SSRI that doesn't affect the memory

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jcms

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Which one is your favourite?? :laugh:

Some people take Zoloft, would this be one???
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I was reading about one in a journal the other day. Now where did I put it...
 
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Acute administration of citalopram (marketed as Celexa) was shown to facilitate memory consolidation in humans. So, there's an SSRI that might actually help your memory. :)
 
I've been on Celexa for 2 months. I've felt very sleepy all the time. I've also had problems with memorization so I switched to Zoloft. I've never had any problems with my memory - it was really great.

I take SSRI for GAD.
 
jcms said:
Which one is your favourite?? :laugh:

Some people take Zoloft, would this be one???
Click to expand...

This is one of those mileage may vary things. Effexor seemed to be good for my memory, excellent for my vocabulary, and made it completely impossible for me to fall asleep before 2 a.m., which kind of sucked when i had to be up at 6:00.
 
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
 
H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...

Ok, I would probably rip you into a million tiny pieces if you didn't have Wittgenstein as your avatar. Since Wittgenstein is my deity, I will give you a free pass as a coreligionist.

Anyhow, SSRIs do not make you indifferent at all. That was a fear I had before I started taking them. What they do is give you a delay which allows you to put things into perspective before you fly off the handle. Before I started taking Lexapro, I had the propensity to fly off the handle and really overdoit on somewhat trivial things. Now, I tend to think a little bit more before I react. I don't feel foggy at all. I felt foggy when my head was cluttered up with irrational emotions that were pissing me off or causing me stress for no good reason.


To the OP. I have had a lot of success with Lexapro. It made me sleepy for ~1 week, but that seems to have dissappeared. I haven't noticed any negative side effects in regard to memory. If anything, it seems as though my memory has improved - but I have no idea whether that is due to the Lexapro or just devoting more of my brain to retaining facts because I am a medstudent.
 
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H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...

1. Some of us were on it BEFORE we were med students, so don't be so quick to assume otherwise.

2. Some people on SSRI's are not merely med students anymore.

3. Quite the opposite, it actually removes the slothfulness and indifference of depression.

4. Grief and happiness are not diminished, only inappropriate depression.

5. Black and white emotions are great, but with depression a person is mostly in the black, rarely in the white. Where is the joy in that?

6. a chemical imbalance that can cause depression is beyond sucking it up. Either you are a kool-aid drinking scientologist, or you've never had real clinical depression.

Typical of know-it-alls, you have the answers.


To the OP, zoloft has never given me any problems with memory. Last year, my insurance stopped covering zoloft, so I switched to generic celexa (citalopram), and it diminished my memory retention. Luckily, there is now a generic zoloft that insurance covers. The memory is back!

However, everyone may not obtain the same results. I would suggest you speak with your physician about your concerns.
 
racerx said:
To the OP, zoloft has never given me any problems with memory. Last year, my insurance stopped covering zoloft, so I switched to generic celexa (citalopram), and it diminished my memory retention. Luckily, there is now a generic zoloft that insurance covers. The memory is back!
Click to expand...

Thanks for good news :)
 
Interesting topic. Just wondering, do SSRIs help develop permenant positive effects on the neurosystem, or do you have to take it for a long period of time. For example, can you take it for a year or two and be anxiety or depression free for years to come (assuming one doesnt relapse hopefully). Anyone have experience with Xanax? And what dosages are you guys on?
 
helpfuldoc2b said:
Interesting topic. Just wondering, do SSRIs help develop permenant positive effects on the neurosystem, or do you have to take it for a long period of time. For example, can you take it for a year or two and be anxiety or depression free for years to come (assuming one doesnt relapse hopefully). Anyone have experience with Xanax? And what dosages are you guys on?
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SDN isn't really the place for medical advice, so please keep this in mind and I hope that you're not looking for a personal consult...

Statistically it depends on the patient's psychiatric history, with one episode of major depression there is a ~50% risk of relapse, with two closer to ~75%, and with three almost 100%. So while treatment for an episode may be around a year for an episode, if s/he's had three episodes, the psychiatrist will likely suggest remaining on an antidepressant for the foreseeable future. This is not a rule, and with good treatment and therapy it is possible to beat the odds, but this is what we were taught. Many people who have an isolated episode of depression are able to go off of the antidepressant after a shorter treatment time, to my understanding.

Regarding Xanax, be very careful with this benzo, it has the highest risk of developing tolerance and withdrawal. Look into lorazepam/Ativan or perhaps clonazepam/Klonipin since they have a longer duration of action and less risk of dependence. They tend to control anxiety just as well. For a benzodiazepine-naive patient, try buspirone (a partial 5HT agonist) for anxiety control, it has few adverse effects and is well tolerated, plus it's extremely inexpensive, is not scheduled, and has far less sedation.

Furthermore, prescribing an SSRI/SNRI/atypical antidepressant should help in managing anxiety, especially generalized or social anxiety. That way you can manage your patient with only a small script for benzos if they're having panic attacks.

To upperclassmen, please correct me if I am wrong in these points. Still learning here. :D
 
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I'm on Celexa currently and haven't noticed any memory loss. Sure, I have trouble memorizing every stupid little detail that we need to learn for our classes, but I think we're all there. I've done both Lexapro and Prozac before and also didn't notice memory impairment. I wasn't in medical school when I was on those, though, so I might not have had reason to notice. :) Not an SSRI, but Wellbutrin sucked for me -- it made me really, really anxious. Just throwing that out there.
 
i'd be screwed without lexapro. seriously. escpecially considering recent events.

but in the end, you need to talk it over with your doc. there are like 10 different SSRI's and as someone said earlier, your milage may vary.

but i still like lexapro.
 
stoic said:
i'd be screwed without lexapro. seriously. escpecially considering recent events.

but in the end, you need to talk it over with your doc. there are like 10 different SSRI's and as someone said earlier, your milage may vary.

but i still like lexapro.
Click to expand...

Everyone's mileage varies; that's exactly why patients need to talk to their own doctors. SSRI's seem kind of unpredictable to me.
 
Since this seems to be a commonly occurring thread, here's just a summary of what people have posted, feel free to edit. NOT MEDICAL ADVICE. Just some anecdotes from med students.

SSRI's/chronic antidepressants

Zoloft:
- no memory loss in 1 case
- weight gain

Effexor:
- no memory effects reported
- insomnia

Lexapro:
- sleepiness for a week
- no memory effects x2, worked well

Celexa:
- diminished memory, Zoloft reported better for this person
- fatigue
- benefit for 1 person who has tried Lexapro, Prozac and Wellbutrin

Wellbutrin:
- anxiety

Benzodiazepines/acute/etc.

Xanax/Alprazolam:
- high tolerance and withdrawal
Lorazepam (ativan), Clonazepam (klonopin)
- longer duration of action than alprazolam, less risk of dependence
Buspirone (Buspar)
- nutrasweet for benzos, far less sedation, still anxiolytic
 
The plural of anecdote is not fact.
 
Rogue Synapse said:
The plural of anecdote is not fact.
Click to expand...

My favorite is when people randomly spout out speciously relevant platitudes. When a lot of these competing drugs have poorly understood mechanisms of effect, sometimes it's important to hear people's anecdotes and experiences. I think as medical students, we're smart enough to realize that "mileage may vary". No drug monograph will definitively say "no memory effects!" or "no weight effects!" -- there's no concrete answer, or else people would obviously flock to that drug en masse. Obviously sample sizes of 1-2 are inadequate, but if the only other mitigating factor is which pharmaceutical company bribed the prescribing psychiatrist the most, then I think hearing anecdotes might be pretty relevant.
 
H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...

no need for that, test went good.
 
SSRI--> increased BDNF

if you are really depressed, it might more than balance out any memory problems
 
After 10 days on Zoloft I've noticed huge memory improvement (comparing to Celexa). Anxiety level a little higher (temporary I hope). No changes in appetite.
 
H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...


it is pretty insensitive to criticize people for taking a medication for a condition which they very easily could be genetically predisposed to.
 
Tried Serzone, Effexor (got jittery too), and Lexapro. Lexapro has been the best for me....haven't noticed any real cognitive side effects compared to the others.
 
H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...

This is kind of a bunk statement. Stronger anti-psych medications like lithium, depakote, and zyprexa (bi-polar and seizure meds) will make a person rather indifferent to life, but the SSRIs do not do this to the same degree. It is not like you still don't have good and bad days....it just helps smooths out the ride. The alternative (worse case scenario) is not getting any help and committing suicide (Which happened to a close family friend of mine who was a successful judge of mid-50s age, he left behind a wife and 2 kids), or just living a very sad life with lack of meaning, not being able to get out of bed, etc.
 
Why was this thread dragged up from 2006?

Anyway, I'd like to hear more at any rate. I just finished 4 weeks of psych and still don't understand why you would pick 1 SSRI over another in someone who's never been on SSRI's in the past. Is it doctor personal preference?
 
I'm on Luvox; anyone on Luvox as well?
 
akpete said:
Why was this thread dragged up from 2006?

Anyway, I'd like to hear more at any rate. I just finished 4 weeks of psych and still don't understand why you would pick 1 SSRI over another in someone who's never been on SSRI's in the past. Is it doctor personal preference?
Click to expand...

Just from personal experience, I think that yes, it may be personal preference (the doc might know such and such med better and have more experience with it), maybe side effect profile, I don't know...

I started TCA's, SSRI's didn't do cr@p for me. Well, wait, I'm taking the TCA to see if it helps with the chronic pain (LBP & migraines from hell), not for depression.
 
So I asked this in the thread that got closed: How prevalent is this phenomenon of taking anti-depressants? If you are on meds, what are your thoughts about how this might affect your residency application? Can programs access this kind of information about you?
 
Goran said:
So I asked this in the thread that got closed: How prevalent is this phenomenon of taking anti-depressants? If you are on meds, what are your thoughts about how this might affect your residency application? Can programs access this kind of information about you?
Click to expand...

goran, there is nothing about your medical history on your ERAS application for residency. only after i matched and my hospital sent me my credentialing packet was there a form asking about my past medical history, meds i'm currently taking, etc.. they probably use this info for the hospital employee insurance coverage. i wouldn't worry too much about this, if you think you have a problem and your doctor prescribes something to help you - dont pass it up and suffer in silence just b/c you think it might affect your match, it wont. a lot of people are on a lot of different medicines for everything from anxiety to heart conditions. im nearly positive none of that goes in your deans letter so programs wouldn't find out until post match, and then only when you tell them like on a insurance form. my hospital also requested my physician fill out an H&P form and say that i was cleared to start residency. thats it.
 
jcms said:
Which one is your favourite?? :laugh:

Some people take Zoloft, would this be one???
Click to expand...

so learning and memory are related to neurogenesis in hippocampus, and prolonged stress and depression greatly decrease formation of new neurons in hippocampus. anti-depressants actually have been shown to improve memory via increased neurogenesis, as does regular physical activity (aerobics)
 
I was on Effexor in the past and had no memory problems with it. I have also been on Celexa without memory problems. The only drug that really affected my memory was Topomax for migraines. I wish they would have prewarned me about that or I would have immediately asked for another drug. So definitely stay away from that. Not an antidepressant but it's known to cause memory problems.
Does anyone know the rate of mental disorders among med students?
 
Doublecortin said:
so learning and memory are related to neurogenesis in hippocampus, and prolonged stress and depression greatly decrease formation of new neurons in hippocampus. anti-depressants actually have been shown to improve memory via increased neurogenesis, as does regular physical activity (aerobics)
Click to expand...

...after 4-6 weeks.
 
Doublecortin said:
so learning and memory are related to neurogenesis in hippocampus, and prolonged stress and depression greatly decrease formation of new neurons in hippocampus. anti-depressants actually have been shown to improve memory via increased neurogenesis, as does regular physical activity (aerobics)
Click to expand...

basupran said:
SSRI--> increased BDNF

if you are really depressed, it might more than balance out any memory problems
Click to expand...

Woah, there - not facts by any means. First off, the conjectured mechanism of antidepressants is increasing BDNF. We know this to be somewhat true, but also know it's not the whole story. If you knock out BDNF in the dentate gyrus, you decrease their effectiveness but you do not wipe out their effectiveness.

Neurogenesis only occurs in the dentate gyrus (& SVZ) - not in CA1 or CA3. BDNF supports neurogenesis, however it has wildly different effects depending on the part of the hippocampus and part of the brain. IIRC, increased BDNF in the PFC actually puts one at risk for inducing depression. Neurogenesis is just one part of learning and memory - wiring of the hippocampus and entorhinal cortex are huge.

While BDNF is the big craze right now, there is another mechanism that's been around for a while in the community. The inhibitory 5-HT presynaptic autoreceptors are thought to downregulate during those 2-4 weeks of latency - thus allowing for release with higher existing synaptic concentrations.

As for memory issues, I'm not aware of any SSRI that have been shown to spare memory more than another.
 
Maxprime said:
Woah, there - not facts by any means. First off, the conjectured mechanism of antidepressants is increasing BDNF. We know this to be somewhat true, but also know it's not the whole story. If you knock out BDNF in the dentate gyrus, you decrease their effectiveness but you do not wipe out their effectiveness.

Neurogenesis only occurs in the dentate gyrus (& SVZ) - not in CA1 or CA3. BDNF supports neurogenesis, however it has wildly different effects depending on the part of the hippocampus and part of the brain. IIRC, increased BDNF in the PFC actually puts one at risk for inducing depression. Neurogenesis is just one part of learning and memory - wiring of the hippocampus and entorhinal cortex are huge.

While BDNF is the big craze right now, there is another mechanism that's been around for a while in the community. The inhibitory 5-HT presynaptic autoreceptors are thought to downregulate during those 2-4 weeks of latency - thus allowing for release with higher existing synaptic concentrations.
Click to expand...

Which one makes your pee-pee not work so good?
 
I recommend a good enema rather than pills.
 
Maxprime said:
Woah, there - not facts by any means. First off, the conjectured mechanism of antidepressants is increasing BDNF. We know this to be somewhat true, but also know it's not the whole story. If you knock out BDNF in the dentate gyrus, you decrease their effectiveness but you do not wipe out their effectiveness.

Neurogenesis only occurs in the dentate gyrus (& SVZ) - not in CA1 or CA3. BDNF supports neurogenesis, however it has wildly different effects depending on the part of the hippocampus and part of the brain. IIRC, increased BDNF in the PFC actually puts one at risk for inducing depression. Neurogenesis is just one part of learning and memory - wiring of the hippocampus and entorhinal cortex are huge.

While BDNF is the big craze right now, there is another mechanism that's been around for a while in the community. The inhibitory 5-HT presynaptic autoreceptors are thought to downregulate during those 2-4 weeks of latency - thus allowing for release with higher existing synaptic concentrations.

As for memory issues, I'm not aware of any SSRI that have been shown to spare memory more than another.
Click to expand...

Interesting. We did not study the SSRI's in nearly this detail.

However, we DID learn that they've been shown to downregulate B-adrenergic receptors, thus contributing to their antianxiety but also potentially the weight gain effects.

Did anyone else learn the B-receptor downregulation concept??
 
Tired said:
Which one makes your pee-pee not work so good?
Click to expand...

o.k. I have to admit that made me laugh.

Buproprion has been shown to improve sexual function in some studies.
 
So it seems like everyone is on drugs, Right?
 
cfdavid said:
Interesting. We did not study the SSRI's in nearly this detail.
Click to expand...

That's because most of it isn't very clinically relevant (I'm in grad school). Neurogenesis is so rare in the brain and so poorly understood that it doesn't have a lot of clinical use yet. BDNF presents a lot of technical barriers that are just now being overcome (mainly developing the virus for gene transfer and how wildly different it changes behavior based on location), look for questions on BDNF & antidepressant treatments to be answered in the next 3-4 years (IMO).

cfdavid said:
However, we DID learn that they've been shown to downregulate B-adrenergic receptors, thus contributing to their antianxiety but also potentially the weight gain effects.

Did anyone else learn the B-receptor downregulation concept??
Click to expand...

I didn't hear this, very intrigued. Anyone care to post some references? It's past midnight and therefore too late for me to get too far off on this tangent. :)
 
arsenewenger said:
So it seems like everyone is on drugs, Right?
Click to expand...

Biggest risk factor for developing depression is "stressful life events" (don't get me started on what that may or may not mean) - it's a good thing med school doesn't involve much stress. :)
 
Maxprime said:
As for memory issues, I'm not aware of any SSRI that have been shown to spare memory more than another.
Click to expand...

so are you saying that all SSRIs would negatively affect memory?:eek::(
 
Horowitz said:
so are you saying that all SSRIs would negatively affect memory?:eek::(
Click to expand...

If I say yes, it's a safe assumption that you would develop memory issues. :)

It's been reported in the literature as a side effect, although I don't recall (hardy har) it being on the list of chief reasons for discontinuing treatment. I remember reading it in a review article from the late 90's from someone @ Harvard. For a lot of people, treating their depression does a lot better things for their working memory than anything the drugs could do to impair it - the hippocampus is chocked full of glucocorticoid receptors.
 
Maxprime said:
SSRI > 2ndary TCAs > Primary TCAs :(
Click to expand...

I don't think there's a primary TCA. I think you meant tertiary TCAs > secondary TCAs.

nefazodone, mirtazepine, Bupropion ("No More Bad Sex") have the least sexual side effects
 
H_Caulfield said:
Wait, wait...you guys are serious? I can't believe so many med students are on that crap. No, I don't think you guys will find one that doesn't fill you with slothfulness and indifference. Note that it just makes you shallow, being on it; your capacity for both grief AND happiness is diminished. I'm pretty black and white and emotional, and that's a hell of a lot better than a whole lot of gray.

Sorry this is so insensitive, but to the original poster: suck it up. You'll be smarter (less foggy, tired, and drugged up), and you won't miss out on those highs that come along once in a while.
Click to expand...
That sounds an awful lot like the criteria for borderline personality disorder (splitting and emotionally labile). And if you are wondering what the treatment for it is, please refer to this thread http://forums.studentdoctor.net/showthread.php?t=347789
 
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