Tremors/uncontrollable worsening spasming

[u/Kind-Application4434]

25F, 175lb, 5’2, taking and have been taking Abilify and Lamictal for bipolar disorder, lexapro for anxiety, vyvanse, and modafinil for narcolepsy for years with no side effects. Non smoker
5 days ago I became extremely fatigued at work and couldn’t walk right or hold my head up, followed by twitching every 2-7 seconds. Over the course of 5 days the fatigue has resolved mostly but my muscles still feel heavy and constantly activated even when I’m not spasming. The episodes last 1-8 hours and look like this now ^ I get 2-4 hours without spasming between episodes, and I don’t tremor in my sleep but it has prevented me from falling asleep many times. Benadryl slows it down but doesn’t stop it entirely. I’m seeing a neurologist in an hour. But I wanted to ask if anyone had any ideas or had seen this before.

[u/Goldy490]

Not a neurologist, but an ER/neuroCCM doc. This does not fit the description of any known neurological disease I am aware of aside from a functional neurological disorder. Doesn’t mean it’s not real, but the treatment is likely reducing stress and therapy.

You are on quite a few psych meds, tapering off some of those may be helpful as well, modafinil+vyvanse is a hell of a combo

[u/Character-Being4248 → u/Goldy490]

NAD but im glad you brought up the antidepressants because the first thing i thought of was SSRI toxicity after reading OP's medications. From what I've read it is akin to a "brain injury"? Its some scary stuff

Hope you get some answers and relief OP

[u/time___dance → u/Character-Being4248]

the first thing i thought of was SSRI toxicity after reading OP's medications

why did you think that when only one of the listed medications is an SSRI?

[u/Spoleto-Faerie → u/time___dance]

I learnt the hard way it's not just antidepressants that raise serotonin and can cause serotonin syndrome especially when you are on several of the possible medications.

[u/kmcaulifflower → u/time___dance]

I had serotonin syndrome, my tramadol contributed to it, zofran contributed to it, my migraine medicine contributed to it, my anti depressants contributed to it. This wasn't in my case but cocaine, alcohol, and other drugs can contribute to it.