View Full Version : Do mood stabilisers help with cognitive impairments??


Fuzzy12
01-10-13, 12:36 PM
I've read quite a few papers now that state that bipolar disorder (both I and II) come with cognitive impairments like issues with executive function, memory, inattention, etc. So quite similar to ADHD. In ADHD, however, these issues can be managed (or attempted to be managed) using medication.

With bipolar disorder on the other hand it seems like most research is done to study if mood stabilisers cause cognitive impairments (seems like they don't, but it's not conclusive, I think.)

So I guess, it's unlikely that mood stabilisers actually help with cognitive impairments. I know, anti depressants have done nothing for my ADHD-like symptoms.

If they don't help, what does? Does anything help at all or are we just doomed to live with cognitive impairments?

Any inputs/personal experience?

ezridax
01-10-13, 12:59 PM
I've been wondering about all this myself. Let's keep each other posted on any new news, shall we?

namazu
01-10-13, 01:03 PM
Probably "yes and no".

To the extent depression (etc.) worsen cognitive function, and mood stabilizers (+/- anti-d's) fix that, meds can improve functioning.

However, there can be residual/persistent impairments even between episodes, and there's not a ton of research yet on inter-episode functioning by medication status as far as I know.

Also, some mood stabilizers (including some of the anticonvulsants) can themselves have adverse cognitive side effects.

You win some, you lose some.

ezridax
01-10-13, 01:05 PM
This is less specific to your situation and more general, but they say that poeple who regularly use their brains in higher-order thinking are less likely to experience lapses in memory/judgement as they get older.

So, doing a lot of brain teasers, word puzzles, visual-spatial exercises, etc. might help (?) Keep your brian active by learning new things, but also regularly recalling things you already know. Play games that involve short-term memory. Start keeping a journal and write in it regularly about memories from your childhood/youth to keep that part of your mind alive, and so you have something to refer back to as you get older and have a harder time remembering.

Fuzzy12
01-10-13, 01:12 PM
Probably "yes and no".

To the extent depression (etc.) worsen cognitive function, and mood stabilizers (+/- anti-d's) fix that, meds can improve functioning.

However, there can be residual/persistent impairments even between episodes, and there's not a ton of research yet on inter-episode functioning by medication status as far as I know.

Also, some mood stabilizers (including some of the anticonvulsants) can themselves have adverse cognitive side effects.

You win some, you lose some.

What do you win?

My cognitive impairments never let up, irrespective of if I'm depressed, hypomanic or the rare euthymic episodes where I suspect I might be somewhat normal. I'm always dysfunctional.

keliza
01-12-13, 08:03 PM
Most people who have cognitive impairments have minimal impairment during euthymic periods; it's during depression and mania that the impairments are obvious, in most people. During euthymia it's statistically significant, but it takes very little to be statistically significant in "real world" application, so it's still something that, when not in a major mood episode, you probably wouldn't notice much.

I have some cognitive impairment from my meds. It's not terrible, but it's annoying. The main issue is losing words. I have tip-of-the-tongue phenomena on a daily basis, which is common with the medication I'm taking to curb mania (Trileptal). Some aphasia is to be expected with all anti-epileptics. I experienced some of the same with Lamictal, too, but not as bad. It's something I've learned to live with, because the impairments from not being medicated would be astronomically worse than the current state of affairs.

So that is the win/lose situation. I win by not having manic episodes. I lose words. Whatever. I'll survive. :)

adelynsmommy
01-12-13, 09:07 PM
I took lithium while undergoing shock treatments (typically a no-no because of cognitive impairments) and I have felt like a moron ever since (coupled with ADHD symptoms!)

I definitely blame lithium (and the ECT) for my cognitive decline...I often feel like I have a brain injury.

Idiota
01-14-13, 06:13 AM
They don't.

Fuzzy12
01-14-13, 12:28 PM
Sigh, then I guess, I'm ******.

desafinado
01-30-13, 03:07 AM
my experience is different than the general consensus. i tried a series of antidepressants which exacerbated my problems. when i eventually tried (and stayed on, for almost 7 years now) lamictal, it was like a thick, dense fog between my brain and the world was removed. it's like a screen had been in front of my eyes, for lack of a better way of describing it. for the first time in my life i could actually have a thought. and this was 5 years before being diagnosed as ADD, so cognitive function wasn't the primary focus of my treatment.

Raye
01-31-13, 07:21 AM
Fuzz-

I haven't noticed any change in cognitive impairments since being on mood stabilizers, just that my moods have been a h*** of a lot better.

I know it's very important to you to improve you CI's, but as I said before, most docs want to get the main symptom under control first, which would be your depression.

daveddd
01-31-13, 07:26 AM
stimulants, should help with that

but if not i have heard of valproic acid helping

Fuzzy12
01-31-13, 07:29 AM
stimulants, should help with that

That's the problem, Dave. I have all the symptoms of ADHD but I don't actually have ADHD but bipolar disorder so I can't get stimulants prescribed. However, mood disorders aren't known to help with cognitive impairments so I worry that even when my moods are more stabilised my cognitive impairments will still be there and there's nothing that can be done against them.

daveddd
01-31-13, 07:34 AM
have you had cognitive impairments your whole life?

if so it shouldn't matter what your dx is?

if stimulants treat those symptoms,you should get them, they have been proven safe in your type of bipolar

Fuzzy12
01-31-13, 07:40 AM
have you had cognitive impairments your whole life?

if so it shouldn't matter what your dx is?

if stimulants treat those symptoms,you should get them, they have been proven safe in your type of bipolar

Yes, but to a much smaller extent when I was child. Not enough to conclusively prove I have ADHD.

daveddd
01-31-13, 07:45 AM
im saying this based on extensive experience with this matter


if you feel strongly about these impairments effecting you, find a doctor that will help you with them


im "bipolar N.O.S." and receive adderall

Abi
01-31-13, 07:52 AM
Depakote and Lithium CAUSE / EXACERBATE cognitive impairments.

Wellbutrin reduces them for me without inducing mania.

Risperdal helped clear my head but had intolerable physical side effects.

purpleToes
02-04-13, 01:06 PM
Yes, but to a much smaller extent when I was child. Not enough to conclusively prove I have ADHD.

That's terrible logic. Doctor should be concerned with treating your symptoms, not your diagnosis. I'm not aware of anything that conclusively proves ADHD EXCEPT a remission of symptoms with ADHD medication.

Idiota
02-04-13, 06:44 PM
im saying this based on extensive experience with this matter


if you feel strongly about these impairments effecting you, find a doctor that will help you with them


im "bipolar N.O.S." and receive adderall

how does that happen? My psychiatrist basically said any ADHD I may have is untreatable due to my having been manic in the past. I wanted to kill him.

No doctor in my experience has been helpful with that. How did you get adderall? Are there any studies that are official that I can forward to my psychiatrist. Being unable to concentrate has ruined my life.

The problem I have with how mental health is handled is that a lot of us with problems have significant financial stress and employability problems. If that isn't dealt with, no amount of therapy or drugs(if they don't work) will help you. For a psychiatrist, the whole thing is a fairly detached process. "See you in 4-6 weeks" you don't matter. What good is a social worker when they themselves are struggling? it's just kind of ridiculous.

scatterbraingrl
04-26-13, 04:46 AM
This is less specific to your situation and more general, but they say that poeple who regularly use their brains in higher-order thinking are less likely to experience lapses in memory/judgement as they get older.

So, doing a lot of brain teasers, word puzzles, visual-spatial exercises, etc. might help (?) Keep your brian active by learning new things, but also regularly recalling things you already know. Play games that involve short-term memory. Start keeping a journal and write in it regularly about memories from your childhood/youth to keep that part of your mind alive, and so you have something to refer back to as you get older and have a harder time remembering.

This is absolutely correct. As a professional musician, the older musicians I interact with on a regular basis always seem to have sharper minds than other people around their age. I'm pretty sure that's why a lot of them want to play as long as they can so their brain doesn't come to a halt. I feel like that even with short periods of not playing my instrument! I suppose I'll be playing it the rest of my life for that reason.

I like video games, word games, & other mind stimulating activities. I always have to be doing SOMETHING, which is really annoying sometimes when I just want to relax. I also picked up German gradually this past decade & learned a lot more of it when I went overseas a few years ago. I've read many articles that advocate taking up a language or going back to one you learned in the past (i picked up Spanish again off & on as well). Even learning an instrument at ANY age is good for you, no matter how advanced you actually get at it... as long as you enjoy it & learn something from it, it's great for your brain. Just wanted to comment on ezridax's comment...

As for mood stabilizers & cognitive impairments, I'm not sure on that just yet since I just started meds this week, so I'll have to follow up on that later... but I'm very curious about it as well. I will say memory issues highly influenced my decision to get on meds because since my mind is constantly racing, I've been forgetting silly things that I normally don't forget. Part of the recent problem was other medications enhancing my ADD symptoms (relentless allergies, hormonal, & at 1 point last year, pain meds), so I've tried eliminating those to see if the memory issues resolve. So far, so good... I've been remembering where i put my keys, I made a flight on time, I know where I've put things, etc :)

Idiota
05-24-13, 08:54 AM
No, mood stabilizers do NOT help cognitive impairments. If anything, they make them worse. Seriously.