Q and A: What Drugs Might Cause Side Effects in My Character With Alice in Wonderland Syndrome?

04 Dec

Q: I have a question about Alice in Wonderland Syndrome (AIWS) My character is in his mid-30s. From what I’ve gathered from reading this syndrome, it is fairly common with children and with migraine sufferers and it is controllable. However, I want my character to have side-effects. In other words, even though the AIWS and his migraines are under control, he is increasingly erratic. Insomnia, impotence, and irritability would all be a bonus. Could he be dosing himself with some type of herb that he doesn’t realize would have these side-effects when combined with the medication prescribed for AIWS. Or is there a medication for AIWS that might cause these kind of side-effects but be subtle enough in the beginning that the person becomes mentally unstable before he realizes something is wrong?

FY Bailey

A:    Alice in Wonderland Syndrome is also known as Todd’s Syndrome. It is a neurologic condition that leads to disorientation and visual and size perception disturbances (micropsia and macropsia). This means that their perception of size and distance is distorted. Much like Alice after she descended into the rabbit hole and consumed the food and drink she was offered.


AIWS is associated with migraines, tumors, and some psychoactive drugs. It is treated in a similar fashion to standard migraines with various combinations of anticonvulsants, antidepressants, beta blockers, and calcium channel blockers. Both anticonvulsants (Dilantin, the benzodiazepines such as Valium and Xanax, and others) and antidepressants (the SSRIs like Lexpro and Prozac, the MAOIs like Marplan and Nardil,, and the tricyclic antidepressants like Elavil and Tofranil, and others) have significant psychological side effects. Side effects such as insomnia, irritability, impotence, confusion, disorientation, delusions, hallucinations, and bizarre behaviors of all types–some aggressive and others depressive. Beta blockers can cause fatigue, sleepiness, and impotence. The calcium channel blockers in general have fewer side effects at least on a psychiatric level.
As for herbs almost anything that would cause psychiatric affects could have detrimental outcomes in your character. Cannabis, mushrooms, LSD, ecstasy, and other hallucinogens could easily make his symptoms worse and his behavior unpredictable.

Your sufferer could easily be placed on one of the anticonvulsants, one of the antidepressants, or a combination of two of these drugs and develop almost any of the above side effects, in any degree, and in any combination that you want. This should give you a great deal to work with.


9 responses to “Q and A: What Drugs Might Cause Side Effects in My Character With Alice in Wonderland Syndrome?

  1. Pat Browning

    December 4, 2011 at 12:21 pm

    Interesting blog. I took Valium for years. My doctor said he always knew when school started in the fall because teachers rushed to him for Valium prescriptions. One day I just said, enough of this stuff, and quit taking it (and I’ve been an old grouch ever since.) Not long ago a doctor prescribed a one-time prescription for Valium. I took one pill and it almost knocked me out. I threw out the rest of them.

    Pat Browning


  2. Debra E Marvin

    December 4, 2011 at 3:35 pm

    Well, this is interesting. I used to go through this when I was a child and I thought I was just strange. It hasn’t happened in a very long time. I’m glad I read your post today. It doesn’t change the ‘strange’ factor but it’s nice to know it has a name.

    Thanks for continuing to provide these kinds of posts and a place to ask such questions.


  3. Laura Mitchell

    December 5, 2011 at 7:53 am

    Is this condition associated with a particular area of the brain, e.g. the temporal lobe?


    • D.P. Lyle, MD

      December 5, 2011 at 8:25 am

      It’s not really known exactly what parts of the brain are involved in this odd syndrome—and some of it might spill over into the psychiatric arena from the arena of pure neurology. But I would suspect that the temporal lobes are involved. And this syndrome can occur in persons with temporal lobe epilepsy so that suggests that this lobe is indeed involved.


      • Laura Mitchell

        December 5, 2011 at 8:31 am

        Ah. I asked because I’ve heard that people with temporal lobe epilepsy have auras as part of their prodrome.


      • D.P. Lyle, MD

        December 5, 2011 at 8:37 am

        As do those with migraines in many cases and this syndrome is often associated with migraines.


      • Laura Mitchell

        December 5, 2011 at 8:39 am

        Do we have any ideas about what causes migraines? I have several friends who suffer from them.


      • D.P. Lyle, MD

        December 5, 2011 at 8:44 am

        Migraines are in the broader arena of what we call vascular headaches and are due to changes in blood flow to the brain from vascular spasm and then dilation. No one knows why some people suffer from these and others do not.


  4. Dorie

    September 13, 2013 at 4:23 pm

    These symptoms also occurs when heavy drinkers suddenly
    give up drinking, this condition is called ‘delirium tremens’.
    Someone practicing alcohol abstinence might put a particular emphasis on body detoxification through diet
    or supplements. One from the interesting outcomes of irresponsible drinking
    is that it dons hormones such as estrogen.



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