meds, auras, seizures, vagus nerver stimulator

I have a question for other epileptics taking mirtazapine. I take 500 mg ER lamotrigine and 1500 mg ER levetiracetam in the morning. I take 45 mg mirtazapine about an hour before going to bed and sometimes 10 mg zolpidem (ambien) if I think I need it. My blood pressure is on the low side, 96/62. Once in a while I’ve had auras (few and far between), but they occur 5 or so minutes after going to bed and about 5 min. later after waking up, still in bed. Twice this week, I’ve some really deep and long lasting aura’s after 5 min of going to bed, none in the morning. They might be seizures, but I usual black out during one. Last night was the most intense one I’ve ever had after going to bed. It was so deep I would call it a seizure even though I stayed awake. It lasted minutes (maybe 10 min. to eternity). Then I get little or no sleep. I have a headache this morning which is rare.

 I take the mirtazapine to counteract the depressionand insomnia caused by the seizure meds. Has anyone else with epilepsy gone through the same thing? Problems just after going or waking up in bed with mirtazapine. When I stay awake, sit in my recliner, and watch TV I never have a problem. I don’t know if it related to trying to shut down my mind and/or blood pressure. If I can get a ride, I have an appointment to see my Dr. next week. I was wondering if anyone else with epilepsy had similar problems while on mirtazapine? I’d like to be on different seizure meds and/or anti-depressant.

 My Dr. once suggested a vagus nerve stimulator. I read it can/may also treat depression after up to 9 months of use. They are not cheap, +/- $20,000, but I have Medicare (in the U.S.) and insurance to cover the cost. I just don’t like the idea of going through surgery and having a device implanted in me. Does anyone with a vagus nerve stimulator recommend it or have had negative results?

Thanks, steve

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