View Full Version : Cognitive Impairment from Dextroamphetamine


Roundabouts
08-19-15, 10:52 PM
So for the past month and a half I've been taking 10-15 mg dex, and I've been contending with some pretty upsetting cognitive symptoms. Since being on this drug, my reasoning, memory, and creativity have taken a pretty nasty hit. I was prescribed this medication to help with my treatment-resistant depression and the cognitive dulling associated with it - initially it worked wonderfully but now it's anything but. About the first 45 minutes or so of taking a spansule or tablet I feel a noticeable mood lift along with a mild boost of mental acuity, but in the ensuing hours my mood remains fairly good at the sacrifice of my mental sharpness. I basically feel like a motivated zombie.

There seems to be a general consensus that amphetamines are neurotoxic, and so I have become convinced that my dopamine neurons and receptor sites have been damaged. What I find interesting is how numerous studies have found methylphenidate to be neuroprotective. I'm wondering what your thoughts are on this, and if it might be worth asking for Focalin at my next pdoc visit.

I should note that I have an anxiety disorder, so I am sensitive to the PNS effects of Adderall and Ritalin due to their l-isomers. I took Focalin a few years back, but I had a fever the 2nd or 3rd time I took it....which worried me from trying it again. That being said, I had previously tried Ritalin and never had a fever from it...yet Ritalin has the d-isomer....so I'm conflicted on whether the fever was a result of the Focalin. I remember there were a lot of coworkers who were sick at the same time I came down with the fever, so I don't know if that was the cause.

The reason I continue to take the dex is because it helps tremendously with my motivation, and I know what these stimulants are capable of therapeutically. I've been on Adderall as well and that worked VERY well for me on motivation and focus, but it just has way too many side effects.

A penny for your thoughts...

dvdnvwls
08-19-15, 11:13 PM
It's very likely that either you're having caffeine or your dose is too high. Completely eliminate caffeine first; if that doesn't work, get your dosage reduced.

It's important to eat well. If you under-eat, this can also happen.

Pilgrim
08-20-15, 03:33 AM
I wanted to say that my memory now is better than ever, that I can remember.
I think the problem is these medications wax and wane. I never have to be too creative but I would say when the medication works well my reasoning is better.
It sucks to have to rely on a drug to deal with certain problems but I think if you work with it, eating well drink water, it's definitely the way to go.

aeon
08-20-15, 04:14 AM
There seems to be a general consensus that amphetamines are neurotoxic...

Nope. Methamphetamine can be, but not dextroamphetamine. Dex even demonstrates neuroprotective qualities.

Go read some Wikipedia. :p


cheers,
Ian

sarahsweets
08-20-15, 12:58 PM
There seems to be a general consensus that amphetamines are neurotoxic, and so I have become convinced that my dopamine neurons and receptor sites have been damaged.
This is not true and as far as I know there isnt any solid evidence to suggest it is. In other words, the majority of us here would have damaged dopamine receptors and such. It sounds like something I have read on those anti-med anti-adhd sites.

Fuzzy12
08-20-15, 01:13 PM
I've never heard anything about dex being neuro toxic either, on the contrary.

Maybe your dose is too high? Or maybe it's too low? At lower doses dex helps me with my mood and motivation but not focus or clarity of thinking, which seems to kick in with higher doses..for me at least.


Also, are you getting enough sleep? When km.sleep deprived I can't focus or think clearly even when I take dex (though it might still help with my mood)

Daydreamin22
08-20-15, 07:50 PM
I noticed the same thing when I was taking adderall. If you ask drs or other people about it they'll stare at you.. that's it. It's very frustrating to say the least. No one listened to me. But yea, I'm worried about it too. I was on it for years and am now off of it. People do come on here complaining about the effects it has on them. You're not alone, but the companies don't report about it... drs don't know about it... they don't listen... etc. etc. It was crazy making. I know how you feel and 7 years later I have nothing to validate my experience.

dvdnvwls
08-20-15, 08:41 PM
I noticed the same thing when I was taking adderall. If you ask drs or other people about it they'll stare at you.. that's it. It's very frustrating to say the least. No one listened to me. But yea, I'm worried about it too. I was on it for years and am now off of it. People do come on here complaining about the effects it has on them. You're not alone, but the companies don't report about it... drs don't know about it... they don't listen... etc. etc. It was crazy making. I know how you feel and 7 years later I have nothing to validate my experience.

At that time, did you quit having caffeine? And if you never had or had already quit caffeine, did you have your dosage reduced until the bad effect went away? If you didn't go through those possibilities, then it's most likely that one of them was the problem.

Roundabouts
08-20-15, 09:04 PM
Thank you all for the replies. I don't touch caffeine at all, and I don't believe that my dosage is the culprit. If I take just 5 mg for the day, the negative effects are less I suppose but I also don't benefit therapeutically from the drug. Where I am now, about 10-15 mg, is the sweet spot for me.

I'll say that I don't get a full 7-8 hours of sleep every night, but the impact from mild sleep deprivation just doesn't explain these negative effects I am getting. Even when I go through a period of adequate, restful sleep, it's no different.

I don't know, I'm planning on taking a break from it and evaluating my options. I just don't like what it's done to my head at all. I feel like a robot and I hesitate before saying or writing things because I'm slower at putting things together.

I forgot to mention that the other meds I am on are Remeron, Brintellix, Klonopin (1 mg daily), and Tenex. I'm pretty sure the benzo has resulted in some cognitive dulling, but the dex has made it worse.

Daydreamin22
08-20-15, 09:06 PM
At that time, did you quit having caffeine? And if you never had or had already quit caffeine, did you have your dosage reduced until the bad effect went away? If you didn't go through those possibilities, then it's most likely that one of them was the problem.

dosage or caffeine.. I don't think so... I think the problem was much bigger than that.

Daydreamin22
08-20-15, 09:06 PM
Thank you all for the replies. I don't touch caffeine at all, and I don't believe that my dosage is the culprit. If I take just 5 mg for the day, the negative effects are less I suppose but I also don't benefit therapeutically from the drug. Where I am now, about 10-15 mg, is the sweet spot for me.

I'll say that I don't get a full 7-8 hours of sleep every night, but the impact from mild sleep deprivation just doesn't explain these negative effects I am getting. Even when I go through a period of adequate, restful sleep, it's no different.

I don't know, I'm planning on taking a break from it and evaluating my options. I just don't like what it's done to my head at all. I feel like a robot and I hesitate before saying or writing things because I'm slower at putting things together.

I forgot to mention that the other meds I am on are Remeron, Brintellix, Klonopin (1 mg daily), and Tenex. I'm pretty sure the benzo has resulted in some cognitive dulling, but the dex has made it worse.


It could be hypomanic symptoms... I got those. They used to say it was because I had bipolar and thats why I was having those symptoms... but you don't have to have a diagnosis to get those symptoms. But still the hypomania doesn't explain everything I went through on adderall.

Roundabouts
08-20-15, 09:08 PM
To combat this mental slowing, I've ordered a bottle of Alpha Brain by Onnit, as I've read good things about it. It seems to be a highly reputable and esteemed product...https://www.onnit.com/alphabrain/

Anyone try it?

Daydreamin22
08-20-15, 09:12 PM
Never heard of them.

dvdnvwls
08-20-15, 09:22 PM
To combat this mental slowing, I've ordered a bottle of Alpha Brain by Onnit, as I've read good things about it. It seems to be a highly reputable and esteemed product...https://www.onnit.com/alphabrain/

Anyone try it?

"Highly reputable and esteemed" but no one here has even heard of it? That would be a new one. :)

A highly effective way of persuading you to part with your money for not much benefit, is my guess.

Daydreamin22
08-20-15, 09:23 PM
To be fair there is really no one on the forums right now...

dvdnvwls
08-20-15, 09:23 PM
dosage or caffeine.. I don't think so... I think the problem was much bigger than that.

Did you actually try removing all caffeine and lowering your dosage until the problem went away? Or are you just guessing?

Daydreamin22
08-20-15, 09:24 PM
Did you actually try removing all caffeine and lowering your dosage until the problem went away? Or are you just guessing?
Um yes I definitely had these problems at a low dose with no caffeine. It wasn't those. You just don't know what I'm talking about because you don't experience these problems.

dvdnvwls
08-20-15, 09:25 PM
To be fair there is really no one on the forums right now...

If there really was a highly reputable and esteemed product, we'd all be talking about it already, or at least we'd all know its name.

Daydreamin22
08-20-15, 09:25 PM
not necessarily

dvdnvwls
08-20-15, 09:25 PM
Um yes I definitely had these problems at a low dose with no caffeine.

You never mentioned this until now. You easily could have. Sorry for the confusion.

Daydreamin22
08-20-15, 09:26 PM
I don't know what you mean. But, no problem

dvdnvwls
08-20-15, 09:27 PM
not necessarily

If it was brand new, then it couldn't be an "esteemed" product.

dvdnvwls
08-20-15, 09:27 PM
I don't know what you mean. But, no problem

I mean you could have said "I tried that and it didn't work", not just "I don't think it's that".

Daydreamin22
08-20-15, 09:29 PM
I never tried it... ? But I wasn't taking caffeine at the time. So "it wasn't that"

dvdnvwls
08-20-15, 09:30 PM
I never tried it... ?

(eliminating caffeine and cutting the dosage down, back when you had that problem)

Daydreamin22
08-20-15, 09:33 PM
(eliminating caffeine and cutting the dosage down, back when you had that problem)

The problem started with a low dose and no caffeine thought. You randomly decided those could be the problem. It had nothing to do with those.

dvdnvwls
08-20-15, 09:35 PM
The problem started with a low dose and no caffeine thought. You randomly decided those could be the problem. It had nothing to do with those.

Okay, cool, I get it. You could have said that in the first place and saved some confusion, but it's all fine. :)

It's not "random" to expect common problems instead of uncommon ones.

Daydreamin22
08-20-15, 09:46 PM
it's a matter of perception and listening and hearing the person with these problems... it's just not good when there are no answers for "us" out there.

Roundabouts
08-20-15, 10:33 PM
There's good reason to be skeptical about nutritional supplements as they are virtually unregulated, but for some people they make a difference. Whether or not this is placebo, in my book it really doesn't matter. If it helps then that's great, go with it. It's not settled science - there are plenty of unknowns. But right now in my life I want to make an effort to counter this awful brain fog...and that begins by stopping dex.

Diet and exercise are of course critical, but depression leaves you at a disadvantage. Every day is a struggle. The science is pretty clear about shrinkage of the hippocampus in the brain in those with major depression. And for me, cognitive impairment feeds my depression.

Pilgrim
08-21-15, 01:26 PM
At that time, did you quit having caffeine? And if you never had or had already quit caffeine, did you have your dosage reduced until the bad effect went away? If you didn't go through those possibilities, then it's most likely that one of them was the problem.

I remember I was talking with my Psychiatry doctor once and he was also really big on no caffeine.
I find when I'm looking for that extra something I'll reach for the caffeine.

It's like the Dex and caffeine compete with each other. Whilst racing to work last week( and a bunch of thought circulating) I noticed ,and this sounds strange, my Dex didn't like the caffeine. After being on Stimulints for 3 years you think I would have noticed it before. This was the first time I really experienced it.

Waitingame
08-21-15, 09:29 PM
It's like the Dex and caffeine compete with each other. Whilst racing to work last week( and a bunch of thought circulating) I noticed ,and this sounds strange, my Dex didn't like the caffeine. After being on Stimulints for 3 years you think I would have noticed it before. This was the first time I really experienced it.

Acidic beverages (coffee, soda) will diminish effect of dex or Adderall, but is supposed to potentiate Ritalin and its ilk.

As someone else said above, they all work so much better on adequate nutrition. For me, taking any stimulant meds on an empty stomach is a recipe for a runaway, both cognitive and emotional.

dag nab it
08-22-15, 10:57 AM
Roundabouts,

Having you tried INCREASING your dose? Perhaps on a day when you are off, and you feel the "cognitive impairment", you could take an extra dose of Dex to see whether more Dex relieves the problem?

I was getting a stopping, staring type of feeling that would come on some afternoons. I generally do not take Dex past 1 p.m. (sleep issues otherwise), but sometimes when I am working on a project I take additional smaller doses - those afternoons and evenings, I would have that same stopping, staring sort of feeling. I was not sure whether they came because I took too little meds or too much (because the medication lingers with me for a long time and can build up). It turned out the feeling was from too low a dose. I was so cautious taking the Dex - not wanting the sleep problems - that I was giving myself too little medication.

Your situation is a bit complicated though - what with your other meds. Apart from medication, the first thing that comes to mind is blood sugar. Does eating a piece of candy help with the brain issue? (Amphetamines can affect blood sugar.)

sarahsweets
08-22-15, 11:58 AM
Roundabouts,

Having you tried INCREASING your dose? Perhaps on a day when you are off, and you feel the "cognitive impairment", you could take an extra dose of Dex to see whether more Dex relieves the problem?

with a doctors approval. NOT on your own.

Roundabouts
08-22-15, 03:31 PM
Roundabouts,

Having you tried INCREASING your dose?

Yes I have gone up to 20 mg, but that only elevates my mood and general cognitive function very briefly. After about 2 hours I'm back to feeling like I usually do with the med, motivated yet numb and bereft of creativity.

While cogitating on ways to ameliorate this cognitive stunting, I remembered that I had a mostly unused prescription of nuvigil from 2 years ago. So I decided to try it again, and I am definitely happy with the results. My memory, comprehension, and overall clarity of thinking is notably improved while on it. The reason I had decided to not continue with it two years ago was due to the astronomical price. However, I did some research and made some calls to local pharmacies and discovered that generic provigil costs $200 (minus insurance) as opposed to $800 when I last looked.

So, I am going to discuss this with my psychiatrist and will most likely get myself a prescription for it. My pdoc is very liberal about medications and once suggested to me that I consider desoxyn (which I refused), so it's really just a matter of cost.

I also think combining the modafinil with occasional low dose dex might be a prudent choice, as the dex will augment my focus while the modafinil will enhance episodic memory, processing speed, verbal recall, etc.

Pilgrim
08-26-15, 07:04 AM
Diet and exercise are of course critical, but depression leaves you at a disadvantage. Every day is a struggle. The science is pretty clear about shrinkage of the hippocampus in the brain in those with major depression. And for me, cognitive impairment feeds my depression.

This is the key here I feel. I would like to do more at the moment but really can't. I never use to feel this way. My comprehension is the best and I would like to emeliorate this problem. The need to be more productive,in certain spots, would help a lot. I play around with my diet and try to exercise more. I'm not as depressed as I was but it still lingers. The funny thing is I know I would be less depressed if there was certain things I could achieve. Dex is a good place to start.

Sickle
08-28-15, 08:58 PM
I have less of those symptoms. I also take Lamictal for bipolar I disorder and it levels me out but the Dexedrine and nutritional support are great too. Limiting caffeine to green tea helps me a lot. I can take short term benzo or haldol/benzo combo if I get manic but it hasn't happened. I can often remember things better.

wibblet
10-15-15, 07:16 PM
Have you taken anything else to fix this problem? I'm having the same exact symptoms you're describing.

sarahsweets
10-20-15, 09:53 AM
Have you taken anything else to fix this problem? I'm having the same exact symptoms you're describing.

One solution at least in regards to the OP would be a lower dose. Lack of creativity, feeling blunted, procrastination in the extreme are all signs of too high of a dose. Increasing it wont make it work better. A higher dose doesnt=better mechanism of action.