low blood sugar, including:
* anxious feelings
* behavioural changes similar to being drunk
* blurred vision
* cold sweats
* confusion
* cool, pale skin
* difficulty concentrating
* drowsiness
* excessive hunger
* fast heartbeat
* headache
* nausea
* nervousness
* nightmares
* restless sleep
* shakiness
* slurred speech
* unusual tiredness or weakness
Most of these symptoms may be mistaken for various psychiatric disorders when hypoglycemia is discounted as "changing the diet."
3 comments:
Around 1:30AM Friday, I asked my roommate to let me use one tablet of his discontinued supply of glyburide to relieve my insomnia.
The reasoning behind using glyburide was my mistaken conclusion that low blood sugar leads to sedation and eventually sleep.
Backing up that reasoning is my belief based on years of insomnia that hypoglycemia may be the root cause of insomnia and the psychosocial challenges I face daily resulting in social anxiety disorder, borderline personality disorder, and insomnia-induced mania.
Within 2 hours of consuming the glyburide I still cannot sleep. Instad I get a panic attack in bed -- thinking that my roommate might have mistakenly given me a dose of his high potency hydromorphone contin -- and start to sweat profusely.
It's a cold sweat with all the symptoms of low blood sugar: anxiety, the sweats, confusion, weakness...
By daybreak, I find myself at my computer on the Internet, researching glyburide in detail.
At 8 AM, I discover the symptoms of low blood sugar and report them here.
Most of these symptoms may be mistaken for various psychiatric disorders when the "cure" for hypoglycemia is as simple as "changing the diet."
However, the experience of low blood sugar gives me insight into its influence in the process of going "cold turkey".
On or around 9:30 PM March 10, 2006, I consumed 5 mg of Amitriptyline in a cup of tea with approximately 0.250 gram of Chinese green tea (less than 30 mg caffeine). The amitriptyline-laced tea made my tongue feel numb.
That numb feeling on my tongue from the amitriptyline-laced tea is similar to the numbness encountered with ibuprofen. This is also causally associated with the nausea experienced after taking amitriptyline.
Thus the numbness on my tongue, the drug's pain relief and subsequent nausea indicate to me that, like ibuprofen, amitriptyline also suppresses pain. This is probably a cholinergic reaction to the medication.
Within 30 minutes of ingestion, I felt tired and went to sleep.
On waking I experienced light nausea, anxiety and other symptoms associated with amitriptyline.
Ataxia (lack of coordination in walking) was also present throughout the day with anxiety and daydreams.
I feel that this medication would worsen my depression, since the anxiety indicates a hypoglycemic reaction and the daydreams indicate probably suppression of REM and its associated dream state.
Amitriptyline's pain-relieving side effect is associated with both the numbness on my tongue and the brief waves of nausea.
The literature indicates that amitriptyline may also cause anticholinergic psychosis and worsen psychosis. This is due to hallucinations and mania, which may be experienced negatively.
Rather than psychosis, all I have experienced so far are daydreams, which may be a mild form of hallucinations. I also didn't recognize my friend's voice on the phone, and my social skills are temporarily absent.
After four hours awake, I'd recovered from most of the side effects of amitriptyline, except for occasional daydreams.
While the literature claims that amitriptyline is not addictive, the negative side effects (grogginess and brief nausea on waking, followed by 6 hours of anxiety and 12 hours of daydreams) tend to outweigh the positive side effects (pain relief and sedation. For the length of sedation I experienced (7 hours of fitful sleep), the 12 hours of daydreams, 6 hours of anxiety, and the waves of grogginess (including ataxia) does not make amitriptyline a great sleeping aid.
*Possibly the cholinergic reaction to amitriptyline is due to the diphenyl group, i.e the initial sedation and sleep, the anxiety on waking, the brief nausea and the "daydreams."
Overall I feel that in cases of persons with a history of head trauma, borderline personality disorder, dysthymia (depression), anxiety and insomnia associated with hypoglycemia, amitriptyline only worsens the symptoms of depression and anxiety.
Unless one is experienced with the non-pharmaceutical remedies for both anxiety and depression (meditation and perhaps talk therapy), amitriptyline may temporarily cause anxiety and not relieve depression.
However, it is a great sedative.
Timeline of my experience:
Physical condition: history of mild traumatic brain injury.
Rating of psychosocial condition: 4.5 out of 10. 10 = perfect
36 hours awake, feeling manic, had a busy day.
Friday:
9:30 PM - ingested 5 grams of amitriptyline.
11:30 PM - retired to bed after spending an hour on the Internet.
Saturday:
6:30 AM - awoke; stayed in bed.
9:00 AM - had anxiety attack in shower due to the shower door coming off the rail holding it in place. Usually I can put the door back on without incident.
9:30 AM - 1:30 PM: anxiety and daydreams come and go in waves.
1:30 PM - anxiety seems to subside. Daydreams come and go for the next 8 hours
1:30 - 3:30 PM - make
9:30 PM - no anxiety, and daydreams have subsided.
1:30 AM - retire to bed; fell asleep within one hour.
Rating of psychosocial condition: 3 out of 10
Sunday:
8:30 AM - awoke; took shower; had breakfast.
7:30 PM - Rating of psychosocial condition: 4 out of 10
** After-effects of amitriptyline related to blood sugar levels: anxiety and nausea.
Cholinergic side effects of psychosis: hallucinations in the form of daydreams.
This gives me insight into the etiology of brief psychotic episodes being related to changes in blood sugar levels.
Points to note:
1) glyburide causes symptoms similar to a panic attack -- this makes low blood sugar an anxiety inducer.
2) amitriptyline causes symptoms similar to high blood sugar (sedation) followed by anxiety (low blood sugar), nausea (pain-relief) and hallucinations (cholinergic effect).
My appetite however improved despite the psychological reaction to the physiological effect both drugs had on my body.
Today, almost 48 hours later, I am once again asocial and withdrawn.
However, with the brief insight into the role blood sugar levels play in my mind, body and soul, I feel that a good nutritious meal with family and friends is probably the cheapest form of therapy available.
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