Wellbutrin And Hallucinations

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I have not sought diagnosis for narcolepsy, because of the stigma (and thus my desire to be employable, driving, and insurable). I have been able to force myself awake so far, and will only seek the diagnosis when I involuntarily and unconsciously fall asleep. If I am able to appear normal, if sleepy, it's not a problem.


However, I have always (and clearly) had it. I have always been a long sleeper and lucid dreamer. I have also always been tired. I have kept track of myself. In the past, I recorded myself having full dreams in under a hour, usually 20 to 40 minutes (one time I recorded ten minutes). I was usually tired at anything less than 8 hours of sleep. I was only rested from 10 to 12 hours, and only happy at 12 to 14. I had to start warding off sleep attacks under five hours. I could pull all nighters, but at the end of them I starting getting physically ill.


So it's there. For a long time, I didn't care, because playing video games in my head is fantastic. I was able to be quasi-normal with large amounts of caffeine. There were some times when I managed to get non-REM sleep, and it worked out. I am fiercely protective of my dreams, and the idea of taking them away was bad enough. I never drove or did anything dangerous when I felt sleep coming on.


But, I suffered post-traumatic stress, and went through three years of depression. The fatigue became much, much worse. I went from 10 to 12 hours to be rested to 14-16 hours. Well-rested was 16-18. I starting warding off sleep attacks at 7 hours. I became physically ill at less than five hours. I could go into the doctor's and get diagnosed with the flu if I tried to pull an all-nighter.  I never had quality sleep, and I had constant nightmares (and feelings of being trapped in my bed). My cognition and memory (from PSTD, depression, and simple sleep deprivation) dropped dramatically.


So, I ended up being prescribed Wellbutrin. Suddenly I could be rested on 6-8 hours of sleep. I could be well rested on 8 to 10, and happy at 10 to 12 hours. I could go a day and a half without sleep without becoming physically ill. It was wonderful. I felt alive. But I started to realize that I couldn't take it on a daily interval.


It causes all of my narcoleptic symptoms to be much, much worse. The first time I pulled an all-nighter, I hallucinated. I could see my hands move past my shut eyes. All subsequent all-nighters were the same. And it slowly began to accumulate. With daily use, my sleep became fragmented. It's not just one occasion of taking nap at 4:00 and waking up at 4:10 having experienced a full dream, it's every occasion. If I slept, it's never for any length of time. I began to have sleep attacks again, even when I was seemingly rested. The lead-up wasn't just feelings of imminent sleep, but full-on visual hallucinations. Over time, I was lucid all the way through. It wasn't just drawing on a dream after you dreamed lucidly (which I've always been able to do.) No, I was aware of the full sequence. My mind went from concrete thought to fluid thought, to visuals and fluid thought, to visuals and auditory, to lucid dream and however long I wanted to carry it. There was nothing before. I become trapped (paralyzed) more regularly, and scream at non-existent spiders (even if I'm aware they can't really be there.)


So, I am in the predicament where the drug works, but it has progressively worse effects. I can deal with hallucinating while my eyes are shut. I can go about to the point of that first all-nighter. Seeing your hands past your eyes while you're about to go to sleep is okay. Sleep deprivation via dreaming is not. I ultimately end up in the same place I was before, now with overlays on my teacher's blackboard. 


At the moment, I am taking the drug three days a week and going off for four. It increases the dosage effect, but does not add up sleep deprivation. I really do like the feeling of being awake, but I need some idea of what (psychiatric) drug I can take to mitigate the effects of daily use. What has been effective for you? I'm not sure that I really want to lose this feeling of wakefulness, and in some ways, it's the least of the side effects, but only if I use the drug in a way it's not meant to be taken.


Yes, I can change the drug. But I don't want to be in the position where anything life-altering is on record. I know the drug is a stimulant, and it exacerbates the effects. It isn't actually what I experience on a normal threshold. What I experience on a normal threshold may not be great, but it is workable. Even with depression and PSTD, it's workable, provided I get excessive amounts of sleep. I have been on medications (like citalopram) where I am at least well-rested, if sleepy, at 10-12 hours of sleep. So while I am still able to get a handle on it, I would like to keep it off record. At the moment, technically, I have a handle on it, if I only take the pills when I go to school (3 days a week).


I am not sure what the other drugs are like. It does work well, in the way I've taken it. It's utterly fantastic, but not as prescribed. Considering the wealth of drugs that have side effects, it may be the best route for me. But unless I refill it long in advance, it'll eventually be clear I'm not taking it on the daily. And eventually I won't be a student where I can schedule my time creatively.


The first thing out of my psychologist's mouth was sleep test. Test results, unlike chitter-chatter, are part of permanent medical record. I am not going to my psychiatrist with the same response. She, unlike my psychologist, can order one. I do not sleep normally, and would not receive a negative result.


I need ideas.

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You don't need ideas...you need help. Stop playing games with your mind and body.

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If you've figured out you have narcolepsy on your own, you are fairly lucky in that respect.  It only took me 2-3 years to be diagnosed, and I went into the sleep study expecting nothing useful to come of it, but I still went from straight-A student to college-dropout-who-can't-hold-a-temp-job in the interim.  I've heard stats that on average it takes 7-15 years to diagnose.


I'm scared for you based on your descriptions and decisions.  Why are you pulling all-nighters, ever?  Even with regular narcolepsy meds, I can't go more than about 20 hours before I have a mental breakdown - which for me is an obvious sign saying "don't do it!"  Listen to your body & mind.  I understand shift work  from personal experience and know it can lead to long hours, but can see very few situations where an employer would give up an otherwise effective employee just because the employee should not be kept awake for unnatural amounts of time.  (It's not something ANYONE should have to do, much less in the industries where it's required - public safety/medicine being the most obvious examples, but that's a separate topic...)  I see even less reasons to do it as a student, since most colleges have support programs in place and are willing to (reasonably) accommodate students who are up front and mature about their situations.  It's also been shown repeatedly that all-nighters are bad for learning, at least in a "thinking" context rather than just "memorizing".  Are you actually at a school where all students are expected to be awake and studying 18+ hours per day, or do you have work (or other) activities that are dominating your non-class time?


Do you live in the USA, or elsewhere?  (If it's elsewhere, ignore this paragraph.) Jobs can't get your medical record, unless there are specific, valid safety concerns.  If it's actually narcolepsy, safety concerns can usually be alleviated with proper treatment.  As far as medical records are concerned, are you worried because it will show up as a preexisting condition (which in theory shouldn't matter with the new ACA stuff)?  I haven't encountered any stigma with narcolepsy - just confusion because people have misinformation about what it actually encompasses.  It's never been suggested that I should give up my driver's license, and (treated) narcolepsy is by no means an automatic revocation (in my state).


It's difficult to understand why you're putting yourself through what you've described unless you have a martyr complex, or if you are in an environment where medical issues are seen as signs of weakness - instead of normal problems that can be treated/overcome.  If it's the latter, there a many resources out there to help you, and people on these boards are able to point out the best of them if you ask for what you need.  If it's the former, nobody can help you but yourself :)


You ask for ideas, so here's mine: Do the sleep test, research accommodations options with a school counselor or someone else bound to confidentiality, get appropriate medication, and move forward.  If you need other suggestions (from me or others) it would help to know more about why your situation must include things like all-nighters.  (I.e., are you in med school/residency or something?)



Final thought: I've been on Ritalin for ~6 years, and recently had to switch to Wellbutrin and small amounts of caffeine (and am weaning myself off the last of the Ritalin).  It's not as bad as having no medication at all, but it will be night and day (no pun intended) when I get to go back on the Ritalin.  The sleep paralysis/hallucinations came back immediately - I used to be terrified by those repeated episodes, where invariably there was a robber coming into the room where I slept or I was crashing a car repeatedly, all while desperately trying to wake up...until I realized I could just control those thoughts and do cool stuff. I'm glad you already know it's easier to just "roll with it" : )

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You can exist while you try to appear "normal" until something bad happens. I went through exactly what you are and it diminished the quality of my life. It is miserable hiding and hoping not to be "found out". Nothing good will come from it and something very bad may happen without the right treatment.


Without a diagnosis you are vulnerable. Your behavior is without explanation. You have no recourse. You are unprotected.


Get advice other than your own and make well informed decisions. You have a long life ahead of you- get your situation in order.

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