instruction: hello doctor I have been diagnosed with ocd my doctor also briefly talked to me about schizotypal personality disorder I am currently taking fluvoxamine 200 my at night risperidone my at night and modafinil 100 my in the morning it has been well controlled for more than four months now 90 reduction in symptoms for the past two days I have not been able to sleep because I have been seeing shadows moving at the periphery of my vision it scares me so much and when I try to close my eyes I can hear certain noises like laughter or someone moving around this only happens when it is mostly dark at night for this reason I have not slept the first night and somehow fall asleep very late am the second night can you tell me what is causing this
output: hello what you are experiencing is called hypnagogic hallucinations which occur normally when sleeping sometimes but in your case it is due to the modafinil it is known to interfere with sleep and also cause hallucinations also the metabolism will be slowed by fluvoxamine and it lasts longer you should not take it does not affect ocd obsessive compulsive disorder and I would just advise you to stick to fluvoxamine and risperidone and if possible do some sessions of cut cognitive behavioral therapy from a clinical psychologist also it is advisable to not suddenly reduce the modafinil but taper it slowly take 150 my for three or four days then 100 my for a week and then 50 my and then stop also with 90 percent improvement you can consider either reducing the dose of fluvoxamine or also try taking 50 my in the morning and 150 my at night instead of 200 my all at once it will give you better results