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Re: what in my mix could be causing cog impairments? SLS

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


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URL: http://www.dr-bob.org/babble/20110502/msgs/984704.html