Drug interaction with AWS

[Savannah Bolten]

I have a self diagnosis of AWS that I have experienced since I was young. I am 19 now, and starting when I was 17 and started taking antidepressants (citalopram 40mg) for depression my AWS symptoms became more pronounce and often. Recently, about a month ago I also started taking amitriptyline (75mg) for insomnia and the symptoms became much strong and more frequent. I feel as if I am growing or shrinking and objects warp in size almost every time I lay down and/or become sleepy. I told my doctor about this and he diagnose it as hypnagogia or sleep insured hallucinations brought on by an interaction with the drug. I was wondering if this has happened to anyone else and if the more intense symptoms ever go away. Thank you. 

[Kaci Harrison]

Yes these things do happen to me. My psychiatrist told me that there are many medications I should not take, especially certain antidepressants and sleeping pills. He prescribed me lamictal to help treat my anxiety and depression as well as Valium for panic attacks and it was like day and night, it worked much better for me.

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On Jul 28, 2017, at 7:01 PM, Savannah Bolten <sjbo...@gmail.com> wrote:

I have a self diagnosis of AWS that I have experienced since I was young. I am 19 now, and starting when I was 17 and started taking antidepressants (citalopram 40mg) for depression my AWS symptoms became more pronounce and often. Recently, about a month ago I also started taking amitriptyline (75mg) for insomnia and the symptoms became much strong and more frequent. I feel as if I am growing or shrinking and objects warp in size almost every time I lay down and/or become sleepy. I told my doctor about this and he diagnose it as hypnagogia or sleep insured hallucinations brought on by an interaction with the drug. I was wondering if this has happened to anyone else and if the more intense symptoms ever go away. Thank you. 

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[Mike Coulson]

That’s interesting. It’s been a long while since my AIWS episodes went away (20 plus years) . I still get ‘tremors’ where I feel what would be onset symptoms but they don’t develop into actual AIWS even if I ‘dive into’ them. I think people who have experienced this know what I mean. You can do things to pull away from an attack sometimes. 

I take anti-depressants now (escitalopram and clonazepam)  and they have never phased with AIWS onset. It actually feels like it’s quite the opposite - like the calming from them. 

My strongest AIWS feelings would always occur as I was drifting off to sleep or would wake me with great intensity just after I feel asleep. So the whole insomnia thought makes sense. Personally, my reaction to the sleep induced hallucinations diagnosis is that it seems like when I experienced AIWS the most. My worst moments with it were when I felt so tired that all I wanted to do was sleep but I knew it was coming on and was terrified to pass into any form of unconsciousness. 

Mike

On Jul 28, 2017, at 8:01 PM, Savannah Bolten <sjbo...@gmail.com> wrote:

I have a self diagnosis of AWS that I have experienced since I was young. I am 19 now, and starting when I was 17 and started taking antidepressants (citalopram 40mg) for depression my AWS symptoms became more pronounce and often. Recently, about a month ago I also started taking amitriptyline (75mg) for insomnia and the symptoms became much strong and more frequent. I feel as if I am growing or shrinking and objects warp in size almost every time I lay down and/or become sleepy. I told my doctor about this and he diagnose it as hypnagogia or sleep insured hallucinations brought on by an interaction with the drug. I was wondering if this has happened to anyone else and if the more intense symptoms ever go away. Thank you. 

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[Savannah Bolten]

Thank you Kaci and Mike for responding. The symptoms I experience with AWS are not extremely negative, only mildly annoying or bothersome. For example,  when I become sleepy in public and can feel the "tremors" as Mike described. So far I have been able to shake myself out of the "tremors" or calm my anxiety when they do happen, so they have not largely affected me negatively. Hopefully this continues and I just get use to the increased occurrences. I will however, look into lamictal if I ever feel the need to change my prescription. Thank you

[Judy Elliott]

Hi Savannah

Just seen your message on my emails.  I notice that you mention becoming sleepy in public.  I was just wondering if you share my experience of feeling very sleepy or else falling asleep after meals.  I have AIWS permanently, but I also have various other symptoms including sleepiness, which is probably postprandial reactive hypoglycaemia, though postprandial somnolence may also be relevant.  It involves a sudden rise, then fall in blood sugar and the sleepiness is often followed by a kind of rebound insomnia.  I can help the insomnia by eating some porridge oats with hot lactose-free milk and a teaspoonful of sugar. 

I'm dealing with the sleepiness by eating smaller meals, in a dish or on a portion plate and making sure what I eat and drink is not too high glycaemic.  I am generally quite slim, but there was a year when I piled on some weight and had to lose 2 stone.  It is important for me now to maintain a good weight, as a consultant has told me the falling asleep can sometimes lead on to diabetes.  You may only be talking about normal sleepiness, but I thought I'd check whether you get sleepy after eating or drinking.

Judy

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[Savannah Bolten]

Hi Judy,

I do not get sleepy after meals. I just find myself dozing off sometimes which is often followed by AWS symptoms. If I may ask, why lactose-free? Does lactose have anything to do with insomnia and/or AWS? Asking because I have had lactose intolerance since I was born, but as anyone who if lactose intolerant knows, the symptoms come and go with time and grow or lessen in intensity. My tolerance has recently sharply declines and I wonder if that has anything to do with my medication and/or increase in AWS symptoms. 

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[Judy Elliott]

It's interesting that we both have lactose intolerance.  Do you have problems with grains or gluten too?  My son and I are both on a Paleo style of diet.  We must have an ancestry that is quite hunter-gatherer, as we both and have pretty bad problems with grains, milk and seed oils.  I'm not well adjusted to Neolithic foods and find them difficult to digest.  For me, the symptoms included: migraine, IBS, fibromyalgia, brain fog, fatigue, vertigo and arthritis.  My son had a degree of brain fog which caused him some learning difficulties and nowadays, he gets skin problems such as psoriasis if he has too much cheese.  Gluten and corn are the worst for us, but there are more minor problems with lactose - mostly fibromyalgia.  

My migraine was entirely due to food intolerance, but for me the AIWS is permanent and doesn't seem to improve whatever I try.  My doctor and the consultant at the hospital are suggesting there may be a blockage caused by cholesterol and that this could be the reason for the permanent AIWS.  I could do with having a scan of the blood vessels leading to the visual cortex, because it might be possible to have a stent put in.  I've been asked to lose another half a stone, but seem to be maintaining at the same weight (about 10 stone 5) rather than losing weight.  I did get down to 9 stone 12 last year, but didn't stay at that weight for long.  Probably too fond of crisps and chocolate!

I think medication can be involved with this.  I had some tablets which caused me to put on weight and which disrupted my blood sugar, so think they might have been part of the problem.  Sounds like your AIWS may be linked to medication too.

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[Savannah Bolten]

Hi again Judy,

Wow I know you said it must be the crisps and chocolate but I would never be able to stay on a paleo diet so I give you a lot of credit. I'm guessing that that lactose intolerance is just a coincidence. Strange that you mention cholesterol however, my family does have a history of high cholesterol. And in my latest blood test I did have higher than normal levels of it even though I am within "normal" weight range. Could you explain more on how your doctors linked the AIWS and cholesterol. And yes I agree the medication must somehow cause the AIWS to occur or worsen the symptoms I wonder why that is....?

Thank you for sharing so much and congrats on losing  9 stones. Im American so I don't quite know what that means in pounds but congrats either way and I hope you continue to achieve your goal of living heartier. I wish I was as strong willed as you, I need to cut out sugar and are finding it hard to do so, I have a weak spot for Dr. Pepper haha. 

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[Mike Coulson]

I’m a dual national so I’ll convert the measurement.  9 stone would be 126 lbs. That’s pretty much her weight, not her weight loss. Two nations divided by a common language. 

If I can flavor the discussion with a little that both of you wrote - healthy diets and healthy minds about food begin with the thought that total abstinence from certain foods Ia th path to self-dislike and a terrible self image. Sure, there’s a lot of foods that we shouldn’t eat much of in general and many foods that cause issues for specific people, but let’s try to keep ourselves as free as possible. 

Some things I’ve read in these discussions seem like a pursuit of what you are doing wrong. That doesn’t seem like a good way to think about yourself, or a path to a bette life, even if it seems like that’s what a medical professional is saying. 

AIWS has been around far longer that the current food issues and its causes at far more profound than a bad diet. That said, a poor diet isn’t helpful to anyone. So reasonable eating is always good. 

Take care,

Mike

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[Judy Elliott]

Hi Savannah and Mike

Meant to give an answer to these postings ages ago, but I unfortunately had some bad news about my brother and had to go away to Brussels for his funeral.  It's been a bit of a mixture really - very sad funeral, but we also managed to have a bit of a holiday while we were there.  My brother, like my father, had early onset Alzheimer's, so neurological problems seem to be quite common in my family.

Forgot about the difference with UK weight measurements.  It's 14 lbs to a stone, so that means my current weight of 10 stone 4 lbs is the same as 144 lbs.  The weight I lost was approximately 2 stone, so 28 lbs.

Savannah, you asked about how there might be a link between AIWS and cholesterol. Well my understanding of AIWS is that it's caused by reduced blood flow and so reduced oxygen supply to areas of the brain which deal with processing visuo-spatial information. The main areas are Brodman's areas 39 and 40 which appear to deal with the long-term coding of spatial relationships, then there are Brodman's areas 18 and 19 which are involved with size processing and Brodman's area 7 which is activated when reaching for targets. In migraine, reduced blood flow and oxygen supply occurs when there is cortical spreading depression - a wave of depolarisation in the brain and migraine also tends to constrict and expand blood vessels. This is probably what was happening when I had intermittent attacks of AIWS.

For many years now, my AIWS has become permanent, so I have to assume that there are certain blood vessels which have either been considerably constricted, or else have become blocked in some way. Cholesterol is one possible contender for blocking blood vessels, though it could just be the wear and tear from having a lot of migraine attacks which is at the root of the problem.

My migraines proved to be mainly down to problems with grains - possibly including gluten sensitivity.  Effects from gluten are another interesting factor, as migraine has been found to be associated with gluten in gluten sensitive people, in that it can produce cerebral calcification. Having said that, my MRI scan was completely normal, so it seems to be more a matter of some interruption in the blood supply, rather than any visible damage in the brain.

For me cutting down grains so I just eat oats and wild rice has been the way to avoid migraine attacks and I hardly ever get migraine nowadays.  However the AIWS remains a mystery. I'm trying to do something about the raised cholesterol, as it's the only thing which is showing up on blood tests. Problem is there are so few papers on AIWS that it doesn't seem that much is known about it. I have asked for a SPECT scan in the past, as this concentrates more on blood flow, but apparently it's too expensive. Having a look at what is happening with me might be worthwhile for understanding AIWS, as I get it all the time, so there's no problem with trying to provoke it.

My own AIWS has come from chronic migraine problems, but some AIWS is down to other factors, such as inflammation from the Epstein Barr Virus and cerebral infarction - a form of stroke.

Maybe that helps to clarify things a bit, but I'm afraid I'm not making any progress in getting rid of the dratted condition.

Judy

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