Will these little blue pills steal all my words?
September 19, 2011 6:45 PM   Subscribe

Your experiences with antidepressants and, uh, word-forgetting?

After years of good results from brand-name Wellbutrin SR (100mg 3x daily), I'm plenty familiar with the cloudy feeling of mild aphasia described here. While written words no longer flow as easily as they once did, stringing together sentences has been at least manageable.

However, after a weathering couple of nasty personal blows and with the dark, SAD*-infested days of winter looming, Mr. Psychiatrist has suggested upping the dose to 400mg. He thinks it would be a good idea, but he's not adamant. The problem: I need to finish a manuscript by year's end -- and it's one of those rare "screw this up and you'll spend the rest of your life kicking yourself" opportunities. The weepy downturn in mood isn't helping progress any, but I worry that the increased Wellbutrin dosage might shut it down altogether.

It's a long shot, but has anyone experienced degrees of aphasia specifically in relation to lower or higher doses of Wellbutrin or any other antidepressant? With only three months to work, I'm not looking to experiment with a new med, but I am hoping your anecdotal experiences might help me decide whether to up my current dose or just try to push through the fog.

*(FWIW, I'm already doing the light box and vitamin D3 and fish oil. They sort of help.)
posted by anonymous to Health & Fitness (14 answers total) 13 users marked this as a favorite
This is tangential to the question, but can you talk to your psychiatrist/therapist about alternatives to upping your medication levels? Medication works best in conjunction with therapy, and your question sounds like you're more front-loading in anticipation of sadder days ahead, so maybe you can up your talk therapy (if you're in it) or start it (if you're not)?
posted by xingcat at 7:30 PM on September 19, 2011

Okay, weird: I've been on Wellbutrin for a couple of years now, and I have a tendency to trip up when I talk, like stopping mid-sentence or saying the wrong words. And I've been less confident in the strength and coherence of my writing. I've attributed it to age and general derpiness; it's never occurred to me that it could be a side effect of the medication. I don't think it is in my case, but.... hmmm. Now I'm curious.

But I'm not going off my meds to see if my writing and speaking get better. Because if the word-finding trouble I'm going through is the same as yours, I'd take it in a heartbeat over depression. And, as a silver lining, my doubts about my writing ability has me paying more attention to writing, both mine and others', and examining things I'd never looked at before. (Although, still, hmmm.)

Is it possible to try another antidepressant, either with or instead of Wellbutrin? Different antidepressants have their own sets of wacky funhouse side effects, but there might be one that plays a little better with your brain chemistry.
posted by Metroid Baby at 7:58 PM on September 19, 2011 [3 favorites]

xingcat: "This is tangential to the question, but can you talk to your psychiatrist/therapist about alternatives ... "

You could possibly ask about adding in a light dose of a different SNRI or SSRI to give you a jump start without amping any side effects you're experiencing with welbutrin; for a while, I was ono a pretty small dose of Cymbalta, added onto the welbutrin, and I found that it was effective, helpful. But then that troublesome period passed and so I thought "Well, hey, let's drop off of that Cymbalta." and I did so and for the first time (only, thus far, hopefully forever) I experienced what so many others did when getting off of some SSRI or SNRI, and I had to taper off slowly, rather than just quit it, as I'd done with prozac and two or three others.

These are serious medications; we tend to think of them as nothing because docs hand them out like PEZ candies but this is in fact the big time.

You can go up to 350mp of welbutrin; add in a 150mg and drop off one of the 100mg.

I'm @ 400mg of Welbutrin, not sure if it's damped my language abilities or not but it's given so much that I'd have to say that I'd probably continue regardless; it's the first anti-d that ever really helped me, only since I jammed the stuff into my head have I ever experienced life without depression, or even lessor depression, either of which are one heck of a lot better than what I'd . I do have lots of trouble finding words, and names, it's fifteen times better for me to be writing on a puter, online, where I can google whatever I'm looking for by typing in approximation of what it is and/or words related to it. (Ex: I couldn't remember the name cymbalta -- I remembered prozac, paxil, zoloft, but not cymbalta -- so I googled "name of SNRIs" and ZAM !! there is is.)

But I am not certain if this is due to psych drugs or other problems I've had -- plenty of them -- or even just senior moments -- I'm 56; many people in my age group (and esp older than I) just laugh at me when I wonder what it might be, as it's so obvious to them that age can be a limiter, in its way, for so many. Also -- when I'm under the gun and/or in a social situation, this problem goes up, way up; if/when I'm at a party -- which I fucking hate, not because I don't like people (I like the shit out of people, I'm interested in them, I want to hear their story) but rather because of this damn social anxiety/aphasia/wackiness -- and I'm introduced to seven people, their names and much else about them just drop out of my fat head just as fast as I feed it all in there, and I stand there like a fucking dolt, smiling stupidly, sweating, scratching myself, and mostly I just want to jump off the fucking roof. (What I *can* remember is emotional content of each person, how I *read* them; that I easily tie to the person. Names -- forgetaboutit.)

tl:dr -- I have maybe a sort of aphasia but absolutely can write my heart out, still, as good as ever before, best I can tell, it hasn't damped zeal or energies or creativities that I'm aware of.
posted by dancestoblue at 8:17 PM on September 19, 2011

I have absolutely had the side effects you describe. Not only do I space out on words, I trip over basic spoken sentences. Writing is hard, but writing's always hard cuz I'm a perfectionist. Also, my once-sharp memory is foggy.

My current cocktail: 40 mg Lexapro*, 45 mg Buspar, Xanax as needed. No therapy currently, but I've been there.

*Lexapro is the active isomer of Celexa, and 40 mg Lexapro = 80 mg Celexa.
posted by mirepoix at 10:07 PM on September 19, 2011

I'm having the same difficulty with Lamictal at the moment, though not horribly. But yes, it's making it rather difficult for me to form complete sentences with my usual charming (?) verbosity. It's worse when I speak than when I write, though.

No experience with Wellbutrin save hives, but I do know that when I was on Effexor the side effects, which included general brain-fog, got much worse as I increased the dosage until, for various reasons, I couldn't stand the medicine at all anymore. The Lamictal is better. So yes, dosage increases can definitely cause increased brain-difficulties. I was less worried about the word-finding aspects than, well, all the other ones, but that got worse too. Your Meds May Vary.
posted by Because at 12:18 AM on September 20, 2011

Make yourself be physically active for at least 30 minutes each and every blessed day for the next three months. Find a pal to join you, even better if s/he's a fellow SAD sufferer. Hold off on the increased dosing. Hang onto your words a little longer.
posted by mcbeth at 5:05 AM on September 20, 2011

Wellbutrin made me so forgetful - not just in a word retrieval kind of way, but in a relationship-affecting, work-affection, major conversation forgetting kind of way. My dosage was all the way to the max - 450 daily- and I had so much aphasia and SO much depression that I can't believe I stuck with it for as long as I did. Like, a couple of years. I'm on a low dose of an ssri and 30mg of buspar at the moment, and I have been on this combo and stable for a couple of years now. I've mentioned this to various doctors since then, and the consensus was that Wellbutrin works as an additive for other meds, but as a standalone antidepressant it is very hit or miss. In particular, higher doses are no more helpful than lower/midlevel ones.

I say lower the Wellbutrin and add a different class of med.
posted by 8dot3 at 5:41 AM on September 20, 2011 [2 favorites]

I'm on 100mg of Pristiq (which I realize is an anti-anxiety but whatever) and started doing the same thing. Even here I typed in "that" instead of "the" the first time I wrote that first sentence.

Flipping words around in sentences (holy pan to keep the juice out of the fish when it should have been keep the fish out of the juice), calling pears peaches, random other things that I didn't even realize I'd said wrong, it was weird.

Talked to my doctor about it and since it seemed to slow down after that we just let it go. But it's in the file.
posted by theichibun at 6:57 AM on September 20, 2011

I've taken Wellbutrin in the past and never noticed anything - except that it didn't work. I take Lamictal now for epilepsy, and have noticed the same side effects. I'm much better with the written word than the spoken; I tend to ramble and confuse situations when I should be explaining. Ugh. It makes me look like an idiot, and I hate it, but I can't control it sometimes.

The real problem is I've taken (and still do take) a lot - seriously, a lot - of other meds, in combination and alone, for the epilepsy and depression. Most of these have the same side effects, but everyone is different. I cannot stress this enough. My opinion is that we don't truly understand how these medicines affect our brain, and there are so many parts of the brain that could be affected, that there's no way to accurately predict how your brain will react if you don't lower the dosage/do up the dosage/completely go off the meds/add a new med.

FWIW, my vote is for keeping the same dosage and talking with your doctor about adding an additional medicine, after extensively researching possible side effects. You'd want to be careful about adding something new with the exact same side effects as Wellbutrin. Good luck.
posted by doyouknowwhoIam? at 8:05 AM on September 20, 2011 [1 favorite]

When I started, this was really noticeable. It was unsettling to keep mixing up words, but it has since subsided and I've returned to being the witty blacksmith I once was.
posted by the jam at 8:50 AM on September 20, 2011 [2 favorites]

I experience this constantly and it is SUCH a relief to know others do. I sometimes mix up pronouns, names,in fact last night I was struggling to tell someone about something because I couldn't get the correct name in place and kept stopping and confusing myself. I'm on 60mg escitalopram a day.

I do mix things up a lot generally though - thanks, dyspraxia. Putting the hot water in the water glass and the cold water in the tea mug is a particular 'favourite'. So I echo the comments above.
posted by mippy at 9:27 AM on September 20, 2011

You may be able to neutralize this effect somewhat if you make a daily habit of something like crossword puzzles or scrabble. Don't worry at all about finishing the puzzle or doing well; just do it for a little while each day. Practicing the skill of finding the right word makes you better at it. I noticed a real improvement after just a week or so. This might just make it possible for you to have the benefit of the medication without suffering any additional language difficulty.
posted by Corvid at 3:36 PM on September 20, 2011

A few medications created similar conditions for me, and I found that what Corvid recommends was very helpful - doing language & logic-based activities (even listening to hip-hop) seemed to improve things or at least lessened the loss.

It's ridiculously demoralising to go from having access to thousands of words in whatever order you want them to hundreds that come and go at whim and generally in the wrong place, but, at the same time, it's so hard to accomplish anything when disordered that the extra effort to maintain access to your vocabulary is probably more worthwhile than delaying the dosage increase. If your healthcare professional feels you can safely try to ride it out just a bit longer, maybe give it a go. It sounds like you're at the point where the increase would help a lot, though.

Luck & clarity!
posted by batmonkey at 6:39 PM on September 20, 2011

For me the line between normal speech and a mild speech impediment lies somewhere between 300 and 450mg of Wellbutrin daily. I've been on 450 for almost a year now, and hate tripping up on words, restarting sentences, basically sounding a lot less eloquent than I fancy myself being.

I haven't gone back to the lowered dose, though. I've grown fond of not hating every living moment.
posted by tigrrrlily at 10:06 PM on September 20, 2011

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