Misc Coild this be from sedatives? Or my epilepsy? Or something else entirely)

[ChemicallyEnhanced]

I am a on lot of downers, Moderate-high doses of: Sertraline, Quetiapine, Tramadol, Bisoprolol, Naproxen, Trazodone, Chlorpromazine, Cyclizine, Diphenhydramine, Bromazepam. That probably sounds more than is. The bisoprolol and the Naproxen I just started two weeks ago.

I also have epilepsy and the essential tremor an at times .

My symptoms have gotten slightly worse over the 10ish days I have had them. my symptoms are: [according to people around me, I barely even notice myself]
1) Terrible short term, memory; I suddenly forget what I was talking about or have to ask the same person the same question over an over.
2) Again, I don't notice this myself but by family all tell me that I'm constantly slurring and talking in slow motion It's very noticeable, my dad openly mocks me by doing exaggerated impressions of me (like the kind of thing a 7 year old thinks is funny)
3) I tend to tumble a little and a hard time walking "properly" (I guess what would medically be called an "abnormal gait"
4) When I;m typing I mistype about 1/3 of words/ This is NOT normal for me. Sometimes I'll type something and then go back and I can't figure out what I meant to write

I know ya'll aren't doctors but anyone have an other ideas or theories?

 

[Chris42393]

I have epilepsy (though pretty 100% much controlled now), but that same stuff happened to me all the time. Especially 1, 2, & 4. Sound like the seizures started in the Temporal Lobe region. As that region as to do with memory. (I have TL epilepsy)

If I remember correctly, you said you're seizures aren't very well controlled? I think this might be because of that.

Did you talk to your doctor about Vimpat?

EDIT: Since I just saw Jekyl's post. GET OFF TRAMADOL. (completely missed that drug) That is one of the last drugs you want to be on with epilepsy.

 

[Jekyl Anhydride]

Are these from the same doctor? Something you might want to bring up is mixing Tramadol + Sertraline can cause Serotonin syndrome. Mixing Quetiapine + Trazodone can cause Long QT syndrome.

Also the Tramadol can lower seizure threshold & it's metabolism to active O-DSMT is reduced by the inhibition of CYP2D6, which is from the Chlorpromazine & Sertraline, making the drug far less effective.

On another note, the Quetiapine, Trazodone, Chlorpromazine, Diphenhydramine, Bromazepam, Cyclizine & Tramadol all cause sedation with varying degrees and cause synergism between each other to amplify drowsiness.
This might be at the very least, part of the problem.

The impaired gate could be from Extrapyramidal side effects of the Chlorpromazine, exacerbated by one or more of the others. Postural hypotension/dizziness is also indicated with chlorpromazine, quetiapine & trazodone.

The anticholenergic symptoms are going to be high also from the trazodone, cyclizine, chlorpromazine & diphenhydramine, which can cause: dry mouth, constipation, urinary retention, dilated pupils, blurred vision, increased heart rate, and decreased sweating

Regarding a lowered seizure threshold:

the neurotoxicity of tramadol commonly manifests as generalized tonic clonic seizures and was more common in subjects concomitantly consuming anti-psychotics (Chlorpromazine), or anti-depressants (sertraline)- pubmed

chlorpromazine is among other antipsychotics that have a relatively high seizurogenic potential ~nih.gov/pubmed/

and just one part of the sedation:

Chlorpromazine can increase the depressant action of central nervous system depressants- source

It's nearly impossible to determine all of the possible interactions, of all these meds mixed together, but it does seem to be a case of excessive polypharmacy. Discussing ways to reduce your intake or cessation of one or more of the meds with your doctor might be prudent.

There's honestly so much going on between all of them I will have to resume this later. Maybe consulting your pharmacist would be a good idea as well, write down all the amounts and visit vs calling or go to where you fill them.

 

[ChemicallyEnhanced]

All meds from the same doctor apart from Bisoprolol And Bromazsepam.
There's nothing I'd want to cut out really.

I think maybe it's a complication of epilepsy and also of taking too many sedatives. Does that sound about right?

 

[Chris42393]

All meds from the same doctor apart from Bisoprolol And Bromazsepam.
There's nothing I'd want to cut out really.

I think maybe it's a complication of epilepsy and also of taking too many sedatives. Does that sound about right?

I understand not wanting to cut out certain medications (Ie. tramadol), but you can always take something else in its place. With epilepsy, I am ALWAYS looking at medications that can cause seizures or the lower seizure threshold (or even interact with my seizure medication). This medical condition isnt a joke and it can kill you very easily, im sure you.

I think its more of the epilepsy causing the problems. But thats just my opinion (and from having personal experience)

 

[Wilson Wilson]

If you have epilepsy you really should not be on tramadol. It is certainly contributing to your existing problems as it literally reduces the seizure threshold.

 

[ChemicallyEnhanced]

Are these from the same doctor? Something you might want to bring up is mixing Tramadol + Sertraline can cause Serotonin syndrome. Mixing Quetiapine + Trazodone can cause Long QT syndrome.

Also the Tramadol can lower seizure threshold & it's metabolism to active O-DSMT is reduced by the inhibition of CYP2D6, which is from the Chlorpromazine & Sertraline, making the drug far less effective.

On another note, the Quetiapine, Trazodone, Chlorpromazine, Diphenhydramine, Bromazepam, Cyclizine & Tramadol all cause sedation with varying degrees and cause synergism between each other to amplify drowsiness.
This might be at the very least, part of the problem.

The impaired gate could be from Extrapyramidal side effects of the Chlorpromazine, exacerbated by one or more of the others. Postural hypotension/dizziness is also indicated with chlorpromazine, quetiapine & trazodone.

The anticholenergic symptoms are going to be high also from the trazodone, cyclizine, chlorpromazine & diphenhydramine, which can cause: dry mouth, constipation, urinary retention, dilated pupils, blurred vision, increased heart rate, and decreased sweating

Regarding a lowered seizure threshold:


and just one part of the sedation:


It's nearly impossible to determine all of the possible interactions, of all these meds mixed together, but it does seem to be a case of excessive polypharmacy. Discussing ways to reduce your intake or cessation of one or more of the meds with your doctor might be prudent.

There's honestly so much going on between all of them I will have to resume this later. Maybe consulting your pharmacist would be a good idea as well, write down all the amounts and visit vs calling or go to where you fill them.

Damn, I'd completely forgotten this. I very loosely remember it now.
Because of this post (and others) I am definitely asking my doctor to switch to Dihydrocodeine, I was considering it anyway.

 

[Wilson Wilson]

Dihydrocodeine is better than tramadol anyway, both recreationally and for actual pain. I asked to be switched from tramadol to DHC myself due to the seizure risk and because DHC is just better in every way.

 

[ChemicallyEnhanced]

I'm actually excited to see my GP now! Even though I made the appointment several days ago and he apparently could not see me before July 1st. I told the receptionist "Great! I'll either be better - or dead"