On Real Housewives of Beverly Hills, Kim Richards seemingly exists in a perpetual fog of intoxication. The embattled former child star has always been cagey about her substance use, releasing a statement on Twitter that she's not taking any illicit drugs and has “discussed openly [her] issues with alcohol”—while admitting that “sobriety is a lifetime process.” So it was something of a surprise when Richards told plastic surgeon Dr. Paul Nassif on RHOBH's November 7 episode that she takes Trazodone, Topamax, and Lexapro daily. And it could explain a lot. Lexapro is a relatively side-effect-free SSRI, but the other two? Trazodone's a tetracyclic antidepressant that’s often given to recovering alcoholics and addicts for its strong soporific quality—useful for insomniacs who've relied on narcotic-based sedatives—but its side-effects include confusion and difficulty concentrating or remembering things. Topamax is an epilepsy drug and mood stabilizer that’s been used experimentally to treat alcoholism and migraine disorders. It, too, carries some crazy risks: users call it “Dopamax” or “Stupamax” because of side-effects like feeling disoriented and confused, or the inability to remember words or speak in complete sentences. So if Kim's on all of these, it stands to reason she’d seem inebriated, even if she’s not also drinking. Or, as castmate Brandi Glanville said, “doing crystal meth in the bathroom all night.”