me feel strange and lasted about 5 to 10 minutes.
4. December 2008 - I had euphoria, an out of body experience and was hospitalized for seizure after MRI.
5. December, 2008 - I experienced euphoria and uncontrolled laughter during stroboscopic EEG. After the EEG I became confused and was admitted to the ER for 'changed mental status'.
6. December 2008 - I experienced a sensation of 'bugs' crawling from one arm to the other and headache when I sat down to use the computer. I was admitted to the ER for panic over my symptom-Jackson's March?
7. December 2008 - I experienced 'the worst headache ever' and was admitted to the ER-I vomitted, had strange thoughts and was agitated.
8. January 2009 - Stopped Lithium and switched to Gabapentin and Luvox and experienced an improvement in psychiatric and neurologic symptoms (mainly headaches).
9. January 2009 - Stopped Gabapentin and Luvox because I developed a rash, switched to Ativan and added Concerta for attention.
8. February 2009 - Stopped medication for Ambulatory EEG. During ambulatory EEG I experienced headaches, dystonia, visual problems, strong olfactory hallucinations, euphoria and visual illusions.
8. In March of 2009 I started Ativan again then stopped it suddenly and experience a headache so intense I had the ideation it was a living organism trying to pull out of my skull.
9. In March 0f 2009 I start having 'inner voices' telling me to do things.
10. In March of 2009 my symptoms abate on a low dose of Trileptal and Abilify.
11. In May of 2009 I up my Trileptal to 1800 mg and start experiencing dissociative states, inner voices and my first auditory hallucination (of a female voice). I am still on Concerta.
12. In June of 2009, treatment strategy switches from bipolar to ADHD/OCD. I stop Trileptal and Concerta and begin treatment on Dexedrine, Luvox and Seroquel. During treatment on these medications I have severe dissociation, out of body experiences and strange sensations.
13. In July of 2009 I start treatment with Lyrica. My brain seems to run smoother and I am less dissociative, but I am depressed all the time.
14. In July of 2009 I take a large dinovo dose of Seroquel 300 mg, experience strong sensations of fear, have a rage fit, become euphoric and go into dystonia that affects only the right side of my body. Thinking about moving my right arm makes it flail. Trying to stop its movement makes me somnolent. Benedryl and a dose of Lyrica calms the movement.
15. August 2009 - I start Lithium again.
16. August 2009 - I stop Lyrica, what ensues is never ending anxiety and dread. I start Geodon, which helps calm me some but I am way out of wack.
17. October 2009 - I have a strong psychiatric reaction to Topemax, have vivid and strange thoughts/intense feelings of fear.
17. October 2009 - I switch from Luvox to Lexapro and experience an improvement in anxiety, dread and OCD.
18. October 2009 - I titrate off Lithium because my affect had become flat and all I seemed to do was ruminate without end. Once off it I enjoy the novel sensation of emotions and curiously a reduction in suicidal ruminations.
19. October 2009 - I start Keppra and the voices are gone(except for the OCD voice)! My whole system calms down. Headaches get under control.So, what the hell is wrong with my brain? Tell me your diagnosis.
EEG so far has been normal.
My current med regime, which seems to be working just fine: Dexedrine 45 mg, Geodon 80 mg, Keppra 750 mg, Lexapro 20 mg, Tramadol PRN, Gabitril PRN
Past diagnosis: ADHD, Bipolar, OCD, Schizoaffective, Depressed, Borderline, Temporal Lobe Epilepsy, Psychotic Major Depression.
Posted by Phillipa on October 28, 2009, at 18:59:30
In reply to Diagnose me...For fun., posted by Phidippus on October 28, 2009, at 17:03:06
What's you age? But you say your meds are working so is a diagnosis that important? Phillipa
Posted by g_g_g_unit on October 29, 2009, at 9:18:06
In reply to Diagnose me...For fun., posted by Phidippus on October 28, 2009, at 17:03:06
sorry i can't offer anything in the way of a diagnosis, but i'm just curious what the difference between "psychotic(thought things were wrong with my body or that I was making things go wrong with my body by thinking about it)" and OCD, particularly the last past of what you said, which follows the line of a lot of my OCD thinking- things like i "may go crazy and the more i think about it, the more it's likely to happen". i'm coming off Parnate and finding that at night these thoughts are becoming almost unbearable.
Posted by bleauberry on October 29, 2009, at 19:14:39
In reply to Diagnose me...For fun., posted by Phidippus on October 28, 2009, at 17:03:06
I sometimes share my frown on the terms we use in psychiatry to describe symptoms, for the very reason you demonstrated...they don't help much in fixing the problem or identifying the problem. It is a cozy way to feel some control by saying, "Oh I know what that is, it's such-n-such." But then what? Then you go on a drug to treat that such-n-such and get worse. Go figure. Helpful for some I know, but hell for others. Bottom line, not reliable and not duplicatable.
So what is wrong? Many things in your history description jumped out at me. It would take several pages and probably an hour to explain. Other people here are going to be upset with me for saying this because they think I'm obsessed with it. But I KNOW what neuroborreliosis looks looks like. (that's fancy for neuropsychiatric Lyme disease)
Just my two cents.
Unless someone here has a another disease in mind that demonstrates this patient's pattern equally or better than neuroLyme?
The Great Imitator. It mimics just about any and all psychiatric syndromes. In your descripion of history you demonstrated multiple yellow flags that are distinctly unique from anything else I am aware of, yet almost universally common to what I mentioned above. The telltale patterns and clusters are all there, the patterns and clusters not shared by any other explanation. They will appear random and mysterious to the untrained eye.
I am SO glad you have finally had success in stopping this trainwreck! Very cool. No telling if it is longterm or not, but I am hoping it is.
Anyway, your post is Diagnose me...For fun. Well, it aint fun, but for what it's worth, that is the diagnosis presented. It is actually quite classic actually, shared by thousands with either Syphilis (in the old days) or Lyme (these days).
This is the end of the thread.
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