Appreciate your insights on a health problem

April 5, 2010 11:54 PM

I have a crazy health issue/issues and wonder if any of you brilliant people can give me any insights or advice. Thanks for your time.

Alright, where to begin, I have had "persistent Migraine Aura, or visual snow" nonstop for a little over a year. It sucks and it's nonstop, but I have been unable to find any promising treatment for it. Anyone familiar with treatment or that has personal experience with it, please let me know.

Second, I am on the following medicines and wonder if you are familiar with a side effect that I am having. It did not start when I began any of these meds, but it is fairly unpleasant now and I want to know if quitting these might help.

Lamictal 300mg a day (migraines and depression)
Propranolol 120mg extended release (migraines and tremor)
Nefazodone 200 mg a day (depression)
Ativan as needed for anxiety, very rarely taken

My latest issues are with clear thinking and thinking of the proper word. I used to be able to think sharply for most of the day and usually late into the night. Now it seems like I have to get everything just right to get a few hours of sharp, clear thinking. Also, I have a very difficult time thinking of the correct word to say in a sentence. Not just difficult words, but words that must make me seem mentally slow to the people that I'm speaking with. I don't know if this junk is from the medicines/medicne or if it's somehow related to the PMA that I referenced earlier. I probably sound winey and like a big complainer, but this has made my life more miserable than I can explain. I used to be so sharp and always speak perfectly with others and had great self-confidence, but after all this has happened My confidence is shot and I feel dumb a lot and like I can't handle doing the things that can make me fulfill my dreams and become successful. My family has been great through this in helping me, but it makes me feel all the worse, because I now doubt myself to the extent that I wonder if I can make it again in the real world. I never used to think that before all of this. Thanks for taking the time to read my rant here. It feels good to vent sometimes, but seriously if you have any experience with these issues, or advice I'd love to hear it. Thanks and have a great day!

posted by gibbsjd77 to health & fitness (16 answers total)

It is quite common to lose words when on anti-depressants. The side effects will go away once you stop taking the meds, so it isn't permanent. Give your doctor a heads-up about that. It's ok to admit to people that you can't think of words very well anymore. I usually just say whatever comes to mind, correct or no. It's at least amusing and relieves pressure.

As for the auras, that sounds quite scary but I have no advice on that one. Sorry.
posted by idiotfactory at 12:06 AM on April 6, 2010 [1 favorite]

I have had a few experiences with auras not connected to a strong migraine, but each time it only lasted about half an hour. What you are describing sounds debilitating - for me the flashing lights and visual snow were very distracting and all encompassing. It was had to talk to people because parts of their faces would disappear.
Have you had tests done? I'd be looking to have some serious investigations into what is causing this. In my case it I guess it was just minor migraines. I guess if you are on meds for migraines then maybe they only get rid of the headache part? I don't really know, but you should definitely talk to your doctor about this.
posted by smartypantz at 1:29 AM on April 6, 2010

Wow, I never thought to wonder whether other people on anti-depressants had that sort of temporary aphasia, ad I definitely didn't know it was common.
posted by jjwiseman at 2:11 AM on April 6, 2010 [1 favorite]

Are these meds helping your condition? Do you get migraine headaches or just the aura? While it may be side effects of the meds, the aphasia could also be from a the migraine. I presume you've had an MRI and CT and all that. Do they show anything?
posted by brevator at 2:55 AM on April 6, 2010

"persistent Migraine Aura" is not a condition recognized by the medical community, though it is a term bandied about often on internet message boards. If you haven't already, see a neurologist (with whom you should speak about a consultation with a neuro-opthamologist).

You may also profit from seeing a psychiatric professional, and particularly inquiring about Depersonalization Disorder.
posted by phrontist at 3:28 AM on April 6, 2010

(Oh, and I'd just like to say that you're taking many drugs which I, someone with no medical credentials whatsoever, has often heard complaints about regarding lexical recall abilitiy and mental clarity. So it could just be that.)
posted by phrontist at 3:31 AM on April 6, 2010

echoing phrontist- see a (another) neurologist.
posted by gjc at 4:03 AM on April 6, 2010

Mrs. the dief (epileptic) is regularly on one of the drugs you're on (Lamictal) and occasionally on another (Ativan, mostly post-seizure). She has had past issues with aphasia, mostly stemming from poor toleration of another drug (Topamax, thankfully long gone). She has seizures about once every two weeks now, even under drug therapy, but weirdly enough her aphasia used to be worse and her seizures less frequent, and also worse when her seizures were simple partial onset ("zone-outs") rather than what we traditionally think of as full on seizures.

But yes, seconding/thirding/nthing getting to a neurologist. You might be having partial onset seizures and not even know it; we didn't.
posted by the dief at 5:28 AM on April 6, 2010

I don't think that there is anyone on this site who has the appropriate credentials to diagnose your problem or suggest any treatment better than talking this over with your PCP, psychiatrist, and neurologist. Could be side effects of just one medication, could be an interaction between two or more meds. Heck, it could even be something completely novel. There is no way to know unless you go see your care providers.

On the good side, it looks like you've organized your thoughts pretty well and will be able to cut to the chase with them. Good luck. Now quit reading.
posted by The White Hat at 6:08 AM on April 6, 2010

That sounds really hard for you. You must be lonely.

From personal experience only, I haven't had that issue with Lamictal (300 to 400 mgs) or ativan (random amounts taken sporadically). It does give me some minor fatigue. I haven't heard of Lamictal being used for monopolar depression. Who knows.

I also get word-dropping from ADHD that is cured by my Adderall. If you don't have ADHD of course that's not relevant.

If you haven't checked out CrazyMeds, might be a good time to do so.

I suggest, as kindly as possible, talking about this with the person or people who are prescribing you your medications. If you cannot talk to them about this because you are nervous or anxious, or you don't get the words right, you can bring a family member with you. If you can never get time to speak to them, it seems like a good time to get a second opinion. My thought about specialists is that it's always good to get a second opinion no matter what--but it depends on your financial and medical situation.

Best of luck.
posted by internet fraud detective squad, station number 9 at 9:05 AM on April 6, 2010

That sounds terrible, and I think a visit to the neurologist is an excellent idea. It also sounds like something might be off with your medications. I'd get a thorough assessment from your psych, and if you do not get satisfaction, look into a second opinion from a different psych. It may not be your meds, but maybe the solution is an adjustment in dose, eliminating a poor interaction, or dropping or replacing one medication altogether. I also second the recommendation of checking out CrazyMeds. There's some good information there. Best of luck.
posted by katemcd at 9:24 AM on April 6, 2010

I really appreciate your answers. Just for reference I've been to 6 neurologists and 1 neurologist that has been headache specialist for 15 years. His diagnosis was (wow, that's really rare, I've only seen it twice in 15yrs). So needless to say it was depressing, because I kind of lost hope for any serious resolution to my problem. I don't take serious medical advice from strangers, BUT, if someone has been through anything like this I would love to hear what they did to get by and maybe even cured:) Also, to answer one of you the visual aura was debilitating for about 2 months then I finally adapted and kind of pulled myself together to function. I still have it just as much, but I really try day by day to not focus on it, but I inevitably do. Thanks again to everybody.
posted by gibbsjd77 at 11:21 AM on April 6, 2010

Have you had your eyes checked recently? you should get a full eye checkup that checks for glaucoma and make sure that your visual sensations are not a result of something physical with your eyes and thus Causing the migrainse rather than Resulting from them. eye strain can be a real pain.
posted by WeekendJen at 12:54 PM on April 6, 2010

I guess I'm not entirely sure how you would define "persistent migraine aura, or visual snow" but that description sounds a ton like what I experienced with a low-grade case of optic neuritis. It was over a year of vague, flashy, sparkly, dull, not debilitating but certainly annoying, inconsistent, hard-to-describe spots in my vision. I saw a couple ophthalmologists before they finally figured out what was going on. The problem gradually got better as my optic nerve recovered from the irritation, but optic neuritis can be a sign of a more serious problem like MS. MS can also cause the kind of word-finding problems you're experiencing, too. I don't mean to scare you, and certainly it seems weird that 7 neurologists wouldn't have thought to check this out, but you might want to bring up the possibility. I ended up seeing a neuro-ophthalmologist (who even knew that was a specialty, right?) to get it sorted.
posted by vytae at 1:20 PM on April 6, 2010

The second neuro had me see a "Neuro Opthamologist" he said my eyes/optic nerve was fine and that is was probably some type of migraine or brain issue causing the trouble. Thanks for your answers.
posted by gibbsjd77 at 5:02 PM on April 7, 2010

"persistent Migraine Aura" is not a condition recognized by the medical community, though it is a term bandied about often on internet message boards. If you haven't already, see a neurologist (with whom you should speak about a consultation with a neuro-opthamologist)."


- The one neuro doctor I had w/ 15yrs experience in the field was familiar with the PMA name. He said it was incredibly rare and I guess the more technical part was Migraine Aura without infraction. I have seen a neuro-opthamologist too.
posted by gibbsjd77 at 5:04 PM on April 7, 2010