Meds for Cognitive Symptoms?

[jadeglee]

I have severe cognitive symptoms of confusion and disorientation almost everyday. Are there any meds that might help? Do you think Provigil would help?

[MSW1963]

Typically the same meds used to treat Alzheimer's Disease are used to treat MS cognitive problems. I've tried Aricept, Exelon and another I don't remember, lol. I either didn't improve or was intolerent to the side effects.

In my first few years of MS, I theroized that treating fatigue might improve cognition, and for me the stimulants do seem to help.

With stimulants, I can initiate activity better, but I'm just as cognitivly impaired, at a faster pace, and not always with the best results.

I continue to try most of these meds again over the years, hoping that as my MS evolves, my tolerence changes, and willing to try new treatments options that are developed.

[emily06]

What stimulants do you use?

[MSW1963]

I've tried Provigil, Time Released Ritalin, regular Ritalin, and one or two other meds, names that I don't remember. I don't tolerate stimulants in general.

One of the very first stimulants was rx at a full high dose that resulted in visual hallucations and worsened insomnia. After researching the med, I discovered it was one of the 'old' CNS stimulants, no longer recommended, with high rate of hepatic failure associated with it. I'm trying to remember the med name, I'll post it later when I remember.

I'm currently using 1/4 dose of .5mgs of Ritalin, as needed during the day. Between 1/4 dose of Ritalin, and generic Xanax, at .5mgs 2-3x's daily I manage to get through the day, more productive some days than others.

I've tried dosing Xanax before Ritalin, but dosing Ritalin first seems to work better for me. If I use Xanax before Ritalin, I'm not able to overcome the 'slow down' that accompanies Xanax.

My dosing and med effects sometimes remind me of a three ring circus, consisting of a juggling act and jumping through burning hoops, while walking a tightrope.

[its2much]

My neuro has also

recommended cognitive therapy. I haven't scheduled it yet due to the cost.

[mjan]

Sorry for what you are going through. I know it can be disconcerting for sure.

What has helped me early on was oral steroids not IV.
Then having a gentle detox with supplements. I did the 21 day detox recommended by a doctor on Dr Oz show. I bet if you search for his show he'll have a link to it.

Gentle detoxes help reduce the inflammation on the brain which in turn offers you more energy, including mental clarity. Now it is not a fix or cure, but helps, or it did me.
Beats more meds which in turn can add to inflammation via overtaxed liver/kidneys.

Hope that helps.. some.

Warmly, Jan

[MSW1963]

mjan, the oral steriods protocol you describe is so interisting, particularly since your fatigue? cognition? both? improved.

I've avoided steriods in general because of a severe degenerative and progressive bone disease dx'ed in a 1st degree relative after 2-3wks of very short term oral steroid use. It's considered a very rare reaction, unlike the degenerative bone conditions seen with long term steriod use that's typical with MS. Watching a loved one spend a life time dealing with bone replacement surgeries left me a bit weary.

I've always had curiosity about general improvements I might experience. Now with both fatigue and cognitive problems, I'm reconsidering steriods. My doc is not an advocate of steroid use at all, so wish me luck with that.

Congrats to you and thanks for posting the info.

[mjan]

Well that was years ago I was given oral steroids before even being diagnosed, but suspected MS. I wouldn't do that now.

I do gentle detox like that 21 day one from Dr Oz show. But eliminating process foods/chemicals helps a lot. INFLAMMATION is the enemy.

Jan

[Ikaika]

Great posts, thank you- glad I looked in here.

I agree, INFLAMMATION is the $&@#. I eat an anti inflammatory diet best I can. Isn't a cure and sometimes I don't even tell, but it definitely makes a difference and no way am I going to veer away from a healthy diet, we've got such a small margin for error with this disease. We are what we eat, and think.

About the meds for cognitive, which is when clicked here originally... I have tried both Provigil and amantadine and neither had any effect. I just tried Nuvigil this week at 250mg.

Ummmm, with the 250 am dose, I was up for two days and could barely sleep with Ambien even. I obviously cut back on the dosage and am at 35mg, with clarity but still disrupted sleep. And headaches.

The Nuvigil definitely provides cognitive clarity, and almost immed, it's great. It has also seemed to diffuse many of my other daily symptoms.

Coincidence or correlation between reducing inflammation of the brain, I don't know. But I can tell a difference, almost as well as I can with IV solu medrol. Not quite the same more as powerful, but very noticeable difference in clarity and function!

(My body responds very well to solu medrol, I call the wonder drug- and have used for acute flare us as well as chronic maintenance. It's just used only as highly needed, it's too strong to mess around with!) that's a whole different post.

I respond well to stimulants, but they are way too strong for my body, even the smallest dose. And caffeine- yikes I'd be up for days too. Yet I have severe fatigue and cognitive challenges. Go figure

Anyway, my neuro also suggested I try adderall or Ritalin as options if the Nuvigil isn't the right fit.

Do you have more feedback on Ritalin? And/or anything about adderall?

Blessings to all! Keep calm and give thanks
Thank you very much!

[mjan]

Unless you are desperately unfocused and lack energy, I would not fool around with any of these stimulants if it were me. And they can reach a tolerance level and have potential for accidental addiction. Of course that is if you are on it long periods or take more than recommended.

But I don't like amphetamines and neither does MY body. But that's ME! Like you I remain UP UP UP and remain so its not funny.

Now there are a couple of supplements you can try, which I did. It really helped ME and didn't interfere with any other meds I was taking. One is Acetyl L-Carnitine along with Alpha Lipoic Acid. Your neuro may or may not even know about them.

You can look more into these supplements in Tara's Nutrition & Supplement section on here. Its not on first page though. Also look up Shasha as she also promotes these and it worked for her (and me).

Again, steroids helped clear my brain so to speak, but meds, or any other chemicals I ingest tends to cause inflammation along with the disease process. After a gentle cleanse, good supplements and a better diet I do very well cognitively.

Not sure if this will work for YOU, but its just my FYI.

Good luck in your search,

Warmly, Jan

I have a serious sensitivity to RX and interactions with them.

[Ikaika]

Oh Mjan,
Thank you!!

You and our body sound much like mine. Less is more for me with unnatural substances.

That's why this disease management has been a challenge. Trying to find the right balance.

I take some vitamins and supplements and Nordic naturals ultimate omega, which has a good combo of EHA and DHA, helps my cog fog. When I'm energized enough to take them...ugh.

The two you mentioned, Acetyl L-Carnitine along with Alpha Lipoic Acid, I have been meaning to try!! I learned that here exactly from the posts you mentioned.

I am going to look them up right now and order. My good hearted Mom has been egging me on too- mom recommended, can't be bad for you

Seriously, y are right,this may very well be what my body responds best to. Natural ways to improve health. I have been health conscious most of my life, and my career centered around it too. Now I am not working in that manner. I believe. And getting there is half the..fun?

Thank you!! You are the answer I prayed for. I will post back after I try the Acetyl L-Carnitine along with Alpha Lipoic Acid.

Blessings

[Ikaika]

PS Mjan,

I just noticed your signature- I believe in miracles too!!

Blessings for your continued health and tenfold for sharing your experience here. These boards are a lifeline undoubtedly.

[candycane]

I take strattera, an ADD medicine. I think it's helpful.

[bobus498]

Have you tried to get a second opinion on the wisdom of mixing an amphetamine-Ritalin with a benzodiazipine-Xanax for cognitive issues?

[Ikaika]

Does anyone get headaches from the cog meds?

I find Nuvigil works wonders however, I get terrible headaches and even with only 25mg (super low dose) taken early in the am, I have insomnia- even taking an Ambien for sleep.

Amantadine and Provigil do nothing for me- does anyone have one that doesn't give headaches or insomnia?

I know we are all different, just thought I'd ask further...

Blessings!