What causes random fainting episodes?
More than one thing.
There is a lot of data I cannot get but the medical people having seen her would have. First, the fainting. It is striking how well the medication worked on it.
narcolepsy, arrhythmia, seizures are a few possibilities and the doctors previously seeing her have likely either seen seizures or arrhythmias or if they have NOT, then she doesn't have them. Since you didn't say she has those, that is why narcolepsy and simple fainting from hyperventilation go to the top of the list.
Well... one of the best treatments for EITHER narcolepsy OR hyperventilation happens to be antidepressants, maybe the older ones like amitryptiline. Helps on panic attacks that either occur from Xanax or were a reason to have started it. Panic, hyperventilation and narcolepsy are decreased by xanax BUT I think we see the dangers of it. Propranolol isn't the best drug for any of them, but might work in any/all of them and I've no clear reason why they didn't give her any except worries about low blood pressure which are probably NOT the reason for the fainting in any case.
I'm not directly there, but an ER visit AT AN ER that can both Get HER PREVIOUS records and.... you might consider showing some thoughts I've had to them also.
Next, Xanax has a nasty withdrawal that can precipitate any of the issues mentioned on fainting INCLUDING SEIZURES WHICH CAN BE LIFE THREATENING (all in the first week off of it). Xanax withdrawal has to be managed carefully for the first several days. THEN a coordinated addiction program with likely antidepressants, group meetings and counseling.
Hmm... I'vve probably implied ER.
xanax withdrawal can do this....
BUT I don't have a direct enough contact to know if it DID do that! Change in mentation, hallucinations, disorientation are very common with drug withdrawal AND ARE TEMPORARY (goes away generally in a few days). Frankly, I haven't seen this happen in someone who is calm, generally they are very very agitated in addition to the disorientation. I would keep the patient in the hospital until these things got better, personally. And, I would taper the medicine they were withdrawing from in the hospital and send them home... on close to exactly what she's on.
I would also have had labs for electrolytes, make sure she is eating, get a head scan to rule out some other brain problem, and a lot of other labs by me and the neurologist before being sure it is ONLY the drug withdrawal. Furthermore, none of the rehab centers I know will take someone who isn't entirely oriented and pretty close to entirely healthy.
But, I might be overly worried. "Not quite herself", changes in mood, sluggish thinking would rather be expected and not very abnormal, considering. Being a bit off in dates. If awakening not remembering if one is in the hospital for a minute or so.. these are mild symptoms. Not recognizing anyone, having no connection to reality, these would be major symptoms.
Minor symptoms gradually improve over days. Major symptoms can improve pretty fast too, but imply something more/ something else besides withdrawal is going on and is a serious situation.
I suspect that everyone is doing everything correctly (except MAYBE the propranolol) but she needs a head scan. There is still the issue of the fainting attacks and narcolepsy is notoriously overlooked. Low blood pressure can do it. Slight dehydration, or other minor conditions can make someone who's blood pressure normmally runs low faint. I do NOT know if that is at all the case in this situation.
Also, if what we all think is happening is the main thing that's going on with the delusions/hallucinations/etc. the prognosis is very good especially in the short term. In the moderate term, needs to stay away from abusable meds.
Best of Luck !
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