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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Cairo on January 20, 2005, at 8:56:48
How would you rank antidepressants for short term memory problems, fatigue, lack of motivation, and other problems? My daughter is currently on Lexapro 10mg, Librium 5mg, Provigil 100mg for dysthymia, social phobia, and ADD, but she also has LD and a language disorder and we can't afford the above side effects as they are affecting her schoolwork even with 1-on-1 tutoring. She sometimes can't remember something she's just said!
Her mood is now OK, but her social phobia is only somewhat helped by the Librium; Provigil makes her a little more prosocial, but she says her confidence has not been helped. Her attention is not good and stimulants cause anxiety.
Any suggestions?
Cairo
Posted by johnsmith12345 on January 20, 2005, at 11:12:38
In reply to Suggestions for change in AD?, posted by Cairo on January 20, 2005, at 8:56:48
Is there a particular reason why she is taking librium? It seems like it would cause fatigue at the very least, and maybe those other things at the worst.
Posted by Ritch on January 20, 2005, at 12:35:29
In reply to Suggestions for change in AD?, posted by Cairo on January 20, 2005, at 8:56:48
> How would you rank antidepressants for short term memory problems, fatigue, lack of motivation, and other problems? My daughter is currently on Lexapro 10mg, Librium 5mg, Provigil 100mg for dysthymia, social phobia, and ADD, but she also has LD and a language disorder and we can't afford the above side effects as they are affecting her schoolwork even with 1-on-1 tutoring. She sometimes can't remember something she's just said!
>
> Her mood is now OK, but her social phobia is only somewhat helped by the Librium; Provigil makes her a little more prosocial, but she says her confidence has not been helped. Her attention is not good and stimulants cause anxiety.
>
> Any suggestions?
>
> Cairo
SSRI's can be notorious for name-recall and word-recall problems. You might suggest a switch from low-dose Lexapro to low-dose Prozac. I found it to have the least impact on memory than the other SSRIs. My guess is that her doctor is primarily using Lexapro for the social phobia. Prozac might make her too nervous, though. It is much more energizing than Lexapro. Who knows? Maybe a switch from Lexapro to Prozac would allow her to not need the Provigil?
Posted by Cairo on January 20, 2005, at 13:26:28
In reply to Re: Suggestions for change in AD?, posted by johnsmith12345 on January 20, 2005, at 11:12:38
Librium is for social phobia which was not helped by Lexapro and we needed something to help with school refusal. Her fatigue and short term memory issues started before beginning Librium and she is on only 5mg.
Cairo
> Is there a particular reason why she is taking librium? It seems like it would cause fatigue at the very least, and maybe those other things at the worst.
Posted by banga on January 20, 2005, at 13:54:28
In reply to Re: Suggestions for change in AD? » johnsmith12345, posted by Cairo on January 20, 2005, at 13:26:28
Has she tried all of the different stimulants? I hear that Ritalin increases anxiety dramatically, but for some people, Adderall and/or Dexedrine may even lessen anxiety.
Posted by Cairo on January 20, 2005, at 18:12:31
In reply to Re: Suggestions for change in AD?, posted by banga on January 20, 2005, at 13:54:28
She has tried them all. Dexedrine was a nightmare in that she became almost violent coming off it in the afternoons. Adderall causes anxiety, but also makes her affect totally flat. Ritalin and all it's forms also caused anxiety which we cannot afford with social phobia.
Cairo
> Has she tried all of the different stimulants? I hear that Ritalin increases anxiety dramatically, but for some people, Adderall and/or Dexedrine may even lessen anxiety.
Posted by Ritch on January 21, 2005, at 0:08:29
In reply to Re: Suggestions for change in AD? » johnsmith12345, posted by Cairo on January 20, 2005, at 13:26:28
What is the Lexapro for? Dysthymia? SSRI's can worsen ADD symptoms and cause fatigue.
> Librium is for social phobia which was not helped by Lexapro and we needed something to help with school refusal. Her fatigue and short term memory issues started before beginning Librium and she is on only 5mg.
>
> Cairo
>
>
>
> > Is there a particular reason why she is taking librium? It seems like it would cause fatigue at the very least, and maybe those other things at the worst.
>
>
Posted by Cairo on January 21, 2005, at 20:01:00
In reply to Re: Suggestions for change in AD? » Cairo, posted by Ritch on January 21, 2005, at 0:08:29
She has dysthymia, but the social phobia was really rearing it's head. Her mood improved upon beginning the Lexapro. She's only had one major depressive episode which, believe it or not, was induced by Strattera; her mood worsened as we gradually increased dose, and got better as we weaned her off. As she's only 15, the pdocs won't try MAOIs. Low dose Librium helped the SP some, but her confidence in social settings is not that good, and the doc won't increase her Librium dosage. She's got a really mixed bag of diagnoses which contribute to her SP: ADD, LD and a language disorder don't help in relation to listening and communicating with your peers.
I know the Lex is adding to fatigue and working memory issues. The doc won't consider lowering the Lex dose a bit, either. We just got back lab results and all looks fine - TSH, iron, B12, etc. - which might have explained her fatigue.
To top it all off, she also looks to me to have symptoms of atypical depression. She can perk up, but seems to have almost a hypofunctioning HPA axis. I have this problem. Cymbalta 5mg seems to perk my HPA axis up a bit, but I can't take more than that. Higher doses caused EXTREME panic and serotonin overload symptoms. No one has ever suggested using Effexor for my daughter and I'd worry anyway after what the Strattera did to her.
What to do?
Cairo
> What is the Lexapro for? Dysthymia? SSRI's can worsen ADD symptoms and cause fatigue.
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