hollywoodfreaks Posted September 29, 2008 Share Posted September 29, 2008 I have had this problem with falling and hurting myself over the past year. First it started when I was playing tennis. My legs locked up and I fell to the ground. The second time it happened my head absorbed some of the blow. Not fun. As it has continued to happen I became increasingly paranoid about it happening, which of course made it more likely that I would fall. It has happened 3 times in the past few days. First, I was trying to get onto a high chair in the cosmetics area of a department store and my legs started kicking helplessly and I crashed forward onto the floor, twisting up my back and spine. That was kind of embarrassing. Then the next day I was walking through a corn maze (admittedly on quite bumpy ground) and was descending some stairs from one of the bridges when I lost control and plunged forward into the dirt. Today, my husband and I were returning from grocery stop when at the top of the stairs I lost control AGAIN, falling to the floor and scraping my knees, elbows and shoulders. So--I'm going to get a sleep study done tomorrow to see if I have narcolepsy. I went to a neurologist and that's what he suspects. He thinks my falling episodes are cataplexy attacks. He also asked me to reduce my Lamictal dose. When I went to my pdoc he was rather dismissive about the whole thing and said Lamictal couldn't possibly be involved. Nevertheless, he sent me to get my Lamictal levels tested which I need to follow up on. This is becoming very distressing not only because of the injuries but the fact I am leaving for Japan in about a week and how in the hell am I going to be able to function with this condition? Since my attacks seemed to be triggered by anxiety I guess I could just numb myself out with Xanax to see if that helps the episodes. Of course the tradeoff with that would be me feeling super tired all day and possibly depressed as well (which seems to coincide with taking Xanax). Does anyone have any insight as to wtf is going on with me? Is there a chance that my meds could be involved? Any help would be EXTREMELY appreciated. Link to comment Share on other sites More sharing options...
Silver Posted September 29, 2008 Share Posted September 29, 2008 Hi - I just checked quickly in Medline and Stockley's, and I don't see anything associating lamotrigine and cataplexy or hyperekplexia (although lamotrigine has been used to treat hyperekplexia and startle-induced seizures in a couple of case reports.) This does not at all mean that you don't have cataplexy/narcolepsy or something else neurologically interesting going on, or some lamotrigine weirdness... I'll keep looking, but probably will not have time to really delve into this til tomorrow evening. Did you talk to the neurologist about possibly using low-dose daily clonazepam instead of alprazolam? Maybe low-grade tired would be preferable to super tired. Not optimal, I know. I hope you have your polysomnogram results back before you go to Japan, as neuro may be able to get some treatment up and rolling before then (and it may be pretty darn quick in terms of effect.) Link to comment Share on other sites More sharing options...
AirMarshall Posted September 29, 2008 Share Posted September 29, 2008 No. Lamictal does not cause cataplexy. However it often causes uncoordination of movement and also Ataxia. Wikipedia comments: "most antiepileptic drugs have cerebellar ataxia as a possible adverse effect" There are about five common causes of ataxia. I recommend that you compare the symptoms of Cerebellar Ataxia to those of Cataplexy, which is usually associated with Narcolepsy. Of particular interest is whether you have had any excessive sleep problems. It makes sense to lower or discontinue your Lamictal to see if your symptoms decrease. Good luck. Let us know what you find. a.m. Link to comment Share on other sites More sharing options...
hollywoodfreaks Posted September 30, 2008 Author Share Posted September 30, 2008 Unfortunately I won't get the results of my sleep study for two weeks, which now that I think about it is okay, because I can't really see myself starting a serious med like Xyrem or Ritalin right before I go on vacation. I think I'll just try the benzo route for my vacation and hope that it helps. Also, about the Lamictal--my neuro suggested going down to 200mg--what would be a reasonable schedule to get it down to that level from 400mg? Link to comment Share on other sites More sharing options...
Silver Posted September 30, 2008 Share Posted September 30, 2008 Um, your neurologist should have suggested a taper-down schedule. In general, one tapers down at the same schedule one titrates up. I would call the neuro and ask her/him specifically for a taper schedule, as neurologic weirdness is in your differential diagnosis. I'm honestly not trying to be coy here, I just think that withdrawal seizures aren't going to make your situation any better. This is well within the "OK things to call about for a clarification" range. Link to comment Share on other sites More sharing options...
hollywoodfreaks Posted October 1, 2008 Author Share Posted October 1, 2008 Oh--well, he wanted me to do it through my psychiatrist, but as I said my pdoc was not interested. So I'll have to do it through the neurologist. I'm planning on visiting him in person if I possibly can, so I'll talk to him about it then. Link to comment Share on other sites More sharing options...
Silver Posted October 1, 2008 Share Posted October 1, 2008 Good plan. And if he's just not going to be available within a reasonable timeframe, then, really, that's a reasonable thing to call about. Have a good trip! If I find anything else on the cataplexy/lamotrigine, I'll post it here. Nothing yet. Link to comment Share on other sites More sharing options...
hollywoodfreaks Posted October 27, 2008 Author Share Posted October 27, 2008 I tapered down to 300mg of Lamictal. Not sure if it has made any difference. At my last pdoc appt, he mentioned something about Wellbutrin in relation to the problem I am having. Why I didn't immediately seize on that as something to try reducing the dose of, I don't know. It would make sense since I just recently upped the dose to 450mg and it's the worst it's ever been. Still haven't gotten the sleep study results, but that's my own fault. I need to make an appt with the neuro to discuss the results. Link to comment Share on other sites More sharing options...
Silver Posted October 27, 2008 Share Posted October 27, 2008 Yes, the recently increased dose of Wellbutrin would be relevant. Worth a followup tomorrow. Especially because the lower dose of Lamictal (the anti-epileptic drug), combined with the higher dose of Wellbutrin (famous for inducing seizures at higher doses), could be kind of a double-whammy. I hope you had a good vacation. I've always wanted to visit Japan. Maybe in a few years... Link to comment Share on other sites More sharing options...
hollywoodfreaks Posted October 27, 2008 Author Share Posted October 27, 2008 My vacation was excellent. The Xanax really helped, despite having to climb and descend endless flights of stairs and escalators. The only time I fell was on a day that I didn't take any Xanax. I tried to get on the monorail but backed off because I got scared. I was yelling at my husband to help me. As the doors were about to close, I tried to scramble on but I ended up falling instead. Some of our luggage was still in the train, but at least my husband got out in time to comfort me. Our wait for them to get our luggage back to us was less than 30 minutes! Impressive. Yeah, I definitely recommend going when you get the chance. It's so fun to learn about the cultural quirks, like there being smoking and non smoking sections at McDonald's and KFC...lol. They are much more relaxed about smoking than we are. There's like two cigarette vending machines on every block. I don't know how anyone could quit smoking there. And there are many spectacular temples to visit, like you might expect. And the insanity that is Toyko. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.