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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by sk85 on November 9, 2012, at 12:52:11
Well I'm back on clomipramine. It just works so well for a lot of things that are going on in my life, from dystonia to OCD. But it really affects my memory - a reason why I have discontinued it before on numerous occasions as my work involves remembering a lot of things. However, for the sake of my emotional and physical wellbeing I guess I'm going to have to sacrifice something. No silver bullet for me.
Still, has anyone tried to take anything for their cognition when on tricyclics or other anticholinergic medication? I'm looking for real experiences. I've tried some supps (phosphatidylserine, low dose piracetam, choline) but they aren't that effective, or maybe I haven't found the right one.-Ikaros
Posted by SLS on November 9, 2012, at 15:50:00
In reply to How to battle anticholinergic amnesia?, posted by sk85 on November 9, 2012, at 12:52:11
> Well I'm back on clomipramine. It just works so well for a lot of things that are going on in my life, from dystonia to OCD. But it really affects my memory - a reason why I have discontinued it before on numerous occasions as my work involves remembering a lot of things. However, for the sake of my emotional and physical wellbeing I guess I'm going to have to sacrifice something. No silver bullet for me.
> Still, has anyone tried to take anything for their cognition when on tricyclics or other anticholinergic medication? I'm looking for real experiences. I've tried some supps (phosphatidylserine, low dose piracetam, choline) but they aren't that effective, or maybe I haven't found the right one.
>
> -Ikaros
Sorry, Ikaros. I don't have any personal experience with the following agents:Cholinesterase inhibitors like Aricept (donepezil)?
Pilocarpine? I mention this drug only because it is an acetylcholine muscarinic receptor agonist. I don't know if it has ever been used to remediate anticholinergic cognitive side effects. Perhaps it is worth a quick look.
- Scott
Posted by jono_in_adelaide on November 10, 2012, at 4:57:41
In reply to How to battle anticholinergic amnesia?, posted by sk85 on November 9, 2012, at 12:52:11
urecholine might be worth a try?
Posted by SLS on November 10, 2012, at 7:19:10
In reply to Re: How to battle anticholinergic amnesia?, posted by jono_in_adelaide on November 10, 2012, at 4:57:41
> urecholine might be worth a try?
To my knowledge, Urecholine (bethanechol) does not cross the blood-brain barrier at therapeutic dosages. Wikipedia is probably wrong.
- Scott
Posted by sk85 on November 10, 2012, at 13:33:53
In reply to Re: How to battle anticholinergic amnesia? » sk85, posted by SLS on November 9, 2012, at 15:50:00
> > Well I'm back on clomipramine. It just works so well for a lot of things that are going on in my life, from dystonia to OCD. But it really affects my memory - a reason why I have discontinued it before on numerous occasions as my work involves remembering a lot of things. However, for the sake of my emotional and physical wellbeing I guess I'm going to have to sacrifice something. No silver bullet for me.
> > Still, has anyone tried to take anything for their cognition when on tricyclics or other anticholinergic medication? I'm looking for real experiences. I've tried some supps (phosphatidylserine, low dose piracetam, choline) but they aren't that effective, or maybe I haven't found the right one.
> >
> > -Ikaros
>
>
> Sorry, Ikaros. I don't have any personal experience with the following agents:
>
> Cholinesterase inhibitors like Aricept (donepezil)?
>
> Pilocarpine? I mention this drug only because it is an acetylcholine muscarinic receptor agonist. I don't know if it has ever been used to remediate anticholinergic cognitive side effects. Perhaps it is worth a quick look.
>
>
> - ScottPilocarpine has the potential to induce epilepsy, so I'd rather not go there.
Aricept is interesting. But has anyone not suffering Alzheimer's taken it and found it useful? Cholinesterase inhibitors can have on their own right numerous SEs.
A more interesting question would be, does tolerance develop to the anticholinergic effects, or is this a false hope?
Posted by jono_in_adelaide on November 11, 2012, at 3:22:39
In reply to Re: How to battle anticholinergic amnesia?, posted by sk85 on November 10, 2012, at 13:33:53
Maybe a change to an antidepressant without significant anticholinergic action would be in order
Mirtazapine seems an obvious choice
Posted by SLS on November 11, 2012, at 6:27:26
In reply to Re: How to battle anticholinergic amnesia?, posted by sk85 on November 10, 2012, at 13:33:53
> > > Well I'm back on clomipramine. It just works so well for a lot of things that are going on in my life, from dystonia to OCD.
Isn't it precisely the anticholinergic effects of clomipramine that are improving the dystonia?
> Pilocarpine has the potential to induce epilepsy, so I'd rather not go there.
A friend of mine has been taking pilocarpine for quite awhile to treat salivary insufficiency. So far, no seizures.
> Aricept is interesting. But has anyone not suffering Alzheimer's taken it and found it useful?
I know two people with depression who have found Aricept helpful to improve depressive and cognitive symptoms. In each case, however, the improvement failed to persist over time.
> Cholinesterase inhibitors can have on their own right numerous SEs.
Which ones in particular concern you?
> A more interesting question would be, does tolerance develop to the anticholinergic effects, or is this a false hope?
For how long have you been taking clomipramine?
For me, the anticholinergic effects of imipramine diminished over time. There were some residual cognitive effects, but I found them to be acceptable.
If you do decide to discontinue clomipramine, you may want to taper gradually in order to prevent a cholinergic rebound that could include a worsening of dystonia.
- Scott
Posted by jono_in_adelaide on November 11, 2012, at 19:22:13
In reply to Re: How to battle anticholinergic amnesia? » sk85, posted by SLS on November 11, 2012, at 6:27:26
This is the end of the thread.
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