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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by v on May 11, 1999, at 5:23:35
i'm noticing that i suddenly can't remember the names of people, places, things, words etc... i suppose it's the dreaded "word finding difficulty" i've heard about.
i've been on 150mg effexor xr for the past 5 months and have recently begun adding 25-50mg topamax at night.
would it be the topamax that's doing it? would nutritional supplements like dmae or ginko help?
thanks
Posted by Cindy on May 11, 1999, at 8:59:46
In reply to getting stupid??, posted by v on May 11, 1999, at 5:23:35
> i'm noticing that i suddenly can't remember the names of people, places, things, words etc... i suppose it's the dreaded "word finding difficulty" i've heard about.
>
> i've been on 150mg effexor xr for the past 5 months and have recently begun adding 25-50mg topamax at night.
>
> would it be the topamax that's doing it? would nutritional supplements like dmae or ginko help?
>
> thanksHi V,
I had those constantly before starting on the Effexor. I just stopped taking mine so I cannot help you on if its that but your not getting stupid. My memory was so bad last year that when I went to pick up some birth papers for my then two year old son, I couldn't remember his birthdate! Now that's getting bad. lol Please let me know if you find out what it is though, the doc just put me back on effexor so it would be interesting to know if I need to look out for this at some point as well. Q? What is topamax?
Posted by v on May 12, 1999, at 6:36:03
In reply to Re: getting stupid??, posted by Cindy on May 11, 1999, at 8:59:46
topamax is an anti-seizure medication also being used as an anti-depressant for rapid cycling.
i can relate to the memory problems being severe - sometimes all i can do is laugh - i'm afraid to let myself take it too seriously...
good luck
> > i'm noticing that i suddenly can't remember the names of people, places, things, words etc... i suppose it's the dreaded "word finding difficulty" i've heard about.
> >
> > i've been on 150mg effexor xr for the past 5 months and have recently begun adding 25-50mg topamax at night.
> >
> > would it be the topamax that's doing it? would nutritional supplements like dmae or ginko help?
> >
> > thanks
>
> Hi V,
> I had those constantly before starting on the Effexor. I just stopped taking mine so I cannot help you on if its that but your not getting stupid. My memory was so bad last year that when I went to pick up some birth papers for my then two year old son, I couldn't remember his birthdate! Now that's getting bad. lol Please let me know if you find out what it is though, the doc just put me back on effexor so it would be interesting to know if I need to look out for this at some point as well. Q? What is topamax?
Posted by Alison on May 14, 1999, at 0:33:55
In reply to Re: getting stupid??, posted by Cindy on May 11, 1999, at 8:59:46
I am currently taking 200mg Zoloft per day, and have been so for approx. 4-5 months. I also have alot of trouble remembering simple everyday things. The psychologist that I am currently seeing has suggested that because the brain is putting so much emphasis on the emotion, whether it be depression or anxiety (I am the proud owner of both !!!) that it is so busy with them to be thinking or doing anything else. It may have trouble recalling and accessing the short term memory.
I don't know it's just a suggestion? I do crossword puzzles to try and keep my mind active and off the other crap!! Sometimes it works !!
Just to make you feel better I forgot how to spell my middle name (Louise) and sometimes I forget how old I am !! (I'm 25!! I remembered!) How bad is that?
Hope you find a way to work this out and let me know, please? As I am a Uni student doing Nursing and there's so much to recall.
Alison
P.S Before the Zoloft I was on 20mg of Paxil (Aropax, here in Australia) for about 18 months. This made me sleep all the time.
Posted by Chris A. on May 16, 1999, at 5:19:34
In reply to getting stupid??, posted by v on May 11, 1999, at 5:23:35
Topomax has the capability to make the most brilliant person "stupid". The drug is notorious for causing cognitive side effects - aka "Topo-Dumb".Speaking from personal experience (it's a relief to be off of it)!
Chris A.
Posted by v on May 16, 1999, at 17:48:34
In reply to Re: getting stupid??, posted by Chris A. on May 16, 1999, at 5:19:34
what dosage were you on? would you please describe the side effects you experienced? how long were you on it? were you also on any other medications? and if so,what?
sorry to be asking so many questions... obviously, you've struck a nerve...
regards,
v>
> Topomax has the capability to make the most brilliant person "stupid". The drug is notorious for causing cognitive side effects - aka "Topo-Dumb".
>
> Speaking from personal experience (it's a relief to be off of it)!
>
> Chris A.
Posted by v on May 20, 1999, at 5:29:45
In reply to Re: getting stupid??, posted by Chris A. on May 16, 1999, at 5:19:34
does anyone know anything about else about this? chris hasn't replied - i'm hoping he/she just hasn't been online yet and will offer the information soon
i've been on 50mg topapmax at night for the past 10 days or so and although yes, i seem more "stupid" to myself, my overall mood seems to be alittle better. hell, i've even started doing some artwork again (although VERY sporadically) and have a piece in a show next weekend... and my athletic training is more consistent (but also not as rigorous as it should be) - my diet alittle cleaner but still taking in too many calories (still 20lbs overweight but maybe oh maybe s-l-o-w-l-y moving in the right direction?)... the house though, is still so filthy i could puke...(but won't start THAT again... :)
as i've said before, i try to keep my dosages down (also take 150mg effexor XR in the a.m.) to hopefully keep down my side effects but now i am concerned about the topamax
what else do we know about this?
thanks,
v
> Topomax has the capability to make the most brilliant person "stupid". The drug is notorious for causing cognitive side effects - aka "Topo-Dumb".
>
> Speaking from personal experience (it's a relief to be off of it)!
>
> Chris A.
Posted by katie on May 20, 1999, at 14:45:36
In reply to Re: getting stupid?? any more info? dr.bob? toby?, posted by v on May 20, 1999, at 5:29:45
> does anyone know anything about else about this?
**********************************8
As for becoming "stupid"... ahhh...I wouldn't go
that far. I do however, try not to get into too many conversations that are over my head intelligence-wise. I've been taking the topamax (100 mg daily) for about a month in conjunction w/ lithium. So far so good, I guess. Apart from a few minor physical side effects ( bad taste and poor circulation), I've been okay.So you like art, huh? I'm a bit of an artist myself. I'm still trying to get motivated enough to get into an oil-painting class again.
Don't worry about your messy house. I had the same problem for about the first three weeks. I think today was the cleanist my kitchen has been since we bought the house!
Well, I hope you find the info you need.
Katie
Posted by Elllen Brodie on May 22, 1999, at 6:32:02
In reply to Re: getting stupid?? any more info? dr.bob? toby?, posted by v on May 20, 1999, at 5:29:45
>Hey Chris,
I've just had my dosage of topamax increase to 250 mg a day. My cognitive skills. are horrible. But it beats the options. I am severe manic depressive. I am learning to laugh at mu dumbness versus feeling so bad all the time. I uses to own my own personal training company which I had to let go, and I am hoping when I feel better to start training myself at least. I will not be able to go back to training again. But that's just the way it is . I have started tai chi which has been a life saver. I am also on a low dose of effexor and take klonopin on an as needed basis. I am hoping that the cognitive dulling lessons overtime but if not I will learn to live with it over suicide attempts any day. Right now I am learning to enjoy each day that I have anyway that I can. Ellen Brodie
> >
> >
Posted by Noa on October 17, 1999, at 17:42:57
In reply to Re: getting stupid??, posted by Chris A. on May 16, 1999, at 5:19:34
>
> Topomax has the capability to make the most brilliant person "stupid". The drug is notorious for causing cognitive side effects - aka "Topo-Dumb".
>
Effexor does it to me. At higher doses, I start to have word retrieval problems--simple words elude me.
Posted by Bob on October 17, 1999, at 17:48:42
In reply to Re: getting stupid??, posted by Noa on October 17, 1999, at 17:42:57
> Effexor does it to me. At higher doses, I start to have word retrieval problems--simple words elude me.
So, Noa, I guess you'd have a problem trying to eschew obfuscation at those times ....
Sorry ;^)
Bob
Posted by Rick on October 17, 1999, at 23:21:07
In reply to getting stupid??, posted by v on May 11, 1999, at 5:23:35
> i'm noticing that i suddenly can't remember the names of people, places, things, words etc... i suppose it's the dreaded "word finding difficulty" i've heard about.
>
> i've been on 150mg effexor xr for the past 5 months and have recently begun adding 25-50mg topamax at night.
>
> would it be the topamax that's doing it? would nutritional supplements like dmae or ginko help?
>
> thanks
-----------Folks, the only stupidity is not checking elsewhere on this wonderful site. In the Tips section (see links at top of page), checking "cognitive problems" in the "psychiatric problems" provides lots of answers to this question. Based on this, I wouldn't be so quick to put the blame on the Topomax; SSRI's seem to be the most-cited culprit.
To make things easy for everyone, I've pasted the entire section below (unfortunately it came out sqooshed...or is that squished?). BTW, as a veteran absent-minded word-loser myself, I'm just razzing my fellow Babblers. Truth is I just happened to run across this stuff while doing a Google search a few days ago. And frankly, I think this is one of those things that dwelling on makes worse. I wouldn't sweat it unless it gets REALLY bad, which isn't likely. (My own 2 cents, not professional advice.)
O.K., HERE'S THE THREAD FROM "TIPS":
Dr. Bob's
Psychopharmacology Tips
Word-finding difficulties from medication
Date: Fri, Oct 28, 1994 5:50 PM
Subject: Word-finding difficulties from SSRIs
From: Ivan Goldberg
On October 20, 1994, Ivan Goldberg wrote:
In a few people in whom I did full neuropsychiatric work-ups prior to SSRI rx, I have been able to confirm the patients' complaints of memory and word-finding problems by deterioration in their performance on the Boston Naming Test and the AVLT.
On Fri, 28 Oct 1994 PMBrig@aol.com wrote:
I also have been hearing more and more complaints of memory problems from patients on SSRIs. More details on the nature of the impairment found in your testing would be helpful.
The Boston Naming Test presents a series of 60 drawings that the patient is asked to name. When administering the test to adults only the more difficult 30 drawings are presented. Among the more difficult objects pictured are a trellis, palette, yoke, and protractor. When adults are retested after an interval of a few months, they usually score as well or better than when tested the first time. When patients taking Prozac are retested they often show a deterioration in their performance on this test. Some of those who show such a deterioration do not mention a memory deficit until they become aware that they did less well on the test the second time.
Rey's Audio Verbal Learning Task presents a list of 15 words to the patient after telling the patient that one will ask for the words immediately after the entire list is presented. This is done five times. The sixth presentation is of another list of words. After the patient responds to that list, one asks for how many of the original words are still remembered. It is expected that not more than three words that were remembered after the 5th presentation are forgotten when the patient recalls the words after giving the words remembered from the 6th trial.
Again, patients do not show deterioration on this task when tested a few months after the first testing. Many people on SSRIs, TCAs, and lithium show a deterioration in their ability to perform on this task when compared to their pre-drug performance.
Date: Sat, Oct 29, 1994 6:38 PM
Subject: Memory difficulties from fluoxetine
From: Raymond Behr
There is a pertinent case report in the Nov/Dec 1994 Journal of the American Academy of Child and Adolescent Psychiatry by Mark Bangs, M.D., et al. The case study describes a 14 year old who complained of memory difficulties on fluoxetine. The patient showed impairment on all 5 scales of the Wechsler Memory Scale-R during treatment. Three of the scales -- verbal memory, visual memory and general memory -- showed statistically significant improvement after the medication was withdrawn.
Date: Sat, 10 Jun 95 08:27 MST
From: dvweiss@amug.org (Dennis V. Weiss, M.D.)
Subject: Word-finding difficulties from SSRIs
Word-finding difficulties in patients taking SSRIs is not uncommon, and has been described as a serotonin-overload effect.
My approach would be to lower the dose and, if necessary, shift to another antidepressant (even a different SSRI, which may not have the same effect).
Date: Sun, 11 Jun 1995 15:30:14 -0400 (EDT)
From: Charles S Berlin
Subject: Word-finding difficulties from fluoxetine
I have a patient who is a writer and has found fluoxetine the most helpful of many agents for her depression. However, every time she goes back on this medication she notes that she then experiences word finding difficulty, even for many simple words (an obvious problem for a writer). When she first reported this to me, I was unsure if this was a definite side effect. However, she did a search and found a number of reports of this, and noted that other patients on the internet patient support newsgroups reported this. When this problem arose every time she went on the medication and cleared every time she went off, there was no doubt about the linkage.
Date: Mon, 12 Jun 1995 23:09:57 -0700 (PDT)
From: "Kristin E. Zethren"
Subject: Word-finding difficulties from SSRIs
I have seen word finding or accessing difficulties with fluoxetine, paroxetine and sertraline, completely unrelated to dose. It was unfortunate to discontine a drug that was working so well in every other respect.
Date: Tue, 27 Jun 1995 20:51:24 -0700 (PDT)
From: Ivan Goldberg
Subject: Memory difficulties from SSRIs
I have seen profound memory disturbances sometimes accompanied by a dysnomic aphasia (profound word-finding difficulties), in both men and women of all ages. This side-effect seems to be dose-related and clears a week or so after the dose has been lowered.
From: PMBrig@aol.com (Peter M. Brigham, MD)
Date: Fri, 4 Aug 1995 08:47:38 -0400
Subject: Word-finding difficulties from SSRIs
I have found occasionally that patients will have a word-finding difficulty on any of the SSRIs, e.g., can't recall the name of someone they know well, etc. At times patients complain of other cognitive problems also.
From: BakerFam@aol.com (Howard Baker)
Date: Sat, 26 Aug 1995 17:24:30 -0400
Subject: Word-finding difficulties from stimulants
I have had a number of patients who are taking stimulants for AD/HD complain that they have transient problems with word finding. They can get the word, but it takes a bit longer than they are used to. It is possible that it is actually a symptom of the AD/HD, but these patients did not notice it before taking the medication. Of course, there are many things that they did not notice before taking the medication, so that could also be an explanation -- i.e., that they had it in the past without noticing it.
Date: Sat, 2 Dec 1995 16:49:12 -0500
From: bb281@freenet.carleton.ca (Ann Van Regan)
Subject: Word-finding difficulties from nefazodone
A woman in her 40s with post traumatic stress disorder and panic disorder has both word-finding difficulties as well as word-substituting (snoring for snowing) problems appear when she gets to 150 mg nefazadone. It seems to be effective in handling her dysthmia and PMS. She's very successful and finds that this is causing lack of self-confidence and making her feel "stupid".
Date: Sat, 2 Dec 1995 22:50:19 -0700
From: ckuttner@proaxis.com (Charles Kuttner)
Subject: Word-finding difficulties from TCAs
This is a frequent side effect of tricyclics; I always heard it said that it was due to anticholinergic actions interfering with cholinergic pathways. I have not seen this side effect with nefazadone, but the drug is so complex to use that I save it for close to a "last resort."
Date: Sun, 03 Dec 1995 12:20:26 EST
From: MWKR59A@prodigy.com (Dr Frederick C Goggans)
Subject: Word-finding difficulties
I would think that the psychiatrist as a person with medical training could ... at least do more detailed mental status and neurological exams to check for other signs of brain integrity. The main point is that a number of conditions that affect the CNS can present with depression first and then slowly in other ways so when atypical things do emerge we need to rethink the diagnosis. I personally had a case like this once where the diagnosis turned out to be Creutzfeldt-Jakob disease in a patient around 40 years of age.
Date: Sun, 3 Dec 1995 10:47:40 -0800 (PST)
From: Ivan Goldberg
Subject: Word-finding difficulties from medication
Dysnomia and paraphasic errors together with other indicators of cerebral dysfuntion are not at all atypical when people take therapeutic doses psychopharmaca. These effects are particularly common with lithium, the other mood stabilizing drugs such as valproate and carbamazepine and antidepressants.
From: RMRich1@aol.com (Roberta M. Richardson, M.D.)
Date: Fri, 3 May 1996 22:39:30 -0400
Subject: Memory difficulties from sertraline
I treated a woman in her fifties who developed memory problems significant enough to impair her on the job, on sertraline. It reversed completely when sertraline was stopped.
This was not a word-finding or apathy problem. She complained of neither of those. It was forgetting things that she had been told or even things she had done.
Date: Sun, 16 Nov 1997 20:59:13 -0500 (EST)
From: "Adele Tutter, M.D., Ph.D."
Subject: Word-finding difficulties from lamotrigine
I am using Lamictal (lamotrigine) quite a bit, mostly as monotherapy in depressed patients in the bipolar spectrum. However, I find that many patients complain of short-term memory disturbance, name- and word-finding difficulties, and a sort of overall cognitive blunting. This doesn't seem to be too dose-related, e.g., patients will report it at 100-200 mg and it doesn't seem to worsen with increased dose (or get better with decreased dose). In some people it gets better with time -- or maybe they just get used to it.
Date: Sun, 16 Nov 1997 23:47:26 -0500
From: Ivan Goldberg
Subject: Word-finding difficulties from lamotrigine
It has been my impression that all mood stabilizing medications induce cognitive changes in many of the patients whom we give such drugs.
Complaints about short-term memory changes or difficulties with word-finding seem common in patients taking lithium, carbamazepine, valproate, gabapentin and lamotrigine.
It seems to me that memory or word-finding changes are no more common with lamotrigine than with other mood stabilizers.
Posted by Rick on October 17, 1999, at 23:48:54
In reply to getting stupid??, posted by v on May 11, 1999, at 5:23:35
Corroborating the Topomax experience cited by another poster (sorry, forget who), the Topomax link on the left of the "Tips" main page does detail possible cognitive side effects.
> i'm noticing that i suddenly can't remember the names of people, places, things, words etc... i suppose it's the dreaded "word finding difficulty" i've heard about.
>
> i've been on 150mg effexor xr for the past 5 months and have recently begun adding 25-50mg topamax at night.
>
> would it be the topamax that's doing it? would nutritional supplements like dmae or ginko help?
>
> thanks
Posted by v on October 25, 1999, at 11:25:08
In reply to Re: getting stupid?? (follow-up), posted by Rick on October 17, 1999, at 23:48:54
the topomax definitely contributed to my "stupidity". i felt like my brain just wasn't making connections as quickly.
i've since stopped taking it and while my memory is still bad (oh well i'm also getting old as well as still on effexor.. :) there's definitely not that "dullness" in my thinking that frustrated me so badly.v
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