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Having blackouts, drooling, excessive sweating and frequently feel nauseous. Brain, heart and blood tests normal. Suggest

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General & Family Physician
Practicing since : 2009
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My son is 26 and has monthly blackouts where he seems to be in pain, has drooling, excessive sweating and appears to be in pain. He seems to be sleeping at first, but then eyes are open, but he is unaware of who we are. He talks but we cannot understand him. Sometimes he seems to be hallucinating, sometimes he walks around. It can last from 30 minutes until the most recent episode (yesterday) which lasted a couple of hours. Then he wakes up and doesn't remember the episode. He is frequently nauseous for a few days. He cannot seem to sleep well, stating he wakes up on the hour, both before and after the episode. Doctors have checked his brain, his heart, his blood sugars and can find nothing. I don't know where to go next.
Posted Tue, 26 Nov 2013 in Drug Abuse
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: All symptoms of substance abuse or syncope Detailed Answer: Hello ma'am/sir and welcome. Thank you for writing to us. With the provided information, if you wouldn't have mentioned the drug addiction, I would have requested you to get his urine and blood checked for substance abuse. Reason being, that the symptoms that you have described match that of an addict who is currently still abusing a substance or is undergoing withdrawal symptoms, or of a condition called neurocardioggenic syncope (in which the heart does not pump enough blood to the brain, which leads to episodes of fainting, blank staring, etc). But as you reported a normal heart and brain function, I would rule out the syncope, which would leave us only with possible substance abuse (which is confirmed from the history). If his heart, brain and blood sugar levels are normal, then that is good news as the substance abuse has not caused any target-organ damage. Unfortunately, the only thing that needs to be done now is to help your son to completely quit both oxycontin and marijuana, in order to start living a normal life again. I should inform you that this will not be easy, but unfortunately is the only solution. I would also like to ask if you conducted an EEG (electro-encephalogram) which checks the brain activity and along with this investigation, do get his sleep cycle analysed to see if there are any other causes other than the substance abuse for his irregular sleep-wake cycle. I hope and pray, your son is strong enough to quit both the substances he seems to be abusing, as he is still young and has a long life ahead of him. Please feel free to write back to me for any further clarifications, I would be more than happy to help you. But, I hope you also understand that the problem/cause is right in front of your, and all you need to do is help your son get it out of his life. Wishing and hoping for the best, God bless.
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Follow-up: Having blackouts, drooling, excessive sweating and frequently feel nauseous. Brain, heart and blood tests normal. Suggest 20 hours later
He is not on oxycontin any more. He goes to a Methadone Clinic once a day to stay off the oxycontin. I thought I had mentioned that. Could it be a side effect of the methadone? And if it's a withdrawal symptom of that, why does it only happen once a month and why is he still sick even if he has gone to the clinic?
Answered by Dr. Shoaib Khan 56 minutes later
Brief Answer: Yes, they could be; need to report to clinic Detailed Answer: Hello once again ma'am. Yes, it could be an effect of methadone or even withdrawal symptoms to oxycontin. Some patients are successfully managed when they visit an addiction center or clinic, but that effect is only temporary which is why regular visits are scheduled. But, there could be a time when your son really requires medical attention and then suffers these symptoms at that time of the month. Also ma'am, if you do not mind me saying this, but in most cases the methadone clinic looks for any symptoms or signs of re-initiation of the substance that was being abused (i.e. oxycontin in your son's case). So that they are sure the patient has not relapsed. You need to check with them if he has ever relapsed, if he has, then this presentation could also be associated with that. The clinic mainly helps in monitoring and if there are any withdrawal symptoms, they help in reducing them. So please do report his symptoms to the clinic to make sure they do all they can to make him more comfortable. I would also like to ask about his use of marijuana. How would you rate his dependence on marijuana on a scale of 1 to 5, 5 being completely dependent. I hope this information helps you ma'am. Please feel free to write to me about any queries you have, I am always available to help and shall always keep you well informed. Best wishes.
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