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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 Evey on March 7, 2016, at 18:39:56
So I have awful brain fog, anxiety, depression whatever you want to call it. I swear it just keeps getting worse and one day I'll be brain dead. I also kind of have chronic fatigue. Anyway, I'm currently on quite the cocktail:
Lamictal 150 mg
Memantine 10 mg
Abilify 2 mg (it's making my thoughts too hyper an manic-y though, so I'm gonna try cutting it in half)
Zoloft (just started this but I've been on it before so I know how it feels, and just went from 12.5 to 25 mg)
Provigil 50-150 mg/day (just started this a week ago, still trying to figure out the dose)Honestly, although Provigil is helping my overall energy, it's not fixing the cobwebs. I've found abilify to be disappointing, because although it helps my ocd a bit it makes me feel too agitated. However, provigil seems to have an antidepressant effect so I think I'm keeping it. Zoloft may or may not be helping my abilify-induced hypomania...I'm going to go with not.
I'm interested in trying either amisulpride or nardil, since I have a lot of atypical, anhedonic depression as well as the other symptoms I mentioned. There are pros and cons to both I know. Which one do you think I should try? I am not good at making decisions, especially when it involves suggesting something new to my pdoc.
Posted by Evey on March 7, 2016, at 20:12:38
In reply to Of these 2, which meds for brain fog?, posted by Evey on March 7, 2016, at 18:39:56
Also wanted to add, I occasionally take this combo with an adderall or ritalin later in the day.
Posted by SLS on March 8, 2016, at 7:52:47
In reply to Of these 2, which meds for brain fog?, posted by Evey on March 7, 2016, at 18:39:56
Provigil gave me incredible brain-fog and cognitive blunting. These effects began soon after starting it, and persisted for 2-3 weeks after discontinuation. If Provigil is indeed the culprit, you might not see an amelioration of cognitive side effects for a few weeks. Hopefully, it would be immediate for you.
Lamictal can produce brain-fog and problems with memory, but this seems to occur in only a minority of people or at higher dosages. Many experience these things as startup side effects that disappear over time. 150 mg/day is not a high dosage. Most people find 200 mg/day to be effective. After some experimentation, I arrived at 300 mg/day as optimal for me.
- Scott
Posted by SLS on March 8, 2016, at 8:01:53
In reply to Of these 2, which meds for brain fog?, posted by Evey on March 7, 2016, at 18:39:56
Knowing the timing of your starting each of the drugs on your list is helpful. It looks to me like Lamictal is the culprit based upon your description. Did the brain-fog begin after starting Lamictal?
When did you start taking Lamictal?
When did you first begin to experience brain-fog?
Of course, cognitive-blunting can be a symptom of depression.
Zoloft gave me brain-fog.
- Scott
Posted by Evey on March 8, 2016, at 18:47:14
In reply to Re: Of these 2, which meds for brain fog? » Evey, posted by SLS on March 8, 2016, at 8:01:53
Honestly, I've had brain fog as long as I can remember. Since elementary school or mid-childhood I've had it, as well as not having a lot of energy. I felt blah a lot as a child, and now it's like I feel brain dead. Although I didn't actually start meds until after I started to feel brain dead. I started them at 17.
Doing cardio exercise a lot doesn't seem to improve any of this very much. I just mention that because I can't count how many times it's been suggested like it's a panacea.
I do remember the order:
I was on cymbalta for about 3 and a half years, and only stopped it recently.
I went on lamictal 3 years ago.
I was taking wellbutrin a couple times over the last several years, it never did much.
Started memantine 2 years ago
Started abilify a month ago.
Started zoloft about a week and a half ago.
Started provigil about a week ago.
I think provigil is giving me a welcome antidepressant effect that is more than I've experienced from other meds. It's also increasing my energy. But I do suspect it's giving me a bit more fog. I think zoloft is maybe. Lamictal I think did too, but it took the edge off of my moods which could be destructive at times. I think I need some kind of mood stabilizer. Does abilify do that? I wish I could afford one of those genetic tests to see what meds would work best. I kind of suspect some sort of antipsychotic would help me. That's when I found amisulpride, but since it's not available in the US yet I don't think my doc would monitor me on it.Any other info you need? Despite my brain fog, I have a decent memory for details. I forgot to add my age is 24. I'm trying to figure out all of this right now so I can get my life on track (which would basically be for the first time it's on track as an adult since I've had a sick brain since late childhood or most likely long before that)
Posted by Evey on March 8, 2016, at 18:58:05
In reply to Re: Of these 2, which meds for brain fog?, posted by Evey on March 8, 2016, at 18:47:14
Today has been a stressful day so I fear my post above may be confusing. I know either zoloft or provigil is giving me brain fog. And I'm pretty sure lamictal did too. I'm generally pretty sensitive to medications...I feel differences early on, from small doses. I feel very hesitant about abilify. I don't think it's helping, but I'm scared of weight gain with other antipsychotics, and the zombie effect.
What meds help brain fog? Can antipsychotics help mental clarity? I can't afford to try going completely off lamictal right now.
Posted by Horse on March 8, 2016, at 22:48:45
In reply to Re: Of these 2, which meds for brain fog?, posted by Evey on March 7, 2016, at 20:12:38
I'm not sure what you could add, since you're on stimulants. I haven't found an AP to help with brain fog AT ALL. Once I was on a micro dose of risperidone, and that seemed to clear things a bit, and I suspect much of that was anxiety reduction.
Wellbutrin could help; maybe switch zoloft for that. Brintellix has helped me in this area. I noticed the difference when I transitioned from Lexapro to it.
Funny you mention provigil. I logged on here with a question about that and nuvigil.
Posted by uncouth on March 31, 2016, at 0:47:54
In reply to Re: Of these 2, which meds for brain fog? » Evey, posted by Horse on March 8, 2016, at 22:48:45
actually my experience was that the brain fog on lamictal was only actually apparant to me after long term administration at 200mg. like, after a while, i only started realizing how poor my memory was and how "foggy" lamictal was making me. try decreasing it and seeing what happens.
I'd also dramatically increase the namenda. You'll feel even WORSE and foggier for a while before the nictonic receptors upregulate, but i still remember first time I went on namenda, really cleared my thinking which was pretty disorganized at the time. Get to 20mg, preferrably 28mg of the new Namenda XR formulation.
Report back!
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