Seizures responsible for raging?

Josie

Active Member
easy child was taking Amitriptyline for migraine prevention. She had to get off from it so she could start a medication for her Obsessive Compulsive Disorder (OCD). She has been on all of the SSRI's with one side effect or another. The amitriptyline did help with her migraines and decreased her anxiety but she still had Obsessive Compulsive Disorder (OCD). Every time we stop the amitriptyline, she has rages. She is taking Seroquel to help with this right now, but it is starting to come back. She did have these episodes even before being on the Amitriptyline but they went away after starting it.

Yesterday, the psychiatrist suggested her rages might be due to partial seizures. He was very interested to hear that her cousin was just diagnosis'ed with seizures. He is going to order an EEG before doing anything else with medications. While I am impressed by this doctor, I am skeptical that this is the answer since it seems to me that the Amitriptyline (which lowers the seizure threshhold) would have made things worse instead of better. She also never rages at school. He said some kids can hold it together at school but fall apart at home even with these seizures. Does anyone who knows about seizures have any thoughts about this?

This psychiatrist is a wonderful doctor. He also does her therapy. He makes her do CBT right there in his office. He spends as much time as he needs on each patient so frequently runs very late but all of our appointments have lasted at least 30 minutes over our scheduled time, so I can't complain. I also like that he is even thinking about seizures since from what I read here, some doctors won't even order these EEG's.
 

TerryJ2

Well-Known Member
Well, it sounds like it's worth looking into. medications don't always work the way you expect. Remember Rogaine, the heart medication that ended up being sold as hair tonic for bald guys?
Your dr sounds like he's very interested in your family and medicine, and also has a curious mind. You don't often find people like that.
 

BusynMember

Well-Known Member
Is the raging AFTER you discontinued the amitriptylene? If so, it could be withdrawal symptoms. I had them too when I discontinued Tofrinil abruptly. It was horrible.
 

BusynMember

Well-Known Member
Is the raging AFTER you discontinued the amitriptylene? If so, it could be withdrawal symptoms. I had them too when I discontinued Tofrinil abruptly. It was horrible.
 

Josie

Active Member
The raging is after taking away the amitriptyline.

She did have a diagnosis of Intermittent Explosive Disorder before the Amitriptyline. She stopped doing that when she was put on the amitriptyline. She also started doing the gluten free diet for stomach issues at around the same time as going on the amitriptyline. I always thought the diet stopped the rages, but it could have been the amitriptyline.

She did discontinue the amitriptyline pretty abruptly, I think. She went from 10mg to 5 for one week and then down to none.
 

AllStressedOut

New Member
Our new therapist in the new psychiatrist office also has mentioned seizures as a cause for raging/meltdowns. We've only been to the intake appointment, so I'll be curious to see what he says when we go back for the full evaluation. Let me know what you find out. This guy sounds great, I wish all psychiatrists were like yours!
 

Sara PA

New Member
I have to agree with you that the Amitriptyline is more likely to lower the seizure threshold than raise it. However, stress can be a trigger for seizures. Perhaps the Amitriptyline was keeping her calm enough that fewer were being triggered???

by the way, Seroquel and all antipsycyhotics can also lower the seizure threshold.

But made my day to hear of a doctor who recognizes the possibility of rages being partial seizures.
 

mom_in_training

New Member
I don't know about the seizures themselves being responsible for the rages. My son sees his neuro tomorrow, I will ask him about that. I have yet to ever hear about that but can say that when my son started taking Keppra for his seizure disorder he went from happy go lucky laughing all of the time to mad at the world. Totally out of charactor for him!!!! It was horrible. Some of the drugs are known to cause anger issues as well as suicidal ideation. I would agree with Sara that it is possible that stress can induce seizures. I personally have learned that stress alone can have a big impact on ones health.
 

Hound dog

Nana's are Beautiful
The only thing I can say is this.....

When I came to this board Travis was a mess. He was suddenly raging out of character and over the top. I had two neuros tell me it was seizure related. I'm not sure exactly what they meant, but once he started his seizure medications I know the out of character/over the top raging (and some other behaviors) disappeared.

I'm with Sara, I have to admit I'm impressed with a doctor who at the very least considers the possiblity. This guy sounds like he likes his job and does it well. A keeper!

It doesn't hurt to look at all possiblities.

Hugs
 

BusynMember

Well-Known Member
You're going to get A LOT of raging when you discontinue an antidepressant. I know how screwed up you feel when you withdraw from them--and I know it first hand. I would bet the raging and out-of-control behavior could be from the withdrawal of the drug. Don't let any doctor tell you there aren't withdrawals from antidepressants. It's not true. I don't know why they tell us it IS true. When I had to abruptly go off imiprimine (cousin to amitripylene) I was crazy until put back on another antidepressant. I got so irrational that I slammed the front of my car into the wall of our concrete garage. It was totally drug withdrawal, totally a different type of "crazy" then just the black depressions and mini-highs I had before.
 

Josie

Active Member
This doctor doesn't seem to consider amitriptyline withdrawal as a possibility. When she discontinued the amitriptyline, the plan was to start the Anafranil right away so I wasn't as worried about the withdrawal effects. Now he wants to rule out seizures before starting it and it is taking a while to schedule the EEG. I really like that he is looking at everything but I am anxious to get her on something to help the Obsessive Compulsive Disorder (OCD) which is just getting worse while we wait.

Every time we decrease the amitriptyline this happens so it seems likely to me that it is withdrawal effect. But who knows, there could be seizures there also.
 

BusynMember

Well-Known Member
Hon, they NEVER told me that ad's have withdrawals. When I as given Paxil I was told there are no withdrawals. Check your search engine under "Paxil Withdrawal" for horror stories from hell. AD's have bad withdrawals. Certainly check for seizures...cover all bases...but it could be simply the withdrawal of the drug. That seriously changes the chemistry in the brain!
 

susiestar

Roll With It
No doctor really wants to believe antidepressants cause withdrawal. They only want to deal with withdrawal from pain medications and from benzodiazepines. At least that is how it seems to me.

Many people do not think about withdrawal when they stop a medication, so they don't tlel the doctor they have had it. I know my doctor was floored when I gave her 5 pages of reputable studies showing withdrawal from effexor and how long it truly took to come off of this medication. (Weeks, it takes WEEKS and MONTHS to get over this medication).

Tri cyclic AD for migraines? Certainly not first line treatment option. Migrianes are thought now to be a type of seizure, I keep up on the researcxh because I have had them since age 4, difficult child since age 2, and easy child since age 5. Ask your doctor about a beta blocker for migraine prevention. These are blood pressure medications, often VERY cheap, that work to prevent migraines. Ask the pharmacist if they would interfere with whatever they want to use for Obsessive Compulsive Disorder (OCD).

RAging definietly can come from seizures. GEt a good sleep deprived EEG. We had one done for easy child for some other problems and the migraines. Knock me over with a feather when they called us in to tell us she had epilepsy, not ADHD. She is doing well on medications now, but we have had some longer seizures also.

Susie
 

smallworld

Moderator
Actually, both Amitriptyline and Nortriptyline are considered first-line treatment for migraines and all kinds of pain (I took Amitriptyline for IBS pain and it worked great). My difficult child 1 has had migraines since age 4 as well, and the first medication he ever trialed was Nortriptyline. It didn't work so he has now been taking the blood pressure medication Propranolol (generic for Inderal) for four years with excellent results.

I think it's great that your psychiatrist is considering all the options. Good luck.
 

BusynMember

Well-Known Member
They still cause withdrawals. I know. I had them. If it were my kid, I'd use something else for Migraines because of the withdrawals. JMO
 

Josie

Active Member
The neurologist gave her the amitriptyline for migraines thinking it would also help her anxiety. It worked on the migraines and lessened her anxiety. Now that there is a psychiatrist involved for Obsessive Compulsive Disorder (OCD), we are having to stop the amitriptyline so she can go on Anafranil, which is another tricyclic a/d. Then we will look for something for the migraines, if needed. Right now, she is taking Seroquel to tone down her anger and that seems to be helping her headaches. It wouldn't be my first choice for migraine prevention, though.

Last night, she cried in her bed for no known reason for more than 30 minutes. Even with me there hugging her and rubbing her back. I let her sleep with me and finally she fell asleep but she was afraid she would wake up and cry in the night. Even she didn't know why she was crying. Could this be a/d withdrawal, too? Seizure?
 

BusynMember

Well-Known Member
My honest guess is withdrawal. I don't know for sure, of course. I was such a mess from imiprimine withdrawal that all I did was cry for weeks. I with the doctors would caution parents about withdrawal syndrome with ADs. They don't even tell adults about it. I don't know what the big secret is, except that probably less people would TAKE the medication if they knew, but...anyways, good luck.
 

Sara PA

New Member
Rages can definitely be temporal lobe seizure activity. It is estimated that only about 50% of temporal lobe seizure activity is picked up on EEGs.
 

Josie

Active Member
This doctor did say that if the EEG didn't show seizures, it still didn't rule it out. He seems to be knowledgeable.

She hasn't had any real raging in a few weeks, since being on the Seroquel. But since Thursday night, she has been having crying spells. She couldn't even go to school yesterday. Today, she isn't sure if she can go to volleyball, which she loves.

The psychiatrist doesn't think this is amitriptyline withdrawal since it started 2 weeks after her last dose. What do you think?

In the 2 weeks since she has been off the amitriptyline, she also took Paxil for 5 days until that appeared to be agitating her.
 

BusynMember

Well-Known Member
I wasn't off imiprimine longer than two weeks before I was put on nortriptylene, which cut out the bizarre withdrawals from the imiprimine, so I don't know how long it would have went on. It was truly unbearable, and not the same as a bipolar rage, at least not in my mind. I really felt like I was going crazy. I don't trust psychiatrists when they tell us about antidepressants. They tend to be in denial about the trouble you can have getting off of them. I plan to take mine for the rest of my life. I don't want to touch Paxil withdrawal. Luckily, it seems to really help me.
 
Top