Posted by Ritch on September 11, 2002, at 13:27:21
In reply to Mental dulling - any ideas which med?, posted by amber_spirit on September 11, 2002, at 11:02:02
> I'm on a combo of
> Depakote ER 1000mg
> Lamictal 25mg
> Seroquel 100mg
> Synthroid 25mcg
>
> I'm having a real problem with mental acuity (wow,
> can't believe I came up with that word). I keep
> forgetting things, I'm disorganized, I can't
> remember from one minute to the next what I'm
> trying to say. Also, I teach and not only do I
> have trouble finding words sometimes (I've had
> this to a certain extent before) but now I can't
> pronounce the words. I'm constantly stumbling
> over what I'm trying to say and having to repeat
> myself. Finally, I have difficulty putting together
> well-organized thoughts.
>
> This is just not me. Part of what makes me a good
> teacher has always been my ability to organize
> and explain things simply. Also, I'm a good speaker.
> I've had word find problems before, but not the
> problems with pronunciation.
>
> Sorry, I'm rambling. My question is - does any have
> any idea which of my meds is most likely to be
> causing these problems? I'm really feeling pretty
> good right now and I don't want to screw it up.
> But its hard to teach when I don't even know what
> I'm saying and can't say it.
>
>Amber,
The Depakote and/or Seroquel would be my guess. Do you take your Depakote ER all at nightime? I went to Abbott's site and read through the stuff on Depakote ER trying to get an idea what was *different* about it. It seems that the peak blood level is what is greatly delayed-from 2-4 hrs post-dosing with standard EC Depakote to 6-8+ hrs with Depakote ER. However there is little difference between the two in blood levels much later in the day from what I understood. If you take all your ER right at bedtime you might be having some trouble in the morning getting your thoughts together (when the blood level is quite high). It might work out better to take 500mg ER twice daily instead (once at bedtime-once midday). That way your blood levels would be much lower in the morning at school and if you took the 2nd one at lunch, the blood level peak from that dose would be delayed until after you got off work in the afternoon. As far as Seroquel goes.. well it is quite sedative from what I remember. It has a very short half-life however. I was taking 25mg at bedtime only and I was zonked on my ass the first few hours of the morning. Later in the day my head cleared up and I seemed to have unusual mental acuity and sharpness (a "rebound" effect-I guess). Maybe you could cut your Seroquel in half to 50mg an hour or two before bedtime only?
some ideas,
Mitch
poster:Ritch
thread:119536
URL: http://www.dr-bob.org/babble/20020906/msgs/119548.html