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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by LynnPerley on December 20, 2003, at 12:45:44
I have been taking effexor xr for quite a while now. My depression is improving to the point the mental slowness, i.e., calling people by the wrong name, having a word in mind but not being able to say it, short term memory problems, "brain fog", etc. side effect of the effexor xr is frustrating. I took provigil for a month and it helped some but the insurance company would not approve it, so I was prescribed ritalin instead. I'm interested in hearing from anyone else who has added ritalin to combat side effects or brain fog from an antidepressant or SSRI. BTW, I take 300 mg of effexor xr every night. I was prescribed a dosage of either 5mg or 10mg of generic ritalin every morning. How long does the ritalin last and does it take a while to build up or does it get out of your system quickly?
Posted by pbjc on December 20, 2003, at 17:32:53
In reply to Ritalin for brain fog, posted by LynnPerley on December 20, 2003, at 12:45:44
You'll find that the Ritalin will wear off within 4-5 hours, so you may want to go to twice a day dosing since that morning dose won't get you through the entire day. I take 60-80 mg of Ritalin a day as an adjunct to my other antidepressant medications. It helps me focus and concentrate as well as improve the other problems you associate with "Brain Fog." These symptoms are all a result of my depression as opposed to yours being caused by your Effexor. I hope Ritalin helps you.
Posted by noa on December 20, 2003, at 18:23:27
In reply to Ritalin for brain fog, posted by LynnPerley on December 20, 2003, at 12:45:44
I take Effexor XR and a stimulant (started with ritalin, now on Adderall XR). For me, the stimulant helps me feel more focused and calm, and I think it helps with alertness.
But the memory effects of Effexor, such as inability to retrieve a word mid-sentence, don't seem to be mitigated by the stimulant for me. For me, it is simply dose-related. When I take about 300 or more mg of Effexor, I also have experienced the word retrieval problems. On lower doses (I was on 262.5 for a long time, now I'm on 225), I have not had the word retrieval problems. (Although I've been on the lower doses for a long time, I recently experienced the word retrieval problems short term when I mistakenly took too much effexor for 2 days. The memory problems lasted for about 2 days as well and then went away).
I also take Serzone for antidepressant effect and to counter some of the other unwanted effects of the Effexor (insomnia, restlessness, muscle twitches, etc.).
Posted by squids on December 20, 2003, at 23:23:15
In reply to Ritalin for brain fog, posted by LynnPerley on December 20, 2003, at 12:45:44
After so many years of being told I was a depressive, I got diagnosed with inattentive ADD this year and put on ritalin. Am also taking zoloft for depression. The ritalin is amazing, wonderful stuff. I can actually sit down and focus now. Yesterday I spent several hours organizing my to-do lists and phone numbers. I actually use my PDA to organize my life now instead of having it as an expensive toy to play games on.
I've taken AD's since I was 17 (am 36 now) and even when they were working I often felt like my mind was mush. But I was supposed to be "cured" so I guessed that was just the way I was normally.
But I really hated that slow feeling. One of the things about ADD is the ability to hyperfocus on occasions - just be totally into what you are doing. I got through college by waiting until the last minute, when the pressure was on my hyperfocus would usually kick in. I love that and feeling slow and stupid just seemed so wrong. I just didn't know what was going on until I got the ADD diagnosis this year.The ritalin does wonders for my overall thinking. I take 5mg focalin (dexmethylfenidate - the more active D isomer of ritalin) 4x a day. In my case it usually takes 15 minutes for it to kick in and each dose lasts about 3 hours. I take mine throughout the day from waking til 5pm. If I take it later I have trouble falling asleep. I haven't had any side effects from it either.
My cocktail is 5mg focalin 4x/day, 100mg zoloft in the morning, and .5 mg klonopin as needed.
Hope it works well for you.
Posted by Siraris on December 22, 2003, at 3:13:33
In reply to Re: Ritalin for brain fog, posted by noa on December 20, 2003, at 18:23:27
I take Klonopin and Paxil for my anxiety/depression and I have had a lot of brain fog over the past year or two (which is odd because it didn't happen before that). My cognition has dropped dramatically, but I am trying to get off Klonopin and hopefully that will help.
I took ritalin for years, and adderall as well, but it always made me so anxious I don't think it helped. My heart would race and whatnot and I would just be in terrible shape.
Ritalin may work, and if it does great, but also look into Strattera. After I wean off Klonopin I am going to try taking Strattera, and see how it works (I tried before but the scheme Lilly had out to administer the Strattera was wrong so it didn't work well). If it works, I will be elated because I can hopefully get myself back.
I also notice a change in my "brain fog" with different doses of medication. When I dropped half a MG of Klonopin 2 daysa go, I definitely felt it easier to think, and have word recall, and I actually obcess less about it now for some reason.
Good luck. :)
Posted by myclonic_jerk on December 24, 2003, at 14:42:05
In reply to Re: Ritalin for brain fog, posted by Siraris on December 22, 2003, at 3:13:33
Greetings,
I took Ritalin yesterday for the first time (along with 400mg Lamictal/60mg Prozac, my mainstay meds);within a couple of hours of taking a 10mg pill, I felt very ill at ease, and it had a marked (negative) effect on my personality later in the evening, when I was socializing.Actually, it turned me into a bit of a ****!
Does this med. require a period of adjustment, as with antidepressants, and then get better?
Or would a 5mg starting dose be more appropriate?
I'm fairly med. sensitive generally, and it took me years to adjust to Prozac.
Worth persevering, Ritalin buffs??MJ.
Keep happy over the next few days guys.
Often easier said than done Iknow.
Posted by pbjc on December 24, 2003, at 15:50:14
In reply to Re: Ritalin for brain fog, posted by myclonic_jerk on December 24, 2003, at 14:42:05
> Greetings,
>
> I took Ritalin yesterday for the first time (along with 400mg Lamictal/60mg Prozac, my mainstay meds);within a couple of hours of taking a 10mg pill, I felt very ill at ease, and it had a marked (negative) effect on my personality later in the evening, when I was socializing.Actually, it turned me into a bit of a ****!
> Does this med. require a period of adjustment, as with antidepressants, and then get better?
> Or would a 5mg starting dose be more appropriate?
> I'm fairly med. sensitive generally, and it took me years to adjust to Prozac.
> Worth persevering, Ritalin buffs??
>
> MJ.
>
> Keep happy over the next few days guys.
> Often easier said than done Iknow.First, I would ask if you took the generic or Brand Ritalin? I can only take the Brand Ritalin because if I take the generic it makes me anxious and jumpy, something about the fillers being different in the generic than in the Brand. Otherwise, it's your body and only you can determine how you are reacting to a particular med, regardless of the experience of others. Ritalin has never had a negative impact on my personality. If anything, it has given me the ability to focus and function in social situations like you mentioned. The CNS stimulating action of Ritalin may affect you differently; I certainly wouldn't take it more than a couple of more times if you had the same reaction, then make sure you get with your doctor and tell him/her your reaction when you take this med.
Good luck.
Posted by tried them all on December 25, 2003, at 14:11:30
In reply to Re: Ritalin for brain fog, posted by Siraris on December 22, 2003, at 3:13:33
I have been taking Concerta for the past two weeks, at 18mg, an introductory dose for sure, along with my Abilify and remnants of serzone and Klonopin and find that the Concerta is amazing. I am very sensitive, so small doses are my way, and find that it makes me alert and focused, alleviates food cravings, does not cause any increased anxiety or racing heartbeat or any such side effects. Only thing is its cost. I know there are those out there taking a whole lot more, but right now this is where my doc has me as we gradually up the Abilify.
Posted by fayth on December 26, 2003, at 20:41:41
In reply to Re: Ritalin for brain fog, posted by Siraris on December 22, 2003, at 3:13:33
Wow.. I suffered with really severe brain fog...or idiopathic hypersomnia for years.. we tried combos of meds for a year.. the ONLY thing that worked for me was taking Effexor with 50 to 60 mgs of ritalin per day. I had high hopes for Concerta but it does nothing for me. We also tried Provigil and again nothing. I get alot of prejustice because of taking Ritalin. Sometimes I do worry it could hurt you because some people will say to me.. "Oh your taking speed" anyone have ideas on that? I just find it pretty funny that almost everyone with this problem is finding the Rit/Effexor combo helpful.
Posted by squids on December 27, 2003, at 0:55:19
In reply to Re: Ritalin for brain fog, posted by fayth on December 26, 2003, at 20:41:41
My doctor puts it this way. Taken according to prescription its medicine. Saving up a couple of days worth to snort at once is drugs.
I think as long as you take breaks every now and then (weekend, 1 week out of 4) you're ok.
just my $.02
Posted by tried them all on December 27, 2003, at 9:34:38
In reply to Re: Ritalin for brain fog, posted by fayth on December 26, 2003, at 20:41:41
I, too, find it amazing that so many are using Effexor. I had a terrible time with it. My BPII has been very hard to pin down and I have been through every category of AD's as well as several within some categories, the SSRI's being the worst for me. The mood stabilizers such as Lamictal, Topamax, etc were all filled with side effects for me as well. I finally went to a psychopharmacologist who is slowly adding a dash of this and a dash of that and I haven't felt this good in years, literally. Each and every one of us is so different and reacts so differently to meds that one treatment for all is ludicrous. Lithium was toxic to me in the initial dose, tiny as it was, and I thought all was lost, but here I am on a novel cocktail. So for some, Effexor and Ritalin works, for others they don't. I had no response to either Strattera or Provigil, but Concerta at minimal dose is terrific......trial and error but it is agony to go through. My only issue right now is early waking....some days as early as 4am after going to sleep at 11 or midnight. Any suggestions for that from anyone?
Posted by LynnPerley on December 30, 2003, at 9:49:23
In reply to Ritalin for brain fog, posted by LynnPerley on December 20, 2003, at 12:45:44
It's been over a week now. Taking 5mg in the early am plus 5 mg after lunch seems to work the best. It is really helping me a lot.
I'm taking effexor because my family doc prescribed it and it is working. Perhaps if I went to a psydoc first they would have tried alternatives first. The bruxism and brain fog were the two longest lasting annoying side effects. I'm not really looking forward to ramping down on the dose but hopefully we will start doing that soon. I don't want to take these drugs for the rest of my life.
Posted by pbjc on December 30, 2003, at 10:44:47
In reply to Re: Ritalin for brain fog, posted by LynnPerley on December 30, 2003, at 9:49:23
Lynn-
I'm glad your morning/afternoon Ritalin dosing is working for you. I've been doing it that way for about 8 years and it gets me through the day without disturbing my sleep. You may not want to stay on these drugs for the rest of your life, but please stay on them for as long as you need to to control your depression. People often relapse back into depression because they stop taking their medication when their mood first shows improvement. Staying on your meds until there is "sustained" mood improvement is always the safe bet. Only you and your doctor can determine how long "sustained" is, but I'd say 6 months.
Oh, and by the way, if you haven't been told, Ritalin is a DEA Class II Controlled Substance. This means that when it comes time to refill your prescription, you'll have to get a new, written Rx from your doctor. These prescriptions can't have refills and your doctor can't phone it in to the pharmacy. Just a little practical advice.Good luck!
pbjc
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