![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by anna on December 21, 1999, at 1:13:39
(Warning I ramble. This is WAY LONG, so I may have broken a Babblerule....sorry. ADHD is my excuse...but then again, it's now my excuse for everything! New to board--have been reading for years, finally just decided to chime in.)
Okay--I'll lay out my "problem" (well, one of them).
I'd love as many opinions/ideas/comments as I can get--quacks/amateurs/fellow med-junkies/ real-honest docs all welcome! (My wonderful psychologist would kick me if she knew I was adding yet another distraction to my collection--one more thing for me to "research" to pieces...so nobody tell...)I think my meds maybe causing me to forget everything...but why now?
Problem:
Over the last few months, I feel I am increasingly forgetting things--primarily in the shorter term. I've always bit scatter-brained and spacey (part of my charm) but not this bad--and it's getting worse. I go to the food store and can't recall why I went. I forget meetings and things I need to do--I write them down, but if I forget to check the calendar...I don't do them. I can't recall things I did an hour earlier. If I called someone yesterday for something important--not just to chat--the next day I can't remember if I called or not. I take a pill and immediately can't recall if I have taken it....I 'm not even phased anymore when I realize (usually on Sunday) that I have left my purse in the office I use since Friday. And I drove all over, and I went to stores...don't ask.I do use all kinds of things and structures to help me stay put together, but if I get out of sync on one thing--it all falls apart and I end up one big disorganized mess very quickly.
I am 40 (oh alright, just 41) female, (like anna would be a boy) and under some major stress, though I likely appear pretty calm even to my pals . (I'm in a job hunt after a miserable work situation--I may have to change cities, I love my home and my friends and hate the idea of change...plus other stuff.) But, I did take months off to relax after I left my last job, got decent severence and, at least until the last couple of weeks, was not overly panicked about my next move.Cocktail?:
Where do I start? Oy! Have taken zoloft for 7 years for panic disorder. Also low dose Trazadone at night. Used to add xanax as needed...doc switched me to Klonopin on same basis maybe 2 yrs ago. Work stress got really bad about 18 months ago--politics and sexism and...yech! (Job itself hi pressure without the other stuff.) Depression crept in--I was taking a lot more Klonopin. Went on Buspar and Wellbruitrin also at this time. Now...flash forward to about 5 months ago. Summer. No more job. Warm. Nice tan. Go shopping. Go to lunch. Finally agree to get second opinion on meds from psychopharmacologist (jeez, are you people all a bit, ah, personality-less? Dr. Bob, not you--not from that pix! Say it isn't so! Ahh...if my doc reads this--and she would know it's moi in a second--don't take the crack personally--I have ADHD and can't help myself...remember?)Now, besides the new p-md I started seeing over the summer(and she didn't change much med-wise from the prior one--whom I like, too) I had already started seeing a psychologist earlier in the year. I wanted to understand why I am so disorganized, absent-minded and distractable. After several months of me saying no-way I got that ADHD thing, I take the written tests and combined with everything else, she confirms her hunch that I do have the ADHD...bad! (And noooow Mom tells me teachers always told her that despite my good grades, I didn't shut up and never worked up to my potential...plus other things that today would have had the school nurse shoving Ritalin down my gullet at lunchtime. )
Bear with me, we're getting there. As of about 3 weeks ago , I'm on 200mg Zoloft/day (am), 200mg Wellruitrin SR (100 am/100 pm) 50 trazadone (pm). Plus, 30-40 mg Adderal/day, split in two doses. I gave up the Buspar and the Klonipin immediately when I started the Adderall--funny how we adhd-ers calm down by taking speed! So, anyway, like I said 20 pages ago, I think the memory lapses began when I went on the Adderal, though I am not suggesting the two are related. I tell my MD-p-doc about the memory stuff.
I think she may be a bit concerned about it, and says the memory loss could be caused by the Zoloft. I express surprise, indicated by a dropped jaw--why now, after 7 years?Recap: Today: Zoloft now 100 mg/day, with 0 the ultimate goal (so far, no panic attacks). Adderal (30-40 mg/day), Welbrutrin SR (200 mg/day) trazadone 50 mg/day. After I get off zoloft completely, doc plans to start cutting back wellbrutrin, but I don't think totally. (Does that cause memory loss?)
But, though Zoloft down, still am forgetting stuff, and it seems no better.
Is it the drugs? Is it the drugs together? Is it the stress? Is it the stress and the drugs together? Is it my mother (I couldn't help it but I can't blame this one on her.) I do realize that prescribing these drugs is not an exact science, and there must be a lot that isn't known yet about these meds. I trust my doc, but wanted to let my fellow sufferers and hopefully other MDs have a shot at this, too.
Can this girl be cured?
Thank you all for your patience. I'll try never to write this much again!
PS-- I don't think this has anything to do with it, but 2 weeks ago I went on Inderal--I have had a familial (essential)tremor in my hands for ages, but getting worse last couple of years. Adderal likely doesn't help it, but I was shaking before I went on it. I now take 40 mg inderal 3x/day and no tremour.
I told the neurologist I saw for the tremour about the memory loss, he didn't seem concerned. At least I don't think he did.....I can't really remember!
Posted by Noa on December 21, 1999, at 2:47:38
In reply to Cocktail? Then why do I forget everything? LONG!! , posted by anna on December 21, 1999, at 1:13:39
Others here will be able to address the chemistry, which I cannot, but I can tell you that for me, effexor has sometimes caused severe word retrieval problems. But not other memory problems.
I do notice, tho, that when my routine changes, I forget things a lot. You are in major transition, so I wonder if that is also contributing to memory problems, disorganization.
Posted by JohnL on December 21, 1999, at 3:28:59
In reply to Cocktail? Then why do I forget everything? LONG!! , posted by anna on December 21, 1999, at 1:13:39
Hey Anna I don't mind your post being long. I found it interesting.
Zoloft is not generally known for cognitive decline. It is the best SSRI in terms of cognitive function, probably due to its 'relatively' stronger action on dopamine than other SSRIs. Wellbutrin on the other hand has been linked with cognitive decline. Why? No clue. That's just what I've seen in literature. Of everything you are taking, I would suspect Zoloft the least. I don't know of any other way to pinpoint which drug is at fault other than withdrawing them one at a time to see what difference each makes.
Tremors as well as cognitive decline are both related to dopamine deficiency. They could be related. Just a wild hunch. I wouldn't know how to approach treatment of that. Perhaps Selegiline in a 5mg - 10mg range. It would be nice to have a doctor with a little more interest wouldn't it? It just seems to me the tremors and memory loss are indeed related.
Hey, I know the perfect cure for you!.....ummmm....wait a minute....damn....can't remember what I was gonna say.......forgot. :) JohnL
Posted by Julie on December 21, 1999, at 10:31:31
In reply to Re: Cocktail? Then why do I forget everything? LONG!! , posted by JohnL on December 21, 1999, at 3:28:59
Hey Anna-
Welcome! I really related to your post: I'm an ADHD plus anti-depressant cocktail woman, too. After a year 8 years ago of nasty depression and frustrating tries of Prozac, Wellbutrin (did nothing), nortryptiline, trazodione, depakote, and lithium (very spacifying and klutzifying), I found that plain ole 150 Zoloft made me feel like my old, mostly non-depressed self. Now I take 187.5 Effexor. (I switched from Zoloft to Effexor after a short depressive episode while my regular p-doc was on vacation; his subsititute prescribed Effexor, which seems to work fine.) Haven't tried Adderal; Ritalin, oddly enough, sometimes made me sleepy! But...I find that on higher doses- of either Zoloft or Effexor, but especially the Effexor- my usual forgetfulness and klutziness get worse. And word-finding difficulties, too... annoying, especially since I'm a teacher. I've talked to my p-doc about it-- he didn't seem concerned. My own best guesses: spaciness goes along with higher doses, which means I might have to trade off between feeling a little gloomier at a lower dosage but being less spaced, or feeling more cheerful but more out-of it. I've also noticed that the higher my stress level, the spacier I get- with one paradox being that, being ADD, I sometimes forget that I'm UNDER the stress, but get mad at myself because I'm being ultra-ADD. I try to keep a sense of humor about the spacy stuff and write EVERYTHING down in several places; I also find that while I notice any increased spaciness and word-finding trouble, my boyfriend and other friends don't usually notice (although no one will let me behind the wheel of a car if they're in it...too many incidents of "Hey, look at that cool billboard/old car/house!" combined with swerving into other lanes, furious honks from other drivers, or worse...)
Posted by anna on December 21, 1999, at 11:49:30
In reply to Re: Cocktail? Then why do I forget everything? LONG!! , posted by JohnL on December 21, 1999, at 3:28:59
> TO:
JohnL
You are just too funny. I see neurologist on Thursday--I'll ask him about the medication you mentioned. However, my tremors aren't drug related and I don't think due to a dopamine definciency--it's a genetic thing that runs in some families.
Noa--
You probably are right about the stress causing most of this...that's what my ph.d-doc, my md-doc, my mom, the mailman....all think it isJulie--
I can relate--we add-ers are sometimes a scream to be with, eh? No one wants to drive with me either--and I only hit posts in parking lots--not other cars! Seriously, sometimes I have a friend's kids in my back seat...and I really have to keep the radio off, concentrate on driving and only talk ot them at red lites.Glad Zoloft works for you. It changed my life when I first went on it--to live panic free opened up the world to me--(literally--I was able to go all over the place). Zoloft loses its effacacy after a long long while--and I've been on it forever. I get the word thing too--great on job interviews!("Ummmm I got my MBA from.....oh, you know--it's on the a east coast...what's that city...the big one..new .york! Ummm... oh, just look at my resume--it's on there!")
Posted by Julie on December 21, 1999, at 16:09:13
In reply to Julie, JohnL and Noa, posted by anna on December 21, 1999, at 11:49:30
Re cars: I usually hit-or back into-posts, too, but every now and then another car just leaps into my path... luckily, no one's ever gotten hurt...
I'm curious about your statement that Zoloft loses efficacy after a long while. Is that from your own experience, anecdotal evidence from other people, studies you've read?
Posted by anna on December 21, 1999, at 22:06:10
In reply to Re: Julie, JohnL and Noa, posted by Julie on December 21, 1999, at 16:09:13
Both the p-docs I've had said Zoloft can lose some of its "umph" after time. But,I was on it for almost six years before the doc added Wellbrutrin, which can "pump up" Zoloft. And that was for depression that the Zoloft (which I originally went on for Panic Disorder and some depression) apparently wasn't touching. I'm getting off Zoloft now not because it "doesn't work", but because I want to see if I can decrease or cut out some of my meds. Doc wants to cut down/out Zoloft first. I'm worried about panic, but so far I'm ok. Does this mean the Zoloft doesn't work anymore and the Wellbrurin is keeping depression and panic under control now? Or that I just don't it (and maybe not the Wellbruitrin) anymore? Or that the inderal is relaxing me? Or....who knows?
This is my way of saying don't get worried that the Zoloft, which you said really works for you, suddenly will quit--it wasn't like that for me at all, and anyway, we are all very different!
Listen, I am flying x-country this weekend. If I find myself trying to get out the emergency exit at 37,000 feet because I "need air", I guess that will end my attempt to decrease Zoloft!
Posted by Barbara on December 22, 1999, at 10:49:26
In reply to For julie, posted by anna on December 21, 1999, at 22:06:10
You all are a source of comfort to me!!! LOL!! And just when I thought I was the only one who did run on stream of consciousness emails - emails - I do run on stream of consciousness legal briefs (but then they are not brief!) I am only missing the rear view mirror on my side of the car - you know the one - on the outside where everyone can see - and I have no idea who is left of me - I pray a lot!!
I am ADD also - 52 years old and just recently diagnosed - I am also trying to combat depression - I take dexedrine (not enough), wellbutrin (useless), cytomel (nothing works without it) estratest (estrogen with testosterone - I take the testosterone for cogitive function (?!?! yea right!!), and now since nothing works ont the depression, Celexa.
The ADD nightmare - Celexa makes me tired all the time- so tired I go into a coma if I put my head down for just a minute - so what next- I had tremendous word retrieval (word retrieval? what a euphemism - I lost my memory!) on Prozac at 40mgs. I think I am going to go off Wellbutrin - what is it doing for me - I cant tell but then I will find out when i go off
of it wont I - and the Celexa - anyone got any ideas. Under stress with not enough sleep my ADD is the pits - my boss just looks at me like I am a lost soul. Good thing he can take a joke!
More than anything I am tired of the fog in the brain. It wasnt always this way and I think it is the depression and not the ADD and I was wondering if any of you with the luck to have both of these problems, have any thoughts on this. Sometimes I even think the Dexedrine is making the ADD worse. In the absence of depression, Dexedrine is wonderful.
I just want the fog to lift.You all are a breath of fresh air - thank you - for your honesty, humor and candor. I am convinced it you dont have ADD, you dont understand. If you dont have it, you cant get the difference.
Barbara
Posted by Julie on December 22, 1999, at 17:58:22
In reply to Re: For julie, posted by Barbara on December 22, 1999, at 10:49:26
Hallowell and Ratey, in "Driven to Distraction," say that ADD and depression often seem to go together. I think that besides maybe sharing some biochemical similarities (i.e., neurotransmitters may be wack in similar ways for ADDers and depressed people), that being ADD is a depressing experience much of the time. I didn't figure out I was ADD until I was 30; my family, and the school system, thought I was "smart but not applying myself," "squandering my potential," yadda yadda. These negative external voices move inside. So finding out that it wasn't my "fault" I was this way helped a lot- although the negative internal voices still often clamor.
Re meds: What worked for me, after a year of Chinese restaurant mix-and-match (pick one from column anti-depressant, one from column trank, one from column "potentiator") has been medium to high doses of first Zoloft, and then Effexor. When the Zoloft kicked in that awful fog-- indescribably painful, as well as enveloping, in my experience-- lifted. I was back to my spacy, klutzy, self-critical, ADD, but often content self, and incredibly relieved to be back in the land of the living.
So you know that your fog WILL lift, right? And that thinking that it won't is one of the symptoms of the depression? Both true.
Another good book: "Yo uMean I'm Not Lazy, Stupid, or Crazy?" by Ramundo and somebody.
Posted by anna on December 22, 1999, at 23:02:12
In reply to Re: For julie, posted by Barbara on December 22, 1999, at 10:49:26
Hey Barbara--Fellow Rambler!!I think my entire life has been run on stream of conscuiousness!!! Depression goes with the ADD --and anxiety and panic--it was one big jumble for me--and I can't figure which causes which or if we just have to accept we are totally nuts and get on with life (which I think we do..sounds like you are atty) and yes, no one understands ADD if they don't have it....some of friends/family think I use as an excuse for my disorganization, etc.--even those that put up with me in college and grad school(Heck, even I thought ADD diagnoses were stupid ...at least until I got mine)
I am better depresssion -wise since they figured out I had ADD--and since I left my last job! But I am totally wired right now--and it's late.
Drug wars--are you working on it? Maybe a different cocktail (or maybe just a martini....)I take adderal--I understand it's a bit more even than the dexadrine alone. Never did ritalin. No, the adderal ain't perfect--in fact, at this moment, judging from the way I am writng, I'd say it's useless, but I just think I need to get myself back on track--it does work for me, but i still need to work at it too. I hate the eating side--I only eat carbs and chocolate, and I know my resistance is down. Also, I sit up till 4 am...I seem to ignore every signal that it's bedtime. Again, I think I just need to push myself a bit to get on a schedule...oh, how do we add-ers even manage to hold jobs?
Never tried the stuff you are on (no estrogen need yet...that will be next!..except I take wellbruitrin--think it works for me. Testosterone for the cognative stuff???? new one on me..maybe that will help my memory and difficulty with words?(does that mean men are more...oh, never mind.)
Enuf....and I've deleted 3/4 of this! I swear I am going to hit send and and log off. now now...i can do it...night
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.