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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Jumpy on March 1, 2003, at 21:55:47
Hey Everyone,
My medications (nardil and klonopin) cause memory loss and cognitive dysfunction. My job in requires that my memory and concentration be very sharp and exact.
Can you receive disability if you are no longer able to work secondary to memory loss?
Does anyone know any good professions that DON'T require intact memory (I can't think of any)?
Any advise is appreciated ... thanks in advance.
Jumpy
Posted by Eilidh on March 2, 2003, at 7:41:57
In reply to Memory Loss ... Disability ... Work, posted by Jumpy on March 1, 2003, at 21:55:47
Did you take Klonopin before Nardil, and did you have memory impairment at that time? Have you only had this problem since taking nardil? How long have you taken nardil? Is it dose related?
I too have the problem since commencing nardil,it is not listed as a side effect, and my pdoc. states he thinks it more due to my mood not being sufficiently medicated rather than the nardil despite the fact I feel brighter than I have for years.I can accept that he may think there is impaired concentration, but years of depression have seen far worse levels than now, so I am convinced the nardil is responsible.
I'm having to find ways round the memory impairment which still permit me to do my job accurately, although it is tough.Which aspects of your job are you finding most difficulty with? Are your colleagues supportive? Could there be different ways of doing the task, or have you reached the point where you would prefer to leave the job because you have struggled enough?
There are professions which are more accomodating of this than others, but without knowing your current employment it is difficult to attempt to identify appropriate alternatives.
If you are wearied with the effort of maintaining employment, and it is proving to be detrimental to your mental health, you should talk with your pdoc. If he/she is supportive of your struggle it is possible for them to argue the case of these difficulties being related to your diagnosis, and secondary to essential medication which is required to maintain your stable mental health. This would be seriously taken into account when your disability application is being considered for payment.
Further advice re this also depends on which country you live in.
Good luck.
Eilidh
Posted by Jumpy on March 2, 2003, at 12:38:02
In reply to Re: Memory Loss ... Disability ... Work » Jumpy, posted by Eilidh on March 2, 2003, at 7:41:57
> Did you take Klonopin before Nardil, and did you have memory impairment at that time?
Took 0.5mg klonopin before, and had mild memory impairment from that.
Have you only had this problem since taking nardil?
Mild impairment from the klonopin, major impairment from the depression, moderate impairment with klonopin and nardil together
How long have you taken nardil? Is it dose related?
Off and on for 4 years ... up to 45mg I have no positive or negative effects from nardil. Once I start 60mgs, I get memory problems, weight gain, insomnia, sexual dysfunction. Have tried 52.5 and 55mgs without benefit.
> I too have the problem since commencing nardil,it is not listed as a side effect, and my pdoc. states he thinks it more due to my mood not being sufficiently medicated rather than the nardil despite the fact I feel brighter than I have for years.I can accept that he may think there is impaired concentration, but years of depression have seen far worse levels than now, so I am convinced the nardil is responsible.
> I'm having to find ways round the memory impairment which still permit me to do my job accurately, although it is tough.Which aspects of your job are you finding most difficulty with?Remember names, concentration, reading
Are your colleagues supportive? Could there be different ways of doing the task, or have you reached the point where you would prefer to leave the job because you have struggled enough?
> There are professions which are more accomodating of this than others, but without knowing your current employment it is difficult to attempt to identify appropriate alternatives.
> If you are wearied with the effort of maintaining employment, and it is proving to be detrimental to your mental health, you should talk with your pdoc. If he/she is supportive of your struggle it is possible for them to argue the case of these difficulties being related to your diagnosis, and secondary to essential medication which is required to maintain your stable mental health. This would be seriously taken into account when your disability application is being considered for payment.He states all antidepressant "dim" cognition.
> Further advice re this also depends on which country you live in.USA
> Good luck.
> EilidhThanks Jumpy
Posted by jrbecker on March 2, 2003, at 14:49:09
In reply to Re: Memory Loss ... Disability ... Work » Eilidh, posted by Jumpy on March 2, 2003, at 12:38:02
I'm assuming you have a lot of anxiety issues if you're using both klonopin and the nardil concommitantly. All that GABA [from both the nardil and the klonopin] is what's causing the memory issues.
Is your anxiety just social in nature or is it more pervasive? Secondly, is it more mental anxiety or does it also pertain to physical symptoms (nervousness, sweating, increased BP)? Reason why I'm asking is because if you're also experiencing physical anxiousness as well, then part of your problem is high peripheral adrenalin levels. This can be treated with a beta-blocker or even moderate doses of magnesium and/or omega-3 oils.
to combat the memory issues, you can maybe try the following ...-use less klonopin dosage during daytime. Add in magnesium or maybe beta-blocker as possible adjunct instead of so much benzo. If I were to suggest a beta-blocker, find one that has some abiity to cross the blood-brain barrier (e.g., atenolol) so that it will also help a little with your mental anxiety. Of course, at the same time, the ones that cross the BBB will cause some memory deficits, but much less than the klonopin. Unfortunately, the beta-blockers' effects aren't as long as benzos, so you might have to have multiple dosages throughout the day (or you can try a suspended release version if you can still find it -- I think inderall is the most popular version of this.]
Another thing you might want to try is adding in some L-Tryptophan or 5HTP in susbstitution for some or all of your benzo. This will basically increase nardil's effect on the serotonergic system. For me, it gives a fairly calming effect. It can make you a little sleepy though, so start low. If you're not into any more pill-popping, then try to increase your complex carbs as much as is reasonalbly possible -- this will hopefully accomplish the same goal. I find that having frequent doses of pastas, grains, and the like keeps me much less prone to not just depression, but also anxiety, than any benzo can accomplish.
Have you tried the fish oil route yet? And if so, how much did you try? Fish oil works pretty well for both my mental and physical anxiety but I find I don't really feel the effects unless I go above 1 g of EPA. The optimal dosage for me anxiety tx is probably around 1.75 g.
Might want to try a memory enhancing substitute like 1) DMAE, 2) ALC, or 3) some choline-type product (cholinergic enhancers can possibly increase anxiety and depression in some, so be cautious.
Lastly, you could maybe try a neurosteroid [but with caution!], such as a low dose of pregnenolone or DHEA. Pregnenolone definitely helps with memory, DHEA to a lesser extent. But here's the catch-22. Pregnenolone also antagonizes GABA, and can increase anxiety {this is all dose-dependent though]. DHEA, once again to a lesser extent, has this problem. Both help to increase the androgens, which will also help with memory, focus, and a little with sex drive as well. "Normal people" also notice a mood lift from this. I myself find this effect very mild though. It does help a lot with stress, in terms of being able to react to it [but that's totally different than helping with anxiety]. If you're going to consider this option, you should start at 2.5 - 5mg daily or every other day. Remember that the neurosteroids are subtle at first and they take 2-3 weeks to take full effect. So start low and monitor your progress.
Don't get me wrong though, klonopin is great. I use it myself sometimes. But it has its downside -- the emotional blunting, it's propensity towards possible dependency (only for some), as well as the obvious memory issues. Moderation is definitely the key I think, especially since you got a pretty hefty bang-for-your-buck already by using the nardil alone for your anxiety.Sorry I can't offer any advice on the employment issue itself. Good luck
JRB
Posted by jumpy on March 2, 2003, at 21:50:43
In reply to Re: Memory Loss ... Disability ... Work, posted by jrbecker on March 2, 2003, at 14:49:09
> Is your anxiety just social in nature or is it more pervasive?
It is essential continuous anxiety.
>Secondly, is it more mental anxiety or does it also pertain to physical symptoms (nervousness, sweating, increased BP)?
Both, mentally I obsessively worry about everything ... from my health to work to family.
Physically, I get elevated heart rate, nausea, diarrhea, dizzy ... this is constant with intermittent discrete episodes of panic attacks.Reason why I'm asking is because if you're also experiencing physical anxiousness as well, then part of your problem is high peripheral adrenalin levels. This can be treated with a beta-blocker or even moderate doses of magnesium and/or omega-3 oils.
>
> to combat the memory issues, you can maybe try the following ...
>
> -use less klonopin dosage during daytime. Add in magnesium or maybe beta-blocker as possible adjunct instead of so much benzo. If I were to suggest a beta-blocker, find one that has some abiity to cross the blood-brain barrier (e.g., atenolol) so that it will also help a little with your mental anxiety. Of course, at the same time, the ones that cross the BBB will cause some memory deficits, but much less than the klonopin. Unfortunately, the beta-blockers' effects aren't as long as benzos, so you might have to have multiple dosages throughout the day (or you can try a suspended release version if you can still find it -- I think inderall is the most popular version of this.]> Have you tried the fish oil route yet? And if so, how much did you try?
No, I am afraid of health food supplements ... without FDA testing you never know how healthy they are.
Fish oil works pretty well for both my mental and physical anxiety but I find I don't really feel the effects unless I go above 1 g of EPA. The optimal dosage for me anxiety tx is probably around 1.75 g.
>
> Might want to try a memory enhancing substitute like 1) DMAE, 2) ALC, or 3) some choline-type product (cholinergic enhancers can possibly increase anxiety and depression in some, so be cautious.
>
> Lastly, you could maybe try a neurosteroid [but with caution!], such as a low dose of pregnenolone or DHEA. Pregnenolone definitely helps with memory, DHEA to a lesser extent. But here's the catch-22. Pregnenolone also antagonizes GABA, and can increase anxiety {this is all dose-dependent though]. DHEA, once again to a lesser extent, has this problem. Both help to increase the androgens, which will also help with memory, focus, and a little with sex drive as well. "Normal people" also notice a mood lift from this. I myself find this effect very mild though. It does help a lot with stress, in terms of being able to react to it [but that's totally different than helping with anxiety]. If you're going to consider this option, you should start at 2.5 - 5mg daily or every other day. Remember that the neurosteroids are subtle at first and they take 2-3 weeks to take full effect. So start low and monitor your progress.
>
> JRBThanks a million ... I might give the beta blocker and magnesium a try. Thanks for your time and effort.
Jumpy
Posted by jrbecker on March 2, 2003, at 22:22:53
In reply to Re: Memory Loss ... Disability ... Work » jrbecker, posted by jumpy on March 2, 2003, at 21:50:43
Good luck. And don't be afraid to try the fish oil. It is of trememdous help to some people for anxiety as well depression. And it is completely safe. Other posters can resonate this approval. Remember that the FDA only throroughly tests drugs that are applying for a patent of a new chemical compound. Most supplements that are naturally-occuring (e.g., fish oil) are given much less scrutiny because of this fact, however, they are indeed monitored. All the fish oil is is oil extracted from actual fish, basically saving you the step of eating it yourself. I would definitely suggest trying it out. The thousands of people who take them can't be wrong. If you have any other inquiries on fish oil, I recommend asking Larry Hoover about it, since he is our resident guru on the topic.
JRB
This is the end of the thread.
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