Are my psychiatric drugs affecting my mental acuity?

May 7, 2019 5:57 AM

I was recently prescribed a set of drugs to treat what is probably a combination of bipolar II and an anxiety disorder. In the past few weeks, I've felt foggy and recall has been difficult. I'm seeing my psychiatrist later this week, but I'd appreciate input from your experience: are these drugs ruining my ability to think?

I've been struggling with bipolar II for a couple of years; prior to a few months ago, my pharmaceutical treatment was a combination of lamictal and a low dose of latuda. I went through a crisis in February (extreme anxiety, mostly), which led to my psychiatrist doubling my dose of latuda and adding lithium. That worked to bring me back from the brink.

In the past month or so, I've been noticing that I've been having difficulty recalling events in my life, factual items related to my work, and artistic and entertainment experiences. I've been having trouble coming up with ideas and communicating complex concepts. I feel a bit like I'm under water.

My work is intellectual / creative, so it's been tough going. It's been distressing at home to communicate with my spouse about things in the past that I struggle to recall.

I'm kind of terrified; this directly impacts my sense of self.

I'm obviously going to talk to my psychiatrist about this, but I'd really appreciate any expert or experiential input that you all might have. Do these drugs compromise mental function? Am I just getting old and worrying about what is standard degradation of function (I'm 43)? Should I be trying something else?

posted by anonymous to Health & Fitness (7 answers total)

Pretty much all antipsychotics can do this; they are drugs that help many people, but they also suck balls. Are you now on lamictal, latuda AND lithium? Polypharmacy is something that sometimes works to minimise side effects... and sometimes does the opposite. Definitely talk to your psychiatrist about it. If they claim it can't be the drugs, find a new one, because as I said this is a well documented thing with basically all antipsychotics. I really hope that you can find a solution that keeps you well while minimising troubling effects. I think it's useful to be clear with your psych about what your personal priorities are; some patients, like you, find their sense of self and ability to work/function really damaged by mental fogginess, while others are perfectly happy to shrug and accept the fogginess but are, for example, really distressed if they gain large amounts of weight. The doctor won't necessarily be able to intuit what is important to you. Also, it is good to document what's happening, the ways in which it is affecting your daily life and ability to do specific things, and the effect that this has on your mood in itself. Good luck.
posted by Acheman at 6:12 AM on May 7, 2019 [7 favorites]

My best friend always described the effects of lithium as "brain packed with cotton." and indeed it's vexing. Good luck in finding a solution.
posted by intrepid_simpleton at 6:20 AM on May 7, 2019 [1 favorite]

Lithium fog is definitely a thing. That said, bipolar itself can affect cognition, and psychiatrists don't seem as prepared to deal with that as they are with some of the other manifestations of the condition. But since this is new and coincides with the med change, that seems the more likely culprit here. Definitely talk to your doctor. Maybe you can tweak your dosage or try something else
posted by Stacey at 6:37 AM on May 7, 2019 [2 favorites]

Yup, I was put on Lithium for a while (I turned out to be misdiagnosed for some issues I had) and it made me foggy-brained as hell.
posted by xingcat at 7:27 AM on May 7, 2019

You can talk to your shrink about scaling back the Lithium, which I agree is likely what's causing you to fog out. Don't panic, though, it's reversible!
posted by DarlingBri at 7:36 AM on May 7, 2019

It also hasn't been very long since your medication change. I have found that the side effects of both antipsychotics and of lithium do even out eventually. However, I have had to deal with memory issues like you describe (though they got markedly worse since I've been on opioids). The trade off of being stable and able to work was worth it for me, though it might not be for you.

I find I have to write EVERYTHING down immediately and in detail (lists, procedures, groceries, etc.), and I talk aloud to myself while working a lot more now.
posted by fiercecupcake at 8:19 AM on May 7, 2019 [3 favorites]

Lithium can have that effect, and so can Lamictal. Latuda had the opposite effect on me though, and was actually prescribed to help combat Lamictal brain fog. Definitely give it more time to see if the side effects even out, and if they don't, talk to your psychiatrist about possibly scaling back the Lithium in favor of Latuda.
posted by cosmic owl at 6:46 PM on May 8, 2019