A DECADE OF FOG

A DECADE OF FOG

As I said in my last blog, I have just recently recovered from a decade in a fog. And I feel great!

Contrast this to a decade ago when I was a prescribed a serious overdose of antidepressants – more than enough to knock out even a depressed elephant. 60 mgs of Prozac and 150 mgs of trazadone  – all of this for a reasonably slender woman. The studies show that 20 mgs of Prozac treats most people with major depressive disorder. http://www.rxlist.com/prozac-drug/indications-dosage.htm.

The prescription was written to treat depression which could cause difficulty concentrating, and memory problems. It was believed that my cognitive problems could be caused by depression rather than CNS lupus. I never had symptoms of crying, loss of enjoyment of favourite activities, or sadness.  However, I was started on a cocktail of drugs that sent me into a downward spiral.  But then things got too complicated to be able to distinguish what was causing which symptoms.

 I had other difficulties like trouble speaking, clumsiness, confusion, fatigue, headaches, pain and sleeping 12 hours a day. And the numerous brain lesions showing on numerous MRIs proved that there was an inflammatory reaction going on within my brain. Thus it was not just depression that was causing the cognitive difficulties.

Over the last decade I slowly cut back on the antidepressants and my cognitive functioning started to improve. At the same time, I took chemotherapy drugs which stopped the development of new lesions on my brain. The drugs taken to combat my overactive immune system were credited with my improving health or, at least, no further deterioration.

But then my brain started to go on another downward trajectory last September. This happened when I replaced one antidepressants medication with another.  I started to take another anti-depressant called wellbutrin. It was billed as causing fewer sexual side effects and I had finally clued into ones sex life does not go on forever so I should pay more attention to it. Once again I was given too high a dose of antidepressants. I was prescribed three 100 mg of the slow release Wellbutrin to take once a day. According to all the published sources this exceeded the maximum dose at one time. Even 300 mgs spread out throughout the day was a dose that sets off a warning for US pharmacists.

As the fall progressed, I got worse. My short term memory was getting dangerously impaired. I could not keep track of who was serving in a tennis game, not to mention the score. When I could not recognize the host of a neighbourhood party a week later, I thought a room on the Alzheimer floor at the local care facility would soon be my new home. I fared very poorly playing brain games with my young nephew. But it was the neuropsychiatric assessment which proved my brain capacity was sliding when I performed worse than the previous test a few years before. 

At this point, my rheumatologist was evaluating whether to place me on a new drug to treat the worsening CNS lupus symptoms. Thankfully, he was being cautious since the new biologic drug, he had in mind, could be fatal. And he needed to line up the proof that I was still not better despite having taken cyclophosphamide, Imuran and methotrexate. He needed to complete paperwork to justify to the Medical Services Plan why I needed to receive this very expensive drug.

You probably have heard about the new biologic drugs available to treat people with autoimmune diseases.  You may have seen the television advertisements that list a zillion side effects and you conclude that someone must be desperate to even consider taking such a drug. Well, yes I was at this point. It seemed like it was either a new drug or soon I would be checking into my new home – one of the locked units for the demented patients at a care facility.

In November, my rheumatologist was waiting to hear from my neurologist. And my neurologist was waiting to hear from the psychiatrist who I had asked to see. However, this neurologist/psychiatrist specialist in CNS lupus was not accepting new patients. It then fell onto my family physician to make a referral to another psychiatrist. She said that it would take more than 6 months before I could get a referral.

Then the precipitating event happened. To find out more read the next blog – The Wakeup Call.