<s>[INST] 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 mg at night, Risperidone 2 mg at night, and Modafinil 100 mg 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 (3 AM) the second night. Can you tell me what is causing this? [/INST] Hello. What you are experiencing is called hypnogogic 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. 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 CBT (cognitive behavioral therapy) from a clinical psychologist. Also, it is advisable to not suddenly reduce the Modafinil, but taper it slowly. Take 150 mg for three or four days. Then 100 mg for a week and then 50 mg and then stop. Also, with 90 percent improvement, you can consider either reducing the dose of Fluvoxamine or also try taking 50 mg in the morning and 150 mg at night, instead of 200 mg all at once. It will give you better results. </s>