Conversation: The conversation between human and AI assistant.
[|Human|] I had brain surgery for Epilepsy in 2005. They removed a section of the right temporal lobe, the hippocampus, and amygdala. Ive been on anti-depressants and anti-anxiety meds since. After many anti-depressants did not help, I was put on Amitriptyline. I take Diazepam for anxiety. With my depression, I had severe insomnia. My Psychiatrist slowly increased Amitriptyline dose and tried adding several meds with it to help sleep and depression. I cannot take Ambien or Lunesta. She tried Trazidone, Ritalin, & when they didnt help, she raised my Amitriptyline all the way up to 200 mg. So I was at 200 mg Amitriptyline and 20 mg of Diazepam at night. I started having uncontrollable muscle spasms when I sat or tried to lay down. She added 3 mg Requip, & then had to up it to 6 mg at bedtime. After concerns over the high dose of Amitriptyline, she lowered it to 150 mg at night and added 10 mg of Celexa. About a week after being put on medicine, I started having problems. Raised BP, cold & shivering, etc. My Psych wouldnt return a call for 3 days in a row, so my pharmacist sent me to the ER where I was diagnosed with drug toxicity. The ER dr had me stop Celexa for 3 days, and then take it every other night until my neurologist could see me. I had to cancel first appt. with my neurologist because I was too sick to drive. I have lowered my Amitriptyline to 100 mg and take the 10 mg of Celexa everyday now, & 20 mg of Diazepam at night. I stopped the Requip. For several weeks Ive had problems with dizziness & falling, especially if I bend over and stand up, or kneel down & stand up. It doesnt matter how slow I move. If I take the meds, I sleep anywhere from 3 to 5 hrs a night. skipped meds one night so I could try taking them in the day. I slept for 15 hours. Tried this a few times, same results. I had an incident over the summer, before Amitriptyline was raised so high and before Celexa and Requip, where I went to bed early one night, woke up 13 hours later, couldnt remember any of the 250 pages I read in a book I had already started, and felt off balance and sick. I went to ER, x-ray & CT scan were clean. I saw my neurologist, he did an MRI and EEG. Both were normal. After being put on Requip, I went back to him. The tremors that I only had on my right side were now on the left. My balance was off, which is wasnt after MRI and EEG. I do see my neurologist Wed., Feb. 5, 2014. What do I need to ask him to do? Sleep study? My pharmacist doesnt think its the meds. My sleep is completely off. I am depressed, with suicidal thoughts (I had suicide attempt in 2006), and I tremor and have balance issues that make me fall or grab on to something all through the day. Help?
[|AI|]  Hi, Thank you for posting your query. You have features of severe depression, and the antidepressants need to be streamlined at an appropriate dose. Your current symptoms are not related to the epilepsy surgery. You should ask your neurologist the cause of your tremors. One-sided tremors are not sued to side effects of medicines. If tremors are due to Chat Doctor.  You need toast him whether you have Parkinsonism. I hope my answer helps. Please get back if you have any follow-up queries or if you require any additional information. Wishing you good health,