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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by B2Chica on May 2, 2011, at 12:41:51
i feel i am having real word finding issues.
what in this mix could be most likely the culprit?i am guessing either the perphenazine or the gabapentin????
4mg perphenazine /day
600-1500 gabapentin/day
50mg pristiq
20mg adderall bid/tid
Posted by Phillipa on May 2, 2011, at 13:04:45
In reply to what in my mix could be causing cog impairments?, posted by B2Chica on May 2, 2011, at 12:41:51
Could it be high anxiety? And fears? I see you are on a lot of meds for this but still wonder as find the same when anxiety is high. Phillipa
Posted by B2chica on May 2, 2011, at 14:35:29
In reply to Re: what in my mix could be causing cog impairments? » B2Chica, posted by Phillipa on May 2, 2011, at 13:04:45
anxiety;s been better the last few days but word finding issues the same.
its to the point where (although i laughed great at this) sunday my 4 year old daughter was stuttering abit and then she stopped looked at me and said " i think i have aphasia cuz i cant think of the word i want to use"...LOL
she's been listening to me too much...but its been pretty bad for about 2 weeks. simple words... or maybe
and i'm thinking out loud now but it seems it happens when i'm at home. and usually my adderall's worn off by then. and i dont always take it as often as i should on the weekends?? maybe thats it?
Posted by linkadge on May 2, 2011, at 15:03:07
In reply to Re: what in my mix could be causing cog impairments? » Phillipa, posted by B2chica on May 2, 2011, at 14:35:29
What dose of perphenazine? If its low, I'd suspect the gabapentin most.
Linkadge
Posted by B2chica on May 2, 2011, at 15:31:59
In reply to Re: what in my mix could be causing cog impairments?, posted by linkadge on May 2, 2011, at 15:03:07
Hi Link!
i'm taking really low (as low as you can) of perphenazine.
2mg bid (4/day)
and between really 600mg-1500mg more or less of gabapentin.
Posted by bleauberry on May 2, 2011, at 15:38:30
In reply to what in my mix could be causing cog impairments?, posted by B2Chica on May 2, 2011, at 12:41:51
All of them with the exception of Adderall, which should actually help to improve it.
It could also be progression of whatever the true underlying problem is. Something the meds do not address. The meds are only for symptoms, not curing what is broken.
Word finding difficulties and difficult to manage psychiatric symptoms are, just as an example, almost universal with anyone who has the organisms associated with Lyme or Lyme-like conditions. Overgrowth of candida can also cause those symptoms. But if you are wanting to point a finger solely at meds, 3 of them look guilty to me, with gabapentin and perphenazine probably being the most guilty.
But who knows. Just my gut instincts for whatever it's worth.
> i feel i am having real word finding issues.
> what in this mix could be most likely the culprit?
>
> i am guessing either the perphenazine or the gabapentin????
>
> 4mg perphenazine /day
> 600-1500 gabapentin/day
> 50mg pristiq
> 20mg adderall bid/tid
>
Posted by desolationrower on May 2, 2011, at 18:16:54
In reply to what in my mix could be causing cog impairments?, posted by B2Chica on May 2, 2011, at 12:41:51
pristique could do this, as well
-d/r
Posted by Phillipa on May 2, 2011, at 22:00:37
In reply to Re: what in my mix could be causing cog impairments? » Phillipa, posted by B2chica on May 2, 2011, at 14:35:29
B2chica smart little girl!!!! So many opinions on here. I'd go with my gut feeling Phillipa
Posted by hyperfocus on May 3, 2011, at 9:39:18
In reply to what in my mix could be causing cog impairments?, posted by B2Chica on May 2, 2011, at 12:41:51
It could be the combination of 3 meds. For me, mixing benzos and TCAs lowers my cognitive functioning significantly to the point where I'll be talking to someone and then forget what I was talking about. Separately, the meds don't really do that. Do you have general cognitive problems like this or is it specifically the word-finding problem?
Posted by B2chica on May 3, 2011, at 10:45:18
In reply to Re: what in my mix could be causing cog impairments? » B2Chica, posted by hyperfocus on May 3, 2011, at 9:39:18
i generally have some short term memory loss due to a couple unsuccessful attempts.
but not really word finding issues.but thinking about it i've been on gabapentin since last nov. and just now having issues.
so its either the amount of gaba used lately due to high anxiety or the perphenazine since i just started that a few weeks ago.some days better than others. so i'm almost thinking its the gabapentin since that i dont use consistently (or at least the amount consistently).
you think thats plausable?
b2c.
Posted by SLS on May 3, 2011, at 11:20:27
In reply to what in my mix could be causing cog impairments?, posted by B2Chica on May 2, 2011, at 12:41:51
> i feel i am having real word finding issues.
> what in this mix could be most likely the culprit?
>
> i am guessing either the perphenazine or the gabapentin????
>
> 4mg perphenazine /day
> 600-1500 gabapentin/day
> 50mg pristiq
> 20mg adderall bid/tid
>
I don't have a guess as to which drug is responsible for your cognitive impairments, although I would not discount Pristiq as the culprit. However, I don't think you should be varying your dosage of gabapentin. I think you should consistently use a dosage of 900mg or higher.
- Scott
Posted by desolationrower on May 3, 2011, at 20:49:48
In reply to Re: what in my mix could be causing cog impairments? » B2Chica, posted by SLS on May 3, 2011, at 11:20:27
> > i feel i am having real word finding issues.
> > what in this mix could be most likely the culprit?
> >
> > i am guessing either the perphenazine or the gabapentin????
> >
> > 4mg perphenazine /day
> > 600-1500 gabapentin/day
> > 50mg pristiq
> > 20mg adderall bid/tid
> >
>
>
> I don't have a guess as to which drug is responsible for your cognitive impairments, although I would not discount Pristiq as the culprit. However, I don't think you should be varying your dosage of gabapentin. I think you should consistently use a dosage of 900mg or higher.
>
>
> - Scottdo you think it is bad to take the gabapentin prn for anxiety, because of the mood stabilizing effects it has will vary?
-d/r
Posted by SLS on May 3, 2011, at 22:33:09
In reply to Re: what in my mix could be causing cog impairments?, posted by desolationrower on May 3, 2011, at 20:49:48
> > > i feel i am having real word finding issues.
> > > what in this mix could be most likely the culprit?
> > >
> > > i am guessing either the perphenazine or the gabapentin????
> > >
> > > 4mg perphenazine /day
> > > 600-1500 gabapentin/day
> > > 50mg pristiq
> > > 20mg adderall bid/tid
> > >
> >
> >
> > I don't have a guess as to which drug is responsible for your cognitive impairments, although I would not discount Pristiq as the culprit. However, I don't think you should be varying your dosage of gabapentin. I think you should consistently use a dosage of 900mg or higher.
> >
> >
> > - Scott
>
> do you think it is bad to take the gabapentin prn for anxiety, because of the mood stabilizing effects it has will vary?
>
> -d/r
Yes. I am concerned that constantly varying the dosage of gabapentin will prevent the establishment of various therapeutic homeostases and perhaps even kindle cognitive impairments due to glutamatergic hyperactivity. It is like going through repeated mini gabapentin withdrawals on a regular basis. My concerns are mostly theoretical and involve alpha2delta calcium channel blockade.In real life, it seems that many people can tolerate using gabapentin as a PRN without sequalae. However, it is usually good clinical practice to maintain a stable dosage to maintain a stable response.
- Scott
Posted by B2chica on May 4, 2011, at 11:29:48
In reply to Re: what in my mix could be causing cog impairments? » desolationrower, posted by SLS on May 3, 2011, at 22:33:09
i guess i didnt even know it had a mood stablilizing effect?
i normally do quite poor on moodstabilizers (makes my mood swings more prominent).
ive actually only used gaba 1xdaily (300 at bedtime) since last sat. and i have been feeling great.
dont know if its stable use or less usage.but my word finding is not NEARLY as bad only slight if any now.
and my mood has been pretty stable, only slightly down sun night.
other than that things are quite well.i think i found my culprit (on more than one issue).
thanks so much for your insight Scott.
b2c.
Posted by desolationrower on May 6, 2011, at 5:14:56
In reply to Re: what in my mix could be causing cog impairments? » desolationrower, posted by SLS on May 3, 2011, at 22:33:09
> > > > i feel i am having real word finding issues.
> > > > what in this mix could be most likely the culprit?
> > > >
> > > > i am guessing either the perphenazine or the gabapentin????
> > > >
> > > > 4mg perphenazine /day
> > > > 600-1500 gabapentin/day
> > > > 50mg pristiq
> > > > 20mg adderall bid/tid
> > > >
> > >
> > >
> > > I don't have a guess as to which drug is responsible for your cognitive impairments, although I would not discount Pristiq as the culprit. However, I don't think you should be varying your dosage of gabapentin. I think you should consistently use a dosage of 900mg or higher.
> > >
> > >
> > > - Scott
> >
> > do you think it is bad to take the gabapentin prn for anxiety, because of the mood stabilizing effects it has will vary?
> >
> > -d/r
>
>
> Yes. I am concerned that constantly varying the dosage of gabapentin will prevent the establishment of various therapeutic homeostases and perhaps even kindle cognitive impairments due to glutamatergic hyperactivity. It is like going through repeated mini gabapentin withdrawals on a regular basis. My concerns are mostly theoretical and involve alpha2delta calcium channel blockade.
>
> In real life, it seems that many people can tolerate using gabapentin as a PRN without sequalae. However, it is usually good clinical practice to maintain a stable dosage to maintain a stable response.
>
>
> - Scott
>You've thought about that a lot i think. It seems plausible, that disturbing the system toward one direction has stronger hysterysis than in another. The whole idea of an antidepressant is that there are multiple equilibria, and the drug can move you from one to another.
-d/r
Posted by SLS on May 6, 2011, at 6:35:10
In reply to Re: what in my mix could be causing cog impairments? » SLS, posted by desolationrower on May 6, 2011, at 5:14:56
> The whole idea of an antidepressant is that there are multiple equilibria, and the drug can move you from one to another.
Holy crap!
I found another person who thinks as I do!
I believe this is why tianeptine can produce an antidepressant effect, despite its doing the reverse of SSRIs. It is my contention that pushing the system in one direction or the other both produce a new homeostasis that more approaches the genetically coded dynamic as the system resets itself.
- Scott
Posted by desolationrower on May 8, 2011, at 19:16:31
In reply to Re: what in my mix could be causing cog impairments? » desolationrower, posted by SLS on May 6, 2011, at 6:35:10
> > The whole idea of an antidepressant is that there are multiple equilibria, and the drug can move you from one to another.
>
> Holy crap!
>
> I found another person who thinks as I do!
>
> I believe this is why tianeptine can produce an antidepressant effect, despite its doing the reverse of SSRIs. It is my contention that pushing the system in one direction or the other both produce a new homeostasis that more approaches the genetically coded dynamic as the system resets itself.
>
>
> - Scottheh, maybe you're just persuasive?
-d/r
This is the end of the thread.
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