antidepressants and concentration and other issues

[Hunter]

I am taking seroquel, remeron, and celexa and things have been really good. I am in therapy too.

I am finding that I am experiencing concentration and memory issues.

I will put things in one place and moments later I am totally forgettful of where I put them. I spent four hours yesterday looking for my cell phone to find it today where I had looked many times.

Even today I was driving to the mall in the east end of my city and soon found myself in the north end wondering why I was there.

I did experience these things right after the death of my dad, but at the time was not on medications or in therapy.

Is this a common thing to happen on meds?

I used to pride myself on my perfect memory and concentration abilities...now they are nowhere to be found and I am scared.

I am not working at the present time but will be looking for work in a few months and the thought of having this problem and trying to work at a job is very scary to me.

your thoughts please

[David O]

Good morning Hunter,

There is plenty of evidence that strongly suggests that many psychotropics (especially antidepressants) affect memory and even focus and concentration. Usually this involves short term memory loss, as well as difficulty focusing or processing information.

Some solutions would be to play board games such as chess, checkers or other games that require concentration, focus and attention to detail. With caution I would recommend (and talking to your MD to make sure that these do not interfere with your meds) Ginkgo biloba, Vinpocetine and Huperzia serrata, which might help (there's always some who suggest that these supplements are little more than witches brew and snake oil) increase mental strength, providing added energy to the brain and preventing the breakdown of chemicals vital to optimal brain function. These supplements can also help reduce stress, a common factor in short term memory loss, which only exacerbates the perceived memory loss, thus worsening it.

I know this is tough... my memory loss always bothers me, and I'm medication free... but also very ancient it seems. But it's normal for us oldies!

Good luck and I hope this helps,

David

[ROCKWOOD]

Whew....I noticed this effect when I got off of my medications. Have been off of them for 6 months now with the exception of Xanax. Before, I was on Effexor(then)Lamictal, Strattera, Xanax and Trazadone.

But never have I experienced it like Monday night. I had a major panic attack in my class. Although I'm prone to anxiety and panic attacks, I've never had one in class.

I was trying to configure a cisco router in my VoIP class, something I'd done many many times. I couldn't for the life of me remember how to do it. I looked back at my notes and I didn't understand anything. I had to leave class because I felt the panic attack coming on and I sat in my car in the parking lot to let it pass.

I'd be interesting in hearing more about the loss of memory. Is it during the course of medications, or can it last after quiting the medications?

[Symora]

I had memory issues as well on Celexa, but I felt it was more of a 'fuzzy' brain', more like not being able to clearly access the memory. I've been off about a month now and I find my mind clearer, and I can find my words more easily as well. Medication is effective but it does affect brain functionning, so it's not surprising that access to memory can be affected...

[Luna-]

Grrrrrrrrrrrrrrrrr. I typed out a whole long reply to you Hunter, just after you posted and then the power went off. Had to sit and do some slow breathing!! %#$&@!! I’ve faced this side-effects issue you brought up, so many times, that I didn’t want to let the post go unwritten, so here we go again:

Is this a common thing to happen on meds?

I used to pride myself on my perfect memory and concentration abilities...now they are nowhere to be found and I am scared.

Yes, it can happen, I experience the same and yes, it's very scary. I’m on Seroquel, Wellbutrin, Efexor and Lamictin for Bipolar1. Seroquel, in particular has caused me some cognitive impairment. The bad news, however is that our illnesses can themselves cause the same symptoms. When depressed, my thinking is very slow and foggy, adding a simple list of numbers is hard, remembering is hard. When manic, I can’t focus or concentrate to save my life, not very much sticks in my brain and things happen that I don’t remember afterwards.

I've been on a long list of many meds trying to find something that is effective for the ups and downs and some meds have been far worse than others. For example lithium probably knocked a good 30 points off my IQ as well as messed my coordination so bad I fell over many times, my hands shook too much to write, not to mention I landed in hospital hallucinating from toxicity.… I won’t go on. I couldn’t live like that! Yet lithium makes others function brilliantly, without these side-effects.

I pride myself on my spelling and Seroquel has definitely affected it. (I just had to look up how to spell ‘definitely’, which I know how to spell!!) Sometimes when I’m talking I suddenly can’t find the word I want, and when it comes to me I sometimes mispronounce it, have to stop and say it again. This began after I started on Seroquel.

People vary in what they consider tolerable. Some side-effects are deal-breakers for some people, but not for others. You weigh up effects vs side-effects.

SO the options are:

1. Stay on the meds

2. Go off the meds

3. Search for other meds which will be effective and won’t cause these side-effects in you. You won’t know until you try each one as they’re different for everyone, but if you’re lucky and find them it’ll be well worth the search.

My BP is so-called ‘treatment resistant’ especially my depression. So when I find something that helps for me, taking the medication is the lesser of two evils. Seroquel has been so beneficial for me, that I’m willing to pay the price. (There were other meds that caused worse cognitive impairment for me.) My other meds also weigh in favour of benefits, although Seroquel is the worst culprit in terms of side-effects for me.

I really dislike taking benzodiazepines (Xanax, Klonopin, valium etc etc.). I’ll take short courses if I must (eg. to sleep during mania), but I don’t want those side-effects long-term, they’re worse than the benefit for me. I'd rather handle insomnia with sleep hygiene, hot milk etc.

For some, ditching the medication in favour of their unmedicated state is the lesser of the two evils and easier for them to deal with, as you saw above. Others stay on it because it relieves their symptoms and enables them to work and function in their roles. People just differ.

But as David O mentioned there is something you can do if you choose to take the meds (my cognitive ability is very valuable to me too and I’m horrified at the thought of losing it!!)

The brain has ‘neuroplasticity’ - plastic in the sense that it can be moulded like plastic. There is lots of spare capacity and extra neurons that are not connected. When we learn the brain forms connections between neural cells so we’re able to master skills and retain them. If you lose some of these skills, (because a medicine eg. suppresses the firing of some neurons), you can actually form new connections by practising the skill and ‘re-learning’ it, not from scratch as you knew it before, but you practise again. This is how stroke patients learn to walk and talk again after the stroke has killed off some neurons.

So you can compensate for the difficulty, as David O said. I look up all the words I can’t spell, say them phonetically, look at them hard and then wait a bit and write them out again. I write a lot (as you may have noticed… *blush*) and I’ve regained most of my spelling and don’t get held up as often anymore. I don’t mispronounce words nearly as often. To remember stuff, I write it down and repeat it to myself a few times. I do Sudoku’s and I’m not too bad. When I was admitted to hospital for depression once, I took Sudoku’s with me, to do, but I couldn’t work out even the simplest ones!! When I got on meds that worked, I could do them again. I still have some cognitive problems, but they're better than they were.

Long story, I’m sorry, but I think I also needed to write it out for myself. Many people go off their meds because they don’t like the way they make them feel. I’ve done it (eg. with lithium, you bet! and benzos) but these days I discuss it with the pdoc first and tell him I want off and then we try something else. It’s always risks and side-effects versus benefits. Good luck!

PS. I take Omega 3 as a supplement.

PPS. I can’t find my cellphone either. It’s been missing for days now!

[David O]

I just wanted to add a bit here, especially following Luna's excellent post. While for most illness one can relapse if they don't adhere to the medication regimen, for Bipolar Disorder and Seizure Disorder, there is a severe added complexity (likely also for Schizophrenia)-- it's called the "kindling effect."

Essentially, if Bipolar Disorder and Seizure Disorder go untreated, over time the cycling can become more rapid, more intense/severe and could begin to occur without environmental stressors-- in other words, self triggering!

The name "kindling" is analogous to what happens to a camp fire, while the logs can burn easily, it may take some kindling to get it started. Once the kindling is lit, the campfire is soon fully ablaze. The process is explained well by Demitri and Janice Papolos in their book The Bipolar Child:

... initial periods of cycling may begin with an environmental stressor, but if the cycles continue or occur unchecked, the brain becomes kindled or sensitized - pathways inside the central nervous system are reinforced so to speak - and future episodes of depression, hypomania, or mania will occur by themselves (independently of an outside stimulus), with greater and greater frequency.

Simply put, nerve cells that were involved in one relapse or episode are more likely to be involved in another and then another and soon they become sensitized to the point that they serve as their own "kindling." Before the effect was in place, it usually took external triggers (which are more controllable). One can push the analogy further and research suggests now that once the fire has spread (once there have been several episodes due to no treatment), the camp fire has spread on its' own. For this reason alone, staying on meds is critical.

Hopefully this info is helpful,

David

[mscat]

I noticed memory issues as well. But , I am on a lot of meds , too many , I think. But , they help me. Lexapro 30mg , and Keppra which just got increased to 3000mg's a day , YIKES . Plus clonipin, clonidine , abilify, thyroid med, shoot I can't remember the rest ... Guess I need to stay on them though , but internally , I struggle with so many issues , it really sucks . Outwardly , I see how the meds have helped me feel better . I am in therapy too, yet , many times things come up unespectly and I am at a loss on what to do . (sigh)

[Luna-]

Thanks for bringing up the kindling effect, David.

Alas, I am one of those whose BP has worsened due to this effect. Due to late diagnosis and treatment with anti-depressants alone, without mood stabilisers, my cycles have speeded up and worsened over the years. I used to have years of normal mood in between episodes, now I have very little time, not more than a month, if any.

So if anyone wants my advice (for what it's worth ) if you have BP, keep taking the meds.

[Lindamomof7]

Hi Hunter well I have the same problems and I have to agree with most of the replys here but then again I have been told there might be something more "organic" going on and after a follow up MRI I have hyperintensities and demylenization going on...

So, there might be some truth in the organic theory or there could be just normal "junk" in my head. But when I totally forget that i have kids to get off the bus or totally forget gaps of time and occurances , something is wrong.... Oh and did I say I am bipolar and on no meds??? So being on meds might not be the whole issue but us depressed/cycling people I guess just have to live with it... My family accepts it more then me because I know I can't do anything I used to.....

Well Luna the more we talk about ourselves, the more we have in common!!! But I too seem to be the victim of the kindling effect. Looking back at my medical records though, I see that it has been at least 15 years since I have been saying to the Dr's there is something wrong with my memory!!! And it got worse and yes my IQ test was taken about 5 yrs ago, and the results were so off the mark because I couldn't remember and my confusion was even worse. So, so much for IQ's!!!:mad: To me they are worthless in determining the level of function I am and my accomplishment of a BS in college and taking courses like trigonometry and statistics....????

I was considering going for my masters in counseling and realizing the licensing test is comprised of mosty statistics etc. there is NO WAY I can even open up that book!!!

So Hunter I guess I would just suggest setting up some simple things like a basket at the doorway for your phone and keys, write things down, I am a visual person right now so everything I have to remember has to be written and read. Good luck....