...to think that antidepressants can really mess up your concentration?

[KoalaDownUnder]

This is really getting me down.

Taking 30 mg of escitalopram (Lexapro) a day. I just cannot focus. Feel like my head is stuffed with cotton wool.

My GP has been tweaking the dosage for months now. Her 'solution' is that I need to persist with it.

Am I imagining things, or has this stuff lowered my IQ (or at least my mental processing speed) by a few points?!

Anybody else?

I have been on citalopram 20mg for five years now. I don't feel that it messes up my concentration, tbh, but maybe that's just me. Could it be your underlying depression causing the problem?

Koals do you know why gp is so wedded to this particular drug? There are loads of them and each one is slightly different and more useful for some issues than others. Any chance of being referred to a psychiatrist?

A lot of gps just don't know enough about the individual drugs to really be effective at treating people. Maybe your gp is great at it, but so many are not. I suspect they see one good response and think 'Oh great, this drug will do wonderful things for everyone' but it doesn't work that way.

user, I'm not sure. I completely agree with you, but this GP specialises in mental health and women's issues.

I have tried many, many different types of anti-depressants over the past 20 years. I always end up increasing the dosage, then ending up with shit side effects, then being switched to something else. Then the cycle starts again.

I can get a referral to a psychiatrist, but they are horrendously expensive here (Aus) and I'm a bit stretched at the moment.

I just don't understand why she thinks this brain-fog thing is all in my head.

Is there any way you could see a different GP Koala? It sounds like your GP is persevering for too long with an AD that's not working for you. I had to change 3 times before I found the one that was right for me and my GP seemed to see 2 months or so as the cut off point if I wasn't feeling some improvement or was struggling with side effects and would prescribe something else at that point.

What's your surgery like, lots of doctors or just one or two? Some of the bigger ones sometimes have a doctor who specialises in MH so you could ask about that if it's a big practice, or is there another one in your area you could switch to?

Don't just put up with it though OP, the AD's are supposed to help you function not make it harder

Sorry OP massive cross post. I honestly don't know what to advise in that case. Only thing that occurs to me is whether any of the older style AD's have been tried? Some GP's seem reluctant to prescribe them these days but I just wonder whether something that works in a different way to modern AD's could be the answer?

How old are you? Brain fog and problems with concentration can be caused by other issues, particularly as we get older. Perhaps investigate that?

I'm 43. Hopefuy not getting Alzheimer's yet!

Hopefully.

Maybe I am.

Possibly. I was one of the people given seroxat many years about and that triggered suicide attempts. My gp didn't believe me either.

But, if you're 43 peri-menopause could well be causing brain fog?

Koala do you know if you've been tested for underactive thyroid or anaemia? Also can give you brain fog.

Glad to hear you're seeing someone who has experience in this area.

If you've tried other meds you know what it feels like to get some side effects which clear after a while, so if you feel like this doesn't suit you and the side effects are getting in the way after months of adjusting your dose then fair enough. Does the gp suggest being extra-patient with this one because she has seen other people take more time to respond than usual? If the answer is no then I feel like she should listen when you say this doesn't seem like the right fit.

Like you I tried lots (over a dozen) ADs. The only one which ever helped me was fluoxetine, and it always stopped working after about 18mos. Treatment-resistant depression is hard to live with.

Would your doctor consider some more innovative treatments like liothyronine or as Hiding says older ADs (MAOIs or tricyclics)?

Thanks guys.

Yes, I have been tested for thyroid and anaemia and just about everything else under the sun; all normal.

I think I'm just going to tell her that this drug doesn't work for me. And maybe such up the expense and get a psychiatrist referral.

They can do... Different anti-depressants act on different brain chemicals. If concentration is a problem on SSRIs (which boost level of serotonin) it might be worth trying an anti-depressant that acts on norepinephrine and dopamine levels as well/ instead: these can be more energising, and some (like bupropion) are even used (either alone or more usually in combination with stimulants) to treat ADHD, so should (if they work for you) actually improve concentration levels as well as depression. But there is a degree of trial and error and people respond individually to different drugs.

I would probably give up on Lexapro, if I were your GP, and try a different type of antidepressant (preferably bupropion/ Wellbutrin, but if too expensive then one of the older tricyclics).

Koala, I wasn't hinting at Alzheimers, but I was wondering about pre-menopausal symptoms. The effects on the brain can start well before periods stop. I don't know if they can test for this, though. Estrogen levels?

Citalopram did that to me OP, switched to sertraline then fluoxetine and doing loads better on that.

Same here with citolopram. They helped me with my depression but made me quite foggy and forgetful. I missed birthdays, appointments etc and was aware I wasn't as sharp at work. It was worth it in my case but perhaps another drug might be worth a try.