Posted by bob (NOT Dr.) on March 6, 2000, at 19:04:17
In reply to Re: Dr Bob, posted by Sigolene on March 6, 2000, at 5:19:25
> Dr Bob,
Alright Dr. B ... seems this here board ain't big enough for the two of us ... draw! ;^)
Dr. Bob always signs his posts with the "Dr." firmly attached. This here Bob almost always signs his name "bob", 85% because I'm often too lazy to hit the shift key and 45% because I have no self-esteem and 30% because I really want to be e.e. cummings.
> I'm now trying to catch up the time lost (do we say like that ?)by studying psychology at University.
You could say "I'm trying to make up for the time lost" or "I'm trying to catch up for lost time" ... in this context, I think most people would use the first.> I've got one question for you, you say you take Nortriptyline. One told me that anticholinergic meds like this one, can cause memory impairments. Did you notice something ? Do you think I could take such med. if I have to study and learn ?
The short answer is "not necessarily ... you need to try it for yourself and, even then, there may be measures you can take to compensate."
The long answer is...
"Can cause" does not equal "will cause".
Your mileage may vary, but I've had next to no side effects from nortrip ... so I'm not necessarily the best person to bounce this off of. On the other hand, all my graduate work was in the psychology of learning, so...
Memory isn't the only thing that influences whether you learn or how well you learn. Your short term or long term memory could be unaffected by a med, but a lack of focus or concentration could interfere all the same. Similarly, a med might influence your motivation -- your interest, your sense of curiousity or challenge -- and that would hamper your ability to learn.
Six months ago, I was taking 75mg/d of nortrip, 200mg/d zoloft, and 1mg/d of klonopin ... then I dropped the zoloft since it just didn't seem to be working for me. After just a week or two of tapering down from that 200mg, I started noticing my focus clearing up as if my sinuses were clearing. It helped me be much more productive in my work.
After trying wellbutrin in combination with the nortrip/klonopin and dropping that (wellbutrin makes me mean and nasty ... something no New Yorker ever needs help being ;^), my pdoc and I had the novel idea of just trying nortrip as my sole AD med, and boosted me up to 150mg/d. It fogged me in again, but nowhere near as bad as I was before dropping zoloft.
The funny thing about zoloft & me is that I had a completely different reaction to it the first time I took it. When I wasn't manic, I was still very focused, confident, and assertive -- all characteristics that help in learning.
Last anecdote -- I've been on ritalin (20mg/d) now for about a week, and my focus and energy is better than it was before I doubled my dose of nortrip. Cognitively, I'm functioning as well as I ever have, I believe. All the same, I wouldn't have described where I was two weeks ago as being impaired cognitively in any way back then ... I seemed fine to me.
I guess my advice is that lots of things can affect your ability to learn. Certainly, being depressed can have a large negative effect -- particularly when it comes to volitional or motivational aspects of learning, but also for purely cognitive aspects as well.
If you're thinking of making some change (and this is true in general, not just for monitoring your learning ability), then you need to keep a journal. Don't just keep track of how you feel, keep track of your productivity. How much are you able to read in a week? Are you keeping up with your coursework? How much are you getting from it? Whatever measures you think are appropriate. You need to do this prior to any change, so you can establish a baseline for comparison. If you want to take it one step further and be proactive about this, every Sunday set yourself some goals for the week as well, so you set yourself a target for performance based upon where you're at.
THEN, you need to make sure you (a) keep recording regularly in that journal and (b) make sure you *do* compare across several weeks. You need to keep in mind that any change in meds is probably going to create some short term problems or fluctuations in how you feel. The hardest thing will probably be keeping the same "yardstick" (or "meterstick") for measuring your progress -- I keep finding that my own ability to assess where I am and how much I can do fluctuates with my meds and how I feel.
Finally, you need to judge any change in your learning with the change in how you feel. If you do wind up with some drop in your learning performance while gaining much more in terms of an improvement in your mood, there are ways of addressing the learning problems. In my own case, ritalin is giving me a nice boost right now, but you don't have to rely on another med to fix a new problem. There are a variety of strategies you could use to address behaviorally any drop in performance -- most of which deal with taking abstract tasks and making them more concrete and multimodal (words + pictures, reading + writing, going beyond reading and highlighting text to outlining and designing self-tests).
Another way to think of it: many modern approaches to "learning disabilities" focus on learner/environment fit instead of looking to remediate some deficit inherent in the learner. The latter stance says there is something wrong with the learner and, if at all possible, this deficit needs to be "filled" or corrected. The former focuses on how to optimize the learning environment to meet the learner's needs. That's the frame of mind you need to keep -- that you may need to make changes to how you approach learning if you start having problems on a new med.
cheers,
bob
poster:bob (NOT Dr.)
thread:26021
URL: http://www.dr-bob.org/babble/20000302/msgs/26157.html