Please help Diagnose:
30 year old female, caucasian. She is 6 foot tall and 190 pounds. She has gained 35 pounds in the last year while eating a vegetarian diet with no dairy or fried foods. Current medications include 300mg Gabapentin 3 times a day, 60mg Cymbalta once daily, 60mg of propranolol once daily, 75mg levothyroxine once daily, 1mg of estradiol daily, 100mg progesterone once daily, 30mg pamelor once daily, and 2000iu of vitamin D twice daily. She has been previously diagnosed with raynauds disease, chronic migraines, premature ovarian failure, osteopenia, anti-tpo antibodies or Hashimoto’s disease, Tachycardia, POTS, Vitamin D deficiency, Dyslipidemia, and a pituitary abnormality. As a child, her period failed to begin, and she was started on HRT. Her karyotype is normal, and so is her anatomy, tho ovaries and uterus did not grow to full size until 2017. She has a concussion history with a visual convergence insufficiency and vertical misalignment. This however is historic, with the last concussion occurring around 5 years ago.
She is currently experiencing extreme exhaustion, insomnia, wide spread pain, dizziness, light headedness, blood pooling in the legs, limb numbness, twitching, shocking jolts, brain fog, aphasia, dexterity issues, memory issues, weakness, bruising, frequent falls and incontinence.
Social history: this patient is a non-smoker, non-drinker, no drugs use ever, and is active whenever her symptoms allow.
Most recent tests reveal: A MRI of the pituitary gland which measures 1.1 x 1.0 x 1.4 cm- no lesion found TSH is 1.35 T4 is 1.4 Prolactin is 11.3 LH is 56.7 FSH is 112.7 Vitamin D is 33 Sodium is 139 Potassium is 4.4 Chloride is 105 Carbon Dioxide is 25 Glucose is 98 Urea Nitrogen is 10 Creatinine is 0.78 Total protein is 7.8 Albumin is 4.5 Total Bilirubin is 0.3 Alkaline Phosphate is 75 Aspartate Aminot is 22 Calcium is 9.6 Alanine Aminotrans is 22 eGFR is 105 Cholesterol is 220 Triglyceride is 228 High Density Lipoprotein is 66 Low Density Lipoprotein is 119 MRI os the c spine reveals minimal multilevel spondylosis but is otherwise normal. IGA of 176 Estradiol of 51 X ray of the sacroiliac joints reveal mild osteoarthritis of the bilateral sacroiliac joints and osteopenia bones. CRP is normal. ESR is normal C3 is 153 C4 is 30 RA factor is normal SSA is 0.2 SSB is 0.2 Iron is 98 Ferritin is 156 ANA is negative Heavy metal tests is normal

This patient is currently involved with neuro, neuro surgery, three endocrinologist, neuro optometry, rheumatology, cardiology, and of course her PCP. None have diagnoses to explain her worsening condition.

7 years ago I went to Neurology with what I now believe to be Occipital Neuralgia.
They did an MRI as I was having ‘headaches’ but because they found inflammation, did a lumbar puncture and found I had MS, which was a distraction from these headaches which have always been my main issue. It’s been getting worse to the point where I’ve quit my career. I’ve also now been given a diagnosis of temporal lobe epilepsy (focal aware seizures and ?myoclonic seizures) with migraine, but I’m convinced my migraine, and perhaps even the epilepsy, has been occipital neuralgia all along.
It’s all triggered by neck movement, car journeys, impact sport, even lying down at the wrong angle, the pillow feels solid like a brick. Feels like I’m wearing a swimming cap, pain/ numbness in my mouth, nose, behind my eyes. Random shooting pains, neck cramps and clicks, can’t even chew my food without it triggering an attack. Numbness in patches, hot/cold feelings, feeling of vibration and spreading wave sensation through my head and shock feelings.
It’s been like this pretty much daily for the past 7 years and I’m getting a bit fed up but optimistic to have found this page!
The only medication that touches it epilepsy wise is Diazepam or Clobazam and maybe Keppra. Topamax is doing nothing.
Nerve block sounds scary but I’ll definitely be trying it if my Neurologist says I can. What have people’s experiences been?
Have any other medications helped? Thinking of trying Nortriptyline (Pamelor in the US I think)

Anyone else feeling like you are running out of options for migraine treatment through the VA? Nothing we are using is working: Botox, Aimovig, sumatriptan, alpha Stim, cephaly, Advil, tylenol, ice, heat, dark blue glasses, eye masks, laying down.
Other meds I've tried: all the triptans, Topamax, Ajovy, Xeomin,SSRI's, SNRI's, pamelor, midrin, meds I can't even remember their name. The list seems endless. I just got told they are cutting my sumatriptan back to 18/90 days (6 per month) from 27/90 days (9 per month). They keep wanting to "wait and see if the injections work." I've been on Aimovig for MONTHS. I've been on Botox for YEARS. How much friggin longer are they going to drag this out? I'm seen by the VA "headache center of excellence" which, I'm sorry - that's a complete joke. I had high hopes of them wanting to do testing to find out the cause (pretty sure it stems from my neck). But no. So far, it's been randomly throwing meds at it. I'm frustrated. I'm feeling ignored. I keep a migraine diary daily. Here's the abbreviated look at my migraine diary: "If I have a headache free day, I'm pretty sure there's something wrong." Does anyone else resonate with that? I never understood suicide. But I do now. I'd never turn to that because it would destroy my family. But I'm starting to get it.
Anyway, needed to vent. Maybe someone has info I haven't been given.
And don't get me started on the disability rating for migraines. They are so bad, I was awarded SSDI at a young age. But VA disability determined I only have "one headache day per month" (I sit at 30% for migraines), I guess they left out that all too important word in that sentence, "I might have 1 headache FREE day per month." I'm awaiting the appeal. I'm about 90 days in and nothing so far.

Note: Title is slightly incorrect because I have not taken the nasal spray Zavegepant (Zavzpret) as it is not available where I live.
Info: I am 22 years old, female, with sporadic hemiplegic migraines. I started having migraines in 2017 and went through many, many tests, treatments, and medications before I was officially diagnosed with hemiplegic migraines in 2020. I have had very regular and normal MRIs, EKGs, EEGs, and other medical exams. I have also had two known concussions (2018 and 2022) with significant post-concussive syndrome symptoms. As a baseline, I usually have ~22-25 migraine days a month without any medication or treatments. My migraines are extremely treatment resistant. Hemiplegic migraines have many contraindicated medications. At the moment, the most effective treatment option are CGRP-inhibitors.
Disclaimer: This is my personal experience and opinion for each medication. Always consult with your doctor on treatment plans for you, and follow all instructions, dosage, and warnings on any medication.

Galcanezumab (Emgality)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: A-

Emgality was the first medication I tried after being diagnosed. I received two loading doses by my primary care physician. (I did faint while leaving the doctor's office, and often fainted when getting the auto-injector vials. For all auto-injectors or syringes, I recommend taking them out of the fridge 30 minutes prior to injection so it can warm to room temperature. This reduces the pain and injection-site inflammation. Note: Do not let any medication warm up and then put it back in the fridge; This reduces its effectiveness.) I used the syringe, and injected on my thighs and stomach. I noticed I had less inflammation and pain injecting in my stomach as it has more fat than my thighs. Emgality worked miracles immediately. The first month I had zero migraines. This continued for the first year or so. I began having migraines again a few months into year two. This is a common issue (:25% for Emgality) as patients can develop immunity. In 2022, I ended up back on Emgality and it began working again, with only 5 migraine days a month. I switched off in 2023 as it did not effectively handle my neuropathy and dysesthesia symptoms and my neurologist wanted to pursue alternative medication regimes.
Erenumab (Aimovig)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: C

I saw a reduction of migraine days with only about ~10-15 a month. I did not like the auto-injector, but it was my only option, which was frustrating as auto-injectors are more painful and aggravating. I took this in late 2022 through early 2023, and I alternated months with Emgality. The months using Aimovig had longer, more frequent migraines.
Fremanezumab (Ajovy)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: D

I tried Ajovy after Emgality, and I only saw very mild improvements of ~15-20 migraine days a month. I also had worse site-injection reactions than Emgality or Aimovig, so I switched.
Eptinezumab (Vyepti)

Preventative migraine treatment
Dosage: 1 infusion every 3 months
Administered in clinic by IV infusion
Grade: F

Vyepti is the current medication I am on. I switched from Aimovig I have been on it for a month, and thus far have had some of my worst migraines ever. Given that it has been a month exactly since my infusion, I do not have any hopes of improvement. I am incredibly sensitve to triggers I was rarely bothered by before,. While there may be other causes, the fact I am having near constant migraines this month despite ideal sleep, food, and life regimen seems to point to Vyepti being very ineffective on me.
Atogepant (Qulipta)

Preventative migraine treatment
Dosage: 1 pill daily
Administered orally
Grade: F

I tried Qulipta in mid 2022. It had all the effectiveness of sugar pills. The draw was that it is a once-daily pill that does not need to be administered at a specific time to be effective, and it would work almost immediately after administering. I took my pills at 8 am. Regardless, it did nothing. I felt like I was unmedicated with 24 migraines the first month I took it. My neurologist actually had me try Qulipta in tandem with Ajovy and neither could break the migraine cycle. As I didn't like daily pills due to forgetfulness, I switched in less than three months.
Ubrogepant (Ubrelvy)

Oral abortive migraine treatment
Dosage: 100 mg as needed
Administered orally at start of migraine
Grade: B

Ubrelvy was the first abortive I tried. I would take a pill at the beginning of the aura or when migraine pain began. It was far more effective taken at the aura, as by the time migraine pain began, it was too late. I enjoyed Ubrelvy because you can safely take two pills if the abortive doesn't work the first time. [Note: You should not take a second dose within 2 hours of the first dose. The maximum dose in a 24-hour period is 200 mg. The safety of treating more than 8 migraines in a 30-day period has not been established.] However, because I was not getting consistent results in aborting migraines, my doctor switched me to Nurtec.
Rimegepant (Nurtec)

Oral abortive migraine treatment
Dosage: 75 mg as needed per 48 hours
Administered orally at start of migraine
Grade: C

Nurtec was the second abortive I tried. The taste is great as the tablet dissolves. I found that taking Nurtec at the start of my migraine pain would relieve the pain for 30 minutes, and then the migraine would return. The safe dosage is 75 mg taken orally, as needed. The maximum dose in a 24-hour period is 75 mg. The safety of using more than 18 doses in a 30-day period has not been established. As such, you cannot mix abortives or double-up, so to speak. When the migraine returned, I had to wait 48 hours to attempt to kill it again, which was frustrating.

Other medications tried:
Butalbital, acetaminophen, and caffeine

Grade: A+
Only medicine that worked to help me break the migraine cycle after getting a concussion. I highly recommend this drug combo if you do not have addictive tendencies and have medication-resistant migraines.

Triptans, including Rizatriptan (Maxalt, Maxalt-MLT), Sumatriptan (Imitrex), Sumatriptan and Naproxen (Treximet) and Zolmitriptan (Zomig)

Grade: F
I used these from mid 2017 until late 2018. They did not reduce my migraines. I was on triptans and anti-depressants at the same time and the combination exacerbated the side effects of each. Note: These drugs are contraindicated for hemiplegic migraines due to stroke risk.

Antidepressants, including Fluoxetine (Prozac, Sarafem), Imipramine (Tofranil), Nortriptyline (Aventyl, Pamelor), and Sertraline (Zoloft)

Grade: F
I took these in conjunction with the aforementioned triptans. I had side effects such as insomnia, mood swings, and extreme suicidal ideation. I stopped medication for the sake of my safety and quality of life.

Midrin (isometheptene mucate, dichloralphenazone and acetaminophen)

Grade: B-
Only effective sometimes. I also had severe dizziness when I recently tried it.

Anticonvulsants, including Gabapentin and Topiramate (Topamax)

Grade: D for 300 mg Gabapentin and Topamax, B for 100 mg Gabapentin
In 2022, I took Gabapentin at 300 mg for migraine-related neuropathy and it made me hyper, unable to sleep, shaky, aggravated my dysesthesia, and gave me feelings of doom. My neurologist prescribed me 100 mg to take before bed to induce sleep and reduce nerve pain. It is effective in preventing neuropathy, but doesn't fully treat dysesthesia. I also have to take 5 mg melatonin with the Gabapentin to actually sleep.

Beta-blockers, including Metoprolol (Toprol XL) and Propranolol (Inderal)

Grade: B-
I tried it in 2021 and I didn't really see a major improvement or effect.

Note: Title is slightly incorrect because I have not taken the nasal spray Zavegepant (Zavzpret) as it is not available where I live.
Info: I am 22 years old, female, with sporadic hemiplegic migraines. I started having migraines in 2017 and went through many, many tests, treatments, and medications before I was officially diagnosed with hemiplegic migraines in 2020. I have had very regular and normal MRIs, EKGs, EEGs, and other medical exams. I have also had two known concussions (2018 and 2022) with significant post-concussive syndrome symptoms. As a baseline, I usually have ~22-25 migraine days a month without any medication or treatments. My migraines are extremely treatment resistant. Hemiplegic migraines have many contraindicated medications. At the moment, the most effective treatment option are CGRP-inhibitors.
Disclaimer: This is my personal experience and opinion for each medication. Always consult with your doctor on treatment plans for you, and follow all instructions, dosage, and warnings on any medication.

Galcanezumab (Emgality)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: A-

Emgality was the first medication I tried after being diagnosed with hemiplegic migraines. I received two loading doses by my primary care physician. (I did faint while leaving the doctor's office, and often fainted when getting the auto-injector vials. For all auto-injectors or syringes, I recommend taking them out of the fridge 30 minutes prior to injection so it can warm to room temperature. This reduces the pain and injection-site inflammation. Note: Do not let any medication warm up and then put it back in the fridge; This reduces its effectiveness.) I used the syringe, and injected on my thighs and stomach. I noticed I had less inflammation and pain injecting in my stomach as it has more fat than my thighs. Emgality worked miracles immediately. The first month I had zero migraines. This continued for the first year or so. I began having migraines again a few months into year two. This is a common issue (:25% for Emgality) as patients can develop immunity. In 2022, I ended up back on Emgality and it began working again, with only 5 migraine days a month. I switched off in 2023 as it did not effectively handle my neuropathy and dysesthesia symptoms and my neurologist wanted to pursue alternative medication regimes.

Erenumab (Aimovig)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: C

I saw a reduction of migraine days with only about ~10-15 a month. I did not like the auto-injector, but it was my only option, which was frustrating as auto-injectors are more painful and aggravating. I took this in late 2022 through early 2023, and I alternated months with Emgality. The months using Aimovig had longer, more frequent migraines.

Fremanezumab (Ajovy)

Preventative migraine treatment
Dosage: 1 vial per month
Self-administered by auto-injector or syringe
Grade: D

I tried Ajovy after Emgality, and I only saw very mild improvements of ~15-20 migraine days a month. I also had worse site-injection reactions than Emgality or Aimovig, so I switched.

Eptinezumab (Vyepti)

Preventative migraine treatment
Dosage: 1 infusion every 3 months
Administered in clinic by IV infusion
Grade: F

Vyepti is the current medication I am on. I switched from Aimovig I have been on it for a month, and thus far have had some of my worst migraines ever. Given that it has been a month exactly since my infusion, I do not have any hopes of improvement. I am incredibly sensitve to triggers I was rarely bothered by before,. While there may be other causes, the fact I am having near constant migraines this month despite ideal sleep, food, and life regimen seems to point to Vyepti being very ineffective on me.
Atogepant (Qulipta)

Preventative migraine treatment
Dosage: 1 pill daily
Administered orally
Grade: F

I tried Qulipta in mid 2022. It had all the effectiveness of sugar pills. The draw was that it is a once-daily pill that does not need to be administered at a specific time to be effective, and it would work almost immediately after administering. I took my pills at 8 am. Regardless, it did nothing. I felt like I was unmedicated with 24 migraines the first month I took it. My neurologist actually had me try Qulipta in tandem with Ajovy and neither could break the migraine cycle. As I didn't like daily pills due to forgetfulness, I switched in less than three months.

Ubrogepant (Ubrelvy)

Oral abortive migraine treatment
Dosage: 100 mg as needed
Administered orally at start of migraine
Grade: B

Ubrelvy was the first abortive I tried. I would take a pill at the beginning of the aura or when migraine pain began. It was far more effective taken at the aura, as by the time migraine pain began, it was too late. I enjoyed Ubrelvy because you can safely take two pills if the abortive doesn't work the first time. [Note: You should not take a second dose within 2 hours of the first dose. The maximum dose in a 24-hour period is 200 mg. The safety of treating more than 8 migraines in a 30-day period has not been established.] However, because I was not getting consistent results in aborting migraines, my doctor switched me to Nurtec.

Rimegepant (Nurtec)

Oral abortive migraine treatment
Dosage: 75 mg as needed per 48 hours
Administered orally at start of migraine
Grade: C

Nurtec was the second abortive I tried. The taste is great as the tablet dissolves. I found that taking Nurtec at the start of my migraine pain would relieve the pain for 30 minutes, and then the migraine would return. The safe dosage is 75 mg taken orally, as needed. The maximum dose in a 24-hour period is 75 mg. The safety of using more than 18 doses in a 30-day period has not been established. As such, you cannot mix abortives or double-up, so to speak. When the migraine returned, I had to wait 48 hours to attempt to kill it again, which was frustrating.
Other medications tried:
Butalbital, acetaminophen, and caffeine

Grade: A+
Only medicine that worked to help me break the migraine cycle after getting a concussion. I highly recommend this drug combo if you do not have addictive tendencies and have medication-resistant migraines.

Triptans, including Rizatriptan (Maxalt, Maxalt-MLT), Sumatriptan (Imitrex), Sumatriptan and Naproxen (Treximet) and Zolmitriptan (Zomig)

Grade: F
I used these from mid 2017 until late 2018. They did not reduce migraines, and instead made me develop insomnia, mood swings, and extreme suicidal ideation. I stopped medication for the sake of my safety. Note: These drugs are contraindicated for hemiplegic migraines due to stroke risk.

Antidepressants, including Fluoxetine (Prozac, Sarafem), Imipramine (Tofranil), Nortriptyline (Aventyl, Pamelor), and Sertraline (Zoloft)

Grade: F
I took these in conjunction with the aforementioned triptans, and I did not see any improvement in migraines. I also had every side effect and it greatly diminished my quality of life.

Midrin (isometheptene mucate, dichloralphenazone and acetaminophen)

Grade: B-
Only effective sometimes. I also had severe dizziness when I recently tried it.

Anticonvulsants, including Gabapentin and Topiramate (Topamax):

Grade: D for 300 mg Gabapentin and Topamax, B for 100 mg Gabapentin
In 2022, I took Gabapentin at 300 mg for migraine-related neuropathy and it made me hyper, unable to sleep, shaky, aggravated my dysesthesia, and gave me feelings of doom. My neurologist prescribed me 100 mg to take before bed to induce sleep and reduce nerve pain. It is effective in preventing neuropathy, but doesn't fully treat dysesthesia. I also have to take 5 mg melatonin with the Gabapentin to actually sleep.

Beta-blockers, including Metoprolol (Toprol XL) and Propranolol (Inderal)

Grade: B-
I tried it in 2021 and I didn't really see a major improvement.

Have been taking Symbicort for the past year and a half for asthma but was prescribed Pamelor (nortriptyline) for migraine. Not loving the fact that there could be potential interactions. Anyone else take both and what has your experience been like?

Hi everyone I’ve been on pamelor (nortiptylne) for about 4 years now and the past like 6 months I’ve been getting weird symptoms that my doctors can’t figure out .. and a lot of them match the side effects to the medicine but I didn’t know if it was rare that It happens this far in? Even my doctor said “it’s possible, but he would highly doubt it” and he really didn’t seem too concerned and just shrugged it off. But I’m so uncomfortable lately.
Symptoms are fatigue, muscle weakness, increased migraines, trouble sleeping, confusion, depersonalization, trouble concentrating, brain fog
28 year old female, weight 170, non smoker, height 5’5, medical issues - vestibular migraines ( reason for the nortriptylne) I also have a condition called hidradenitis suppurativa.
I have had my heart check, blood tests for ebv, Lyme, cbc, magnesium, Tsh, hormones, I have had a brain mri - everything comes back fine.
Only other things I take is some vitamin c, d, b complex and a multi vitamin and some magnesium before bed

Hi everyone I’ve been on pamelor (nortiptylne) for about 4 years now and the past like 6 months I’ve been getting weird symptoms that my doctors can’t figure out .. and a lot of them match the side effects to the medicine but I didn’t know if it was rare that It happens this far in? Even my doctor said “it’s possible, but he would highly doubt it” and he really didn’t seem too concerned and just shrugged it off. But I’m so uncomfortable lately.
EDIT: Symptoms are fatigue, muscle weakness, increased migraines, trouble sleeping, confusion, depersonalization, trouble concentrating, brain fog

I'm hoping anyone has some experience with this- I tried eight weeks ago to increase from 10mg of Lexapro to 15mg, just to try and help the lingering depression (anxiety was much better) and about 5-6 weeks into 15mg I developed these intense non-stop headaches. They lasted for days, until I finally decided to get a psych appt which took another 2 weeks and she dropped me (cold turkey) back to 10mg. Within a few days they were gone. We had a follow up a week later (last week) and she added PameloNortriptyline (started at 10mg/once a day) to see if we could address my ADD and maybe help the depression/apathy that way. (I don't tolerate stimulants) Within 2 days the headaches were back. Searching for info on nortriptyline *causing* headaches is a nightmare because it's perscibed for migraines so that's basically all you get. What I did come across was a medical study (only 4 people though) who were developing headaches as a sign of serotonin syndrome?! Could that be it? I am on Day 7 of Nortriptyline (and month 5 of 10mg of Lexapro at this point)... I am so frustrated and confused. Any advice would be so appreciated. :)

Hi all,
I've been dealing with migraines/headaches for the past year and a half. I think it started due to stress but eventually just became chronic, to where I'm having them every day or every other day. They're very sudden as far as I can tell, as I never notice any warning signs before they hit, and they sit mostly at the front right side of my head and behind my right eye.
About six months ago, I finally broke down and met with my doctor to try and deal with them. He prescribed 10 mg of nortriptyline/Pamelor to help, later increased to 25 mg, and within about 3 weeks of increasing the dose, it almost completely erased them, as I went from almost daily headaches to one per month. 2 weeks ago, though, it just suddenly returned without warning, to where I'm having headaches pretty much daily. I saw my doctor again because of how suddenly the nortripyline just quit on me, and he put me on propanolol (beta blocker) in addition to the nortriptyline.
Unfortunately, the propanolol really doesn't feel like it's impacting me that much. I'm not sure how long it takes for propanolol to become therapeutic, but I've been on it for about a week and it feels barely any better. We tried sumatriptan as an "as needed" relief, but anytime I took it, my neck would become so stiff that I felt like it was resting on stones for hours.
I'm admittedly having a really tough time of it right now, so if anyone has any suggestions on what to try if the propanolol + nortriptyline doesn't work out, that'd be greatly appreciated. I'm nearly about to just go ahead and see a neurologist instead of my general practitioner here.

Hi everyone!
First just want to say how awesome & supportive this group is. Very cool that we have a forum dedicated to these conditions.
Background on myself, 24M with a history of multiple concussions. First migraine was at age 15 and was exercise induced. From ages 15-19 I would have episodic migraines a few times a year that would start with visual aura and end with a 3-5 hour intense headache. At 20 I had my second concussion and from 20-24 my condition shifted away from episodic migraines with auras and into a more chronic & dull pressure that is 24/7 today. Pain is usually a 2-4/10. Sensitive to quick movement, tingling in fingers and lips. Usually by the end of the day there's pressure on the right side of my face (feeling of right eyebrow drooping). Light, movement, and noise can aggravate it further. I also have moments of sharp pain in different parts of the head & neck.
I'm meeting with my neuro in a few weeks and I want to have a good idea of what I can try next. Here are the treatments & medications that I've tried.
MEDICATIONS
Effexor (limited impact)
Pamelor (limited impact)
Gabapentin (was helpful for about a year & then less so)
Ubrelvy (helpful when combined with Tylenol, less effective in the last year)
Rizatriptan (limited impact)
Naratriptan (limited impact)
Nurtec (limited impact)
Emgality & Aimovig (limited impact)
Zoloft (greatly increased anxiety)
Botox (limited impact)
Supplements: Magnesium, Tumeric, Lions Mane (no noticeable difference)
Marijuana & Green Tea (can be helpful! but not sure if it just distracts me or if it actually addresses the pain)
Verapamil (limited impact)

TREATMENTS
Physical Therapy: I had a shouldeneck injury as a child so we've worked on loosening up those muscles & strengthening them. My neuro found I had an aggravated cranial nerve so we did a steroid pack before beginning. The nerve has since calmed down but the head pressure hasn't changed.
Vestibular Therapy: I've generally found the motion exercise to aggravate symptoms. I've got 2-3 more weeks of this so perhaps there will be better results to come.
FL41 Glasses: Have helped when working on a computer, but daily headaches still remain

TESTS
CT, MRI, Blood Scan (all came back clear)

IDEAS FOR NEXT STEPS
Upper Cervical Chiropractor & Cranial Therapy
High Daily CBD dosage
Sleep Study (to rule out Sleep Apnea)
CT Scan for Sinus Inflammation
Elimination Diet
Mushroom Microdose Schedule
Hyperbaric Oxygen Treatment

Is there anything I'm missing or that I've written that has worked for any of you? Also curious if anyone knows of a headache clinic in the US that would be more helpful in addressing this. Been working on this for the last 5 years but want to keep trying new things while I have decent health insurance!
Thank you all so much!

concern: everything hurts all the time and my body is fucked up.
f16, biologically female but transmasc with he/him pronouns, my name is kurtis
5'1" - 107lbs
white
past medications: topamax (2 weeks), pamelor (5 days), gabapentin (nearly a year),
known + diagnosed medical issues: acid reflux, autism, adhd, persistent depressive disorder, generalized anxiety disorder, chronic migraines and headaches (migraines solved by getting glasses, headaches are still generally constant)
family history: unsure, my mom doesn't talk much about my family and my dad is out of the picture, however hypermobility is extremely common in my mom's side to varying degrees,
incidents: broken arm when I was 5, jumped off a tree from 10 feet in the air and hurt my tailbone causing me to be bedridden for several days when I was 11, suicide attempt at 14 with minor tylenol overdose that got treated quickly
past tests done on me:
blood test - nothing notable aside from extremely high vitamin b12 (most likely from tylenol incident) and slightly low vitamin d
mri - nothing notable
eeg - nothing notable
emg - nothing notable
past surgeries:
adenoidectomy a few months ago, good recovery
symptoms: (in google doc form because it's long) https://docs.google.com/document/d/1jH6epprtGnefh9JGBEcZNMry5InEhJwOqOstpJU736k/edit?usp=sharing

25F, no alcohol/drugs. Med conditions: none except chronic migraines, I take Pamelor daily.
Family history; my mom had rheumatoid arthritis, dont think it's relevant here lol
Tl;dr: Picked skin on my thumb and instead of healing, it grew a whole new piece of tissue.
So I bite or pick at my nails on occasion(slowly quitting!) And picked at the skin around my dry thumb nail ~7-10 days ago. Per routine, the skin bled, so I wrapped it in a bandaid like normal. I noticed about 3 days ago, it wasn't healed when the bandaid fell off. Instead, a weird growth has now grown over the spot and is actually covering my nail.
It looks like the original area is actually healed and fine, but now there's this extremely tender mass of tissue covering the corner of my nail. I can gently lift it up and see my nail under it. It seems to have a blood vessel and bleeds when disturbed. My original skin irritation is completely healed except for where this little tissue mass is jutting out. Its weeped through 2 band-aids and some paper towels, doesn't smell great(but not like infected rotting flesh?) Not sure if it'll just heal itself and eventually fall off? Applied neosporin a couple times...
I'm going to try sleeping with it exposed tonight hoping it'll dry out? It's so painful that nothing can touch it at all without a huge spike in pain. Very strange. Any thoughts or ideas or names for what this is?
Pictures! Imgur isn't working today. https://bashify.io/images/wrGDym
https://bashify.io/images/cwaqup
https://bashify.io/images/ggRJKj
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If you’re curious about starting an anti-depressant
here are the 5 antidepressant drug classes and a little bit about each one.

1 Selective Serotonin Reuptake Inhibitors SSRIs

citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd
Drug class
Many professionals claim that this drug class has the best medication for panic attacks and anxiety.
This makes it a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain.
Like any other medication there are advantages and disadvantages of SSRIs.
Over 10% of the US takes an SSRI

2 Tricyclic Antidepressants TCAs

anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
Drug Class
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class. These existed before SSRIs, but they seem to cause more side effects.
The negative effects of antidepressants on the brain (like memory loss & forgetfulness) are usually associated with TCAs. This has led to SSRIs being more commonly prescribed nowadays.
But, TCAs are still often prescribed for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.

3 Selective and Norepinephrine Reuptake Inhibitors SNRIs

cymbalta, duloxetine, effexor, venlafaxine, fetzima, levomilnacipran, pristiq, desvenlafaxine, savella, milnacipran
Drug Class
A similar drug class to the SSRIs but instead of just inhibiting the reuptake of serotonin, it also inhibits the reuptake of norepinephrine.
They’re prescribed for depression, anxiety, panic disorder, fibromyalgia, and even nerve pain.

4 Monoamine Oxidase Inhibitors MAOIs

isocarboxazid, marplan, phenelzine nardil, selegiline, emsam, tranylcypromine, parnate
Drug Class
The first antidepressants! But, not prescribed much anymore because of side effects. These drugs inhibit the reuptake of norepinephrine, serotonin, and dopamine.
The kicker is MAOIs block monoamine oxidase, which breaks down tyramine, which impacts our blood pressure.
So if you’re taking an MAOI you have to avoid tyramine because it impacts blood pressure which can get dangerously high OR low when you take an MAOI.
Tyramine is in; beer, soy sauce, pickled foods, smoked/processed meats & a lot of others things..
That’s just too much to ask & too problematic with the result being deadly blood pressure fluctuations.

5 Atypical Antidepressants

bupropion, wellbutrin, mirtazapine, remeron, nefazodone, trazodone, vilazodone, viibryd, vortioxetine, trintellix
Drug Class
This drug class still works with dopamine, norepinephrine and serotonin. Though, they don’t all work the same.
If you’re prescribed one you’re better off looking up the specific drug vs learning about the drug class.
Articles related to 5 Advantages and Disadvantages of Antidepressants
Best Medication for Panic Attacks and Anxiety
Mental Health Medications and Your Memory
10 Supplements to Improve Your Mental Health

I just got prescribed 10 mg Nortriptyline for chronic Migraines, to be upped to 20 mg. I am meant to switch from Topiramate (Topamax) 100 mg after tapering down because I have experienced severe weight loss as a result of personal circumstances and it is an appetite suppressant. Toprimate has worked incredibly well for me and it is unfortunate that I am deciding to go off. I have browsed the Nortriptyline sub but can’t post on it apparently and I’m really concerned about the side effects. I don’t want to lose weight and I am terrified of the potential fatigue that comes with antidepressants. I also just don’t want to take another new medication because why. They prescribe them at the neurologist like candy and I have been on antidepressants more than a handful of times so I know the drill. TLDR Can someone please share their experiences with Nortriptyline?

27F white 5'8 220 lbs
I had a stable weight of 325 lbs since 2012 until recently
I have previously been diagnosed with:
hyperandrogenemia (2010 these hormones have been within range since 2014)
Migraines(2010)
Visual Snow Syndrome (2020)
Hypothyroidism(2012, then told in 2014 my thyroid is tempermental and goes in and out of range)
I had lymph nodes removed for pain and enlargement in 2016
I also had a teratoma in my pelvis removed in 2007.
Current Medications:
Pamelor
Zofran
Ibuprofen
New symptoms ive had since April:
complete loss of appetite with weightloss of 100 lbs in 6 months, random bouts of severe abdominal pain (gastroenterologist says this maybe Sphincter of oddi dysfunction) nausea and vomiting, diarrhea, severe bloating, muscle/joint weakness and pain,
Long term symptoms:
3 flares of pancreatitis since 2016 with low or normal lipase inbetween, I believe covid set off the last flare End of July, my whole family was covid positive, I instead had pancreatitis. Brain fog, essential tremor, random diagnosed nystagmus, general feeling of being unwell, bradycardia, visual static, palinopsia, night blindness, light sensitivity, fatigue, loss of sensation in left foot, hypoglycemia (since I was a child when they made me do the glucose tolerance test I had a glucose of 23)

Test results:
ct of abdomen/pelvis and brain, Endoscopy, colonoscopy were all clear as of august 2022.
Spinal fluid pressure and everything is okay.
Blood results are insignificant
hgb, hct, mch, always slightly high. PT high, BUN always low. LDH high. hgb A1c 4.4
I recently asked my doctor to do an ANA and Ill include the results and he said it wasnt significant and would retest in a year.
My doctors seems out of ideas and I am very sick.
ANA: https://imgur.com/buvtd8f
ETA: I had a baby in October of last year. She was born full term but really small at 4 lbs 3 oz. In the beginning the weightloss and nausea was thought to be hormonal because of breastfeeding. I did take a few herbal breastmilk enrichers between October-May after approval from my doctor. they contained ingredients: Goats Rue, Milk Thistle, Shatavari, Fennel, Alfalfa, anise, moringa, nettle leaf, and torbangun. They werent all taken at the same time. All of my thyroid hormones were good though out this time.
Thank you for your time and brain power. I'm sorry its so long. Im getting desperate and dont want to leave out anything.

Hello there! 35f here. Started having migraine symptoms in my late 20’s. Mine involves unilateral pain; right side of my head which include throbbing eye, neck, and shoulder pain. For the longest time, I have accepted this fate. But there were days that the pain intensifies, I didn’t know what to do. My doctor prescribed Pamelor. I was on medication for 6 months. At first, it worked pretty well until it didn’t. I stopped taking it coz it wasn’t helping at all. To all the migraine sufferers, you know how it migraine affect all aspects of your life, specially with work. I would miss days at a time when the symptoms gets too unbearable. My right eye would get so sore, it was weird. I also started having anxiety and depression. Fast forward to July of this year, I had my routine physical check up. My blood work showed hyperthyroidism and Graves’ diseases. This means that my thyroid produces too much hormones that causes increased heart rate, eye pain, anxiety, depression, among other awful symptoms. My endocrinologist put me on thyroid medication. Low and behold, no migraines, and all the nasty symptoms. My PCP also put me on a beta blocker which helped tremendously with anxiety. After a month of being on thyroid medication, I have never felt so good after years of suffering with god awful debilitating migraines. And now I have put the puzzle pieces together that I, had been suffering an auto immune that gives me migraine-like symptoms. My thyroid hormones have gotten normal after a month of anti-thyroid medications. I only had to take the beta blocker for a month but I’m still taking the lowest dosage of thyroid medication. I feel so damn good these days. I have forgotten how it felt to be feel normal. I hope my experience will give you guys hope. And ask your doctor to check your thyroid levels next time. Maybe it’ll help you, too! Keep fighting! And always speak up. Ask questions to your PCP about your symptoms. And always, never give up!

7 Popular Medication Classes For Anxiety, Explained By an RN

Selective Serotonin Reuptake Inhibitors SSRIs

citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd
Drug class
This is a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain.
Over 10% of the US takes an SSRI
What Do SSRIs Do?
What does every medication within this class have in common? They all increase the level of Serotonin in your brain. Serotonin is a neurotransmitter. When you take a Serotonin Reuptake Inhibitor, you’re blocking the neurons from reabsorbing Serotonin, meaning there is more Serotonin available.
Since this medication increases serotonin levels, you’ll have more of it to regulate your mood and symptoms of anxiety. Your brain also has to adapt to more Serotonin. It’s thought that by your brain having to restructure from an increase in serotonin, it becomes more able to “remodel” and better able to adapt to stressors like anxiety.
So what does Serotonin do? Well, A LOT. Serotonin influences our mood and emotional state, our digestion, appetite, and our sleep cycle. It is found in your brain, in your intestines and even in your blood. One could argue that it impacts everything.
Did You Know?
Serotonin is even in animals, plants and fungus. We can measure the levels in our blood, but we can’t measure the levels within our brain. Meaning we’re all in the dark as to how much we have in our brain.

Azapirones

Buspar Buspirone
Drug Class
Buspirone is in the drug class of Azapirones. There is no addiction risk, overall there are less side effects than many other anxiolytic medicines. It can take up to a month for the medication to work fully. Typically prescribed for generalized anxiety.
What Does It Do?
This drug class impacts serotonin and dopamine receptors. The full mechanism of the drug aren’t known actually. But, because it seems to take 2-4 weeks to make a difference, that would mean it likely has to do with the receptors for serotonin and dopamine.
It is thought that by the receptors adjusting, it can make them more adaptive and therefore better able to handle stress. Another possibility is that by blocking serotonin receptors, an increase of serotonin is available, which improves symptoms for some types of anxiety disorders.
Did You Know?
The drug Buspar was originally developed for schizophrenia, but wasn’t useful. It did however seem to help people with anxiety. Dizziness seems to be one of the most common complaints as far as side effects.

Antihistamines

brompheniramine, dimetane, benadryl, diphenhydramine, carbinoxamine, clistin, clemastine, tavist, doxylamine, unisom, hydroxyzine, atarax, vistaril, promethazine, phenergan, triprolidine, triafed
Drug Class
Commonly used for allergies but also used for anxiety. Antihistamines are divided into different ‘generations’ & target different histamine receptors in our body.

H1 Receptors: Found Throughout the Body
H2 Receptors: Mostly Stomach Acid Secretion
H3 Receptors: Central Nervous System
H4 Receptors: Still Being Researched

What Do Antihistamines Do?
We’re actually still learning a lot about histamines but what we do know is that anti-histamines are usually anticholinergic; blocking receptors for choline.
Vistaril, hydroxyzine and Atarax are commonly prescribed for anxiety.
While your risks with this drug class are much less severe than when taking benzodiazepines, these are first generation antihistamines. Therefore, they do have a sedating effect (precisely why they can relieve tension) but this also means they can impair our ability to remember, think and learn. Especially the first generation antihistamines that easily penetrate our brain.
An example of second generation antihistamines are Claritin & Zyrtec. Unlike first generation antihistamines, these do not cross the blood-brain barrier as easily. Therefore, they relieve many effects of allergies, but do not have as many sedating properties or memory impairments associated with them. When it comes to anxiety though, Claritin & Zyrtec won’t do you much good.
Did you know?
The only drug within this class that can be given intravenously is Benadryl. Since Benadryl is a first generation, it impacts our body in many ways in addition to the reason why it’s administered. Since first generation antihistamines are much less specific in their effects, they have more side effects.
Though, being the only IV antihistamine available, it is still widely used in hospital settings (for anxiety included).

Benzodiazepines

alprazolam, xanax, chlordiazepoxide, librium, clonazepam, klonopin, clorazepate, tranxene, diazepam, valium, lorazepam, ativan, oxazepam, serax, temazepam, restoril, triazolam, halcion
Drug Class
These are commonly used as anxiety medicines (though can be used for seizures, insomnia, and muscle spasms). They work by quickly slowing down important parts of our brain.
This drug class specifically targets the GABA-A receptor, enhancing its effect, which slows down our central nervous system; this makes us feel relaxed, because the drug has retarted a major gear in our system (sometimes this is EXACTLY what we need).
Anesthesiologists often give Versed (a benzodiazepine) so patients will not remember surgery?
The Drawbacks of Benzos
When Benzodiazepines were first discovered they offered an immediate solution to the overwhelming crippling anxiety that many people face, but the harsh reality is we’re now in a benzo addiction crisis. We’re learning over time as a society, and those changes don’t happen overnight.
This drug class changes our mental state & while the drug is advantageously quick acting, the effects linger. Short-term memory is not as affected, but long-term memory is specifically impaired. The memory loss may occur because events are not transferred from short-term memory to long-term memory.
The effects are similar to the long-term effects of alcoholism (alcohol is also a CNS depressant). Both of these substances, used long term actually damage our brain.
This is why a rehab center isn’t going to allow the use of this drug class while recovering. This is why therapists often (but not always) stray away from patients taking benzodiazepines while trying to work on trauma, recovery, etc. If the brain is not functioning at full capacity & you’re not able to retain information, progress becomes much more difficult.
The most effective aspects of benzodiazepines are precisely why individuals have a tendency to become dependent on them.
Obviously, there is a time and a place for benzodiazepines. They’re a life saver for the (hopefully) occasional panic attack. But how sadistic is that Benzodiazepines have addictive properties, which means that with consistent repeated use we will need increasingly higher doses.
Another point of concern is that this drug will inhibit your brain from initiating activity of GABA A (since the medication has so kindly been doing it). What this means is that after the drug is long gone from your system, your brain experiences a lag in restoring the normal GABA balance.
This is often what is referred to as “rebound anxiety” because your anxiety is likely to get worse, before it gets better after taking a benzodiazepine, especially if taken frequently and long term.
The mental health world is increasingly trying to move towards low dosing and only prescribing for a limited amount of time. I’ve even worked with prescribers who won’t prescribe them, period.
Now, Benzodiazepines are very dangerous to quit cold turkey, so please don’t go flush yours down the toilet after reading this!

Beta Blockers

acebutolol, atenolol, tenormin, bisoprolol, zebeta, metoprolol, lopressor, toprol XL, nadolol, corgard, nebivolol, bystolic, propranolol, inderal, innopran XL
Drug Class
A beta blocker is most often used for heart conditions since this drug class lowers blood pressure and heart rate. But, they do this by blocking epinephrine which we commonly refer to as adrenaline. By blocking adrenaline, you prevent the progression of the physical symptoms of anxiety, like increased heart rate and blood pressure.
These can be prescribed “as needed” and is also prescribed long term to be taken regularly. Sometimes doctors will prescribe them for public speaking, or other stressful events someone has to face.
What do Beta Blockers Do?
Well, they Block Beta-adrenergic receptors, preventing norepinephrine and epinephrine from activating those receptors. This relaxes heart muscles, slows the heart beat, and lowers blood pressure.
That might seem completely unrelated to anxiety to some people, but when anxiety starts it will create physical symptoms that tend to make us feel even more panicked. This is why it can be pretty helpful to stop the physical symptoms from escalating an already not-so-good state of mind.
Did you know?
Beta blockers can be used for tremors, migraines, abnormal heart rhythms, and chest pain too.
Summary
Beta blockers can be a useful anxiety medication. As a nurse some of the things I pay attention to when a patient is prescribed them are obviously heart rate and blood pressure. Energy level is always something that can be impacted too.
It’s not uncommon for someone to become tired, groggy, lightheaded, or get headaches from beta blockers. Even for people who take it for high blood pressure and heart rate, it can have a tendency to drop them too low.
Everyone is different, our diets change, our weight changes, our stress levels change, how hydrated we are fluctuates, our salt intake varies; and all of these impact our blood pressure. So, it’s always a good idea to be keeping an eye on your heart performance with a beta blocker and your doctor who is prescribing should be too.

Tricyclic Antidepressant TCAs

anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
Drug Class
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class. These existed before SSRIs, but they seem to cause more side effects. This has led to SSRIs being more commonly prescribed nowadays.
TCAs are still often prescribed for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.
What do Tricyclic Antidepressants Do?
What do all TCAs have in common? Similar to an SSRI, tricyclic antidepressants impact neurotransmitters. But, in addition to serotonin, they also block the reabsorption of norepinephrine. They ALSO block acetylcholine receptors.
These key differences from SSRIs create a cascade of effects in the body that make them a bit more likely to cause side effects; like dry mouth, blurred vision, and urinary retention.
Did You Know?
In 1945, the Sulphur bridge of the phenothiazine ring of promethazine was altered to synthesize G22355 (a weak antihistamine and mild anticholinergic with sedative properties). The new ‘invention’ was tested as an antipsychotic. It was ineffective for schizophrenia, but did have antidepressant properties. Thus, the first clinically useful tricyclic antidepressant (TCA) was discovered.
Summary
These drugs interfere with our bodies baseline of norepinephrine and acetylcholine. As with any drug; sometimes they create an optimal effect on a person, as for others, not so much. If a person is too excitable and anxious, a TCA can improve their quality of life, while for another it can leave a bad impression.
*Note each drug within the class impacts the degree of these effects a little differently.

Antipsychotics

sometimes referred to as major tranquilizers or neuroleptics
risperidone, risperdal, quetiapine, seroquel, olanzapine, zyprexa, ziprasidone, zeldox, paliperidone, invega, aripiprazole, abilify, clozapine, clozaril, fluphenazine
Drug Class
Commonly used as the first line treatment for schizophrenia & sometimes used for mood disorders, depression, personality disorders, Tourette’s syndrome, Huntington’s disease, and anxiety.
What Do They Do?
Most drugs in this class work to block Dopamine, though some do impact other chemicals in the brain.
Schizophrenia is the major psychotic disorder we use antipsychotics for. Some of the main symptoms are delusions, lack of motivation, unusual behaviors, and hallucinations. Dopamine has been thought to regulate our brains understanding of our surroundings and what it all means to us. So, it’s to be expected that drugs within this class target Dopamine.
This class is broken up into two categories;
First Generation (old, typical): Block Dopamine-2 Receptors, which means they also block acetylcholine, histamine and norepinephrine. which can impact our cognition and the complex way in which we store memories.
*More movement disorders come with the first generation antipsychotics.
Second Generation: (new, atypical): Block Serotonin and Dopamine Receptors. Less risk of extra movements, increased risk of diabetes, high cholesterol, and weight gain.
Hopefully this helps clarify some information on these common 7 classes of medications. If not feel free to submit a question in the comments, or by using my contact form below and I’ll do my best to answer.
Original Post https://twoforsue.com/medications-for-anxiety/

Memory loss is a common topic within the mental health world. I'm going to do my best to summarize some research on which mental health medications impact our memory and why they do.
I'm not against any of these medications. Taking any medication is a risk vs benefit scenario and this is not any sort of medical advise.

I will Include the link to the original post that is probably easier to follow but also going to include all the info below.
https://twoforsue.com/our-memory-is-threatened-by-these-6/

Selective Serotonin Reuptake Inhibitors SSRIs
citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd
Drug class
This is a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain. Over 10% of the US takes an SSRI.
What Do SSRIs Do?
What does every medication within this class have in common? They all increase the level of Serotonin in your brain. Serotonin is a neurotransmitter. When you take a Serotonin Reuptake Inhibitor, you’re blocking the neurons from reabsorbing Serotonin, meaning there is more Serotonin available.
So what does Serotonin do? Well, A LOT. Serotonin influences our mood and emotional state, our digestion, appetite, our sleep cycle. It is found in your brain, in your intestines and even in your blood. One could argue that it impacts everything.
Did You Know?
Serotonin is even in animals, plants and fungus. While we can measure the levels in our blood we cannot measure the levels within our brain. Meaning we’re all in the dark as to how much is within our brain and whether or not it’s even correlated to the amount in our blood.
How SSRIs Impact Memory
Age and gender do not seem to influence the data that SSRIs are correlated with memory effects. Something that is important to mention, is that while research has shown that SSRIs are correlated with memory loss, that doesn’t exactly mean that they CAUSE it. Correlation and cause are two different things. Many people that take SSRIs also take benzodiazepines, drink, smoke, have genetic predisposition to memory loss, etc. Depression and anxiety themselves can even cause memory problems.
Summary
So, after reading through many articles, there overall wasn’t enough credible information to emphatically say that an SSRI causes memory loss. In fact, I came across more research that suggested SSRIs improve cognitive performance and memory. Some data also specifically supported that SSRI’s can improve memory for patients experiencing psychosis and depression.

Tricyclic Antidepressant TCAs
anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
Drug Class
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class. These existed before SSRIs, but they seem to cause more side effects. This has led to SSRIs being more commonly prescribed nowadays. TCAs are still often administered for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.
What do Tricyclic Antidepressants Do?
What do all TCAs have in common? Similar to an SSRI, tricyclic antidepressants impact neurotransmitters. But, in addition to serotonin, they also block the reabsorption of norepinephrine. They ALSO block acetylcholine receptors. These key differences create a cascade of effects in the body that do impact memory. These key differences are also the culprit for the common side effects in this drug class like dry mouth, blurred vision, and urinary retention.
Did You Know?
In 1945, the Sulphur bridge of the phenothiazine ring of promethazine was altered to synthesize G22355 ( a weak antihistamine and mild anticholinergic with sedative properties). The new 'invention' was tested as an antipsychotic. It was ineffective for schizophrenia, but did have antidepressant properties. Thus, the first clinically useful tricyclic antidepressant (TCA) was discovered.
How TCAs Impact Memory
There are multiple reasons why a TCA impacts our memory. The first reason is that we retain memory best when norepinephrine is released at an optimal rate. These drugs block the reabsorption of norepinephrine; which is known to be a moderator of memory. With too much of it, we are anxious and stressed, too little of it and we are drowsy and not as coherent. Either way, the drug has an impact on norepinephrine which directly influences how we store memory.
The second reason why this drug class impacts memory is because it competes with our natural antagonists on muscarinic, and histaminergic receptors. It is well documented that these drugs block muscarinic receptors (which is an acetylcholine receptor), and acetylcholine directly impacts learning and memory.

“Muscarinic acetylcholine receptors in the hippocampus and cortex underlie memory formation”

Summary
So, TCAs are a drug that research has linked with memory impairments and dementia. These drugs interfere with our bodies baseline of norepinephrine and acetylcholine. As with any drug; sometimes they create an optimal effect on a person, as for others, not so much. If a person is too excitable and anxious, a TCA can improve their quality of life (even could improve memory if their extreme anxiety was impairing it), while for another it can make them drowsy and leave a bad impression.
*Note each drug within the class impacts the degree of these effects a little differently.
If you’re feeling like doing a deep dive into some of the articles I read to gain clarity, by all means, click the links below!
Differential Cognitive Actions of Norepinephrine α2 and α1 Receptor Signaling in the Prefrontal Cortex
The effect of tricyclic antidepressants on cholinergic responses of single cortical neurones.
A brief history of antidepressant drug development: from tricyclics to beyond ketamine

Benzodiazepines
alprazolam, xanax, chlordiazepoxide, librium, clonazepam, klonopin, clorazepate, tranxene, diazepam, valium, lorazepam, ativan, oxazepam, serax, temazepam, restoril, triazolam, halcion
Drug Class
These are commonly considered anti-anxiety medication (though can be used for seizures, insomnia, and muscle spasms). They work by quickly slowing down important parts of our brain.
Let’s taco ‘bout it.
This drug class specifically targets the GABA-A receptor, enhancing its effect, which slows down our central nervous system; this makes us feel relaxed, because the drug has retarted a major gear in our system (sometimes this is EXACTLY what we need).
Did You Know?
Anesthesiologists often give Versed (a benzodiazepine) so patients will not remember surgery?
How Benzodiazepines Impact Memory
This drug class changes our mental state & while the drug is advantageously quick acting, the effects linger. Short-term memory is not as affected, but long-term memory is specifically impaired. The memory loss may occur because events are not transferred from short-term memory to long-term memory and thus not consolidated into memory storage. The effects are similar to the long-term effects of alcoholism (alcohol is also a CNS depressant). Both of these substances, used long term actually damage our brain.
This is why a rehab center isn’t going to allow the use of 'said drug' while ‘recovering’. This is why therapists often (but not always) stray away from patients taking 'said drug' while trying to work on trauma, recovery, etc. If the brain is not functioning & you're not able to remember anything, how can you work on it? The most effective aspects of benzodiazepines are precisely why individuals have a tendency to become dependent on them.
Now, don't shoot the messenger. Obviously, there is a time and a place for benzodiazepines. They're an actual life saver for the (hopefully) occasional panic attack. But how sadistic is that Benzodiazepines have addictive properties, which means that with repeated use we will need increasingly higher doses, making the dent in your memory more and more indisputable.
Full Disclosure
My mother was an addict, benzodiazepines being her drug of choice.
Do you know an addict whose drug of choice is a benzodiazepine? No SHAME, but if so, you can probably attest that they don’t remember shit.
How about an addict whose drug of choice is alcohol? All love here, but you can say for certain, they don’t remember shit.
There has even been a fair amount of data to support that the risk of Alzheimer’s is elevated in those taking the drug for over 6 months. One Harvard study even speculated that it would raise the risk by 84%! Seems unrealistic, but who am I to question Harvard; I'll add the link below if you're also feeling speculative.
Another point of concern is that this drug will inhibit your brain from initiating activity of GABA A (since the medication has so kindly been doing it). What this means is that after the drug is long gone from your system, your brain experiences a lag in restoring the normal GABA balance.
This is often what is referred to as “rebound anxiety” because your anxiety is likely to get worse, before it gets better after taking a benzodiazepine, especially if taken long term.
Take it from a nurse who works in mental health; it's not enjoyable being the bystander of a patient trying to escape their benzo addiction.
But this is why the mental health world is increasingly trying to move towards low dosing and only prescribing for a limited amount of time.
Now, Benzodiazepines are very dangerous to quit cold turkey, so please don’t go flush yours down the toilet after reading this.
When Benzodiazepines were first discovered they offered an immediate solution to the overwhelming crippling anxiety that many people face, but the harsh reality is that we’re now in a benzo addiction crisis. We’re learning over time, as a society and those changes don’t happen overnight. And trust me, as a mental health professional I myself occasionally grow infuriated at the amount of family doctors who prescribe copious amounts of benzodiazepines only to later turn the patient away after addiction has crippled them.
Harvard Article Claims Benzodiazepine use may raise risk of Alzheimer’s disease

“Right now I’m having amnesia and déjà vu at the same time. I think I’ve forgotten this before.” ― Steven Wright

Anti-Epileptics
topiramate, topamax, zonisamide, zonegran, levetiracetam, keppra, pregabalin, lyrica, clonazepam, klonopin, rufinamide, banzel, vigabatrin, sabril, phenytoin, dilantin, oxcarbazepine, trileptal, carbamazepine, tegretol, lamotrigine, lamictal, lacosamide, vimpat, valproic acid, depakote, phenobarbital, gabapentin, neurontin
Drug Class
Anti-seizure medications are commonly used for mood disorders and even anxiety in addition to epilepsy.
What Do They Do?
Epilepsy is caused by excessive hyperexcitability of the nervous system therefore, medications in this class are geared toward minimizing excitability. This drug class actually encompasses three different major classes

Blocking Sodium Channels
Enhancement of GABA Inhibition
Regulation of Synaptic Releases

Why it Impacts Memory
Overall, anticonvulsants work in different ways; trust me I rode the magic school for HOURS trying to gain an understanding of them to write this. Truthfully, we still have a lot to learn about them. Their impact is complicated and the effects range based on the dose and drug.
For instance, Topamax has pretty diverse pharmacologic actions, because of that, it has been linked with impaired concentration, cognitive dulling, psychomotor retardation, language and comprehension difficulties, rather extreme effects on short-term memory and working memory, poor verbal fluency and word-finding, reduced IQ scores, abnormal thinking and delayed cognitive speed. Because of this dark cloud of side effects, Topamax is sometimes referred to as 'Dope-A-Max'.
However, a more selective medication within the drug class such as Phenytoin or Tegretol are more specific to blocking sodium channels. Overall, they seem to have less impact on memory and cognitive function.
Many of these drugs listed above have an impact on GABA, and long term exposure to GABA agents can alter the functionality of GABA permanently, which means there are potentially permanent consequences to cognition, behaviors, and memory.
Phenobarbital has been linked to lower IQ, and worse effects than Depakote and Tegretol, however it is actually a barbituate. It’s effects are similar to benzodiazepines which you can read more about above.
Gabapentin, used for seizures and often mood disorders, belongs to it's own drug class. Still, it has been linked to memory impairment. Hence, the name, it also impacts GABA, which as mentioned several times now, certainly plays a hand in our ability to remember. At this point there isn’t enough research to say it’s linked to dementia though.
As far as drugs for epilepsy, Gabapentin is tolerated much better than many others. It’s also worth mentioning that this drug seems to have more short term effects on memory. Some will experience a disorienting feeling or short term memory loss while taking Gabapentin, but the reports of long term memory being impacted are reported less often.
Long Term Effects of Gabapentin

Antipsychotics
sometimes referred to as major tranquilizers or neuroleptics; risperidone, risperdal, quetiapine, seroquel, olanzapine, zyprexa, ziprasidone, zeldox, paliperidone, invega, aripiprazole, abilify, clozapine, clozaril, fluphenazine
Drug Class
Commonly used as the first line treatment for schizophrenia & sometimes used for mood disorders, depression, personality disorders, Tourette's syndrome & Huntington's disease
What Do They Do?
Most drugs in this class work to block Dopamine, though some do impact other chemicals in the brain.
Did You Know?
Oddly enough, memory seems to actually be improved when using an antipsychotic for a person with psychotic symptoms, though there are many that take medications within this class that are not psychotic. So let's talk about that more.
Why It Impacts Memory
First, let's skip back to the purpose of these drugs. Schizophrenia is the major psychotic disorder we use antipsychotics for. Some of the main symptoms are delusions, lack of motivation, unusual behaviors, and hallucinations. Dopamine has been thought to regulate our brains understanding of our surroundings and what it all means to us. So, it's to be expected that drugs within this class target Dopamine.
This class is broken up into two categories;
First Generation (old, typical): Block Dopamine-2 Receptors, which means they also block acetylcholine, histamine and norepinephrine. which do impact the complex way in which we store memories. *More movement disorders come with the old ones.
Second Generation: (new, atypical): Block Serotonin and Dopamine Receptors**.** Less risk of extra movements, increased risk of diabetes, high cholesterol, and weight gain.
What do they all have in common? They impact Dopamine. Long story short; A delicate balance of Dopamine is needed for memory to function. Since this class targets Dopamine, it's fair to say it has the potential to alter our memory. Whether that's a good or bad thing is specific to the patient, but it's typically an unwelcome effect.
Antihistamines
brompheniramine, dimetane, benadryl, diphenhydramine, carbinoxamine, clistin, clemastine, tavist, doxylamine, unisom, hydroxyzine, atarax, vistaril, promethazine, phenergan, triprolidine, triafed
Drug Class
Commonly used for allergies but also used for anxiety. Antihistamines are divided into different 'generations' & target different histamine receptors in our body.

H1 Receptors: Found Throughout the Body
H2 Receptors: Mostly Stomach Acid Secretion
H3 Receptors: Central Nervous System
H4 Receptors: Still Being Researched

What Do They Do?
We're actually still learning a lot about histamines but what we do know is that **anti-**histamines are usually anticholinergic; blocking receptors for choline. The problem is that we need choline to be readily available to have the ability to learn, understand and remember.
Why it Impacts Memory?
Being that antihistamines are often anticholinergic, they do impair our ability to think, learn and remember. Especially the first generation antihistamines that easily penetrate our brain. We already naturally produce less acetylcholine overtime. This is partly why as we age our ability to remember, think, and learn diminishes. It's widely known that anticholinergics impact memory, thinking, learning, and muscle function. It is also suggested that these drugs increase the risk of developing dementia.
Did you know?
The only drug within this class that can be given intravenously is Benadryl. Since Benadryl is a first generation, it impacts our body in many ways in addition to the reason why it's administered. Since first generation antihistamines are much less specific in their effects, they are affiliated with greater memory impairment. Though, being the only IV antihistamine available, it is still widely used in hospital settings.
Summary
Overall, the effects range. Regarding mental health specifically; Vistaril, hydroxyzine and Atarax are commonly prescribed for anxiety. While your risks are much less severe than benzodiazepines, these are FIRST generation antihistamines. Therefore, they do have a sedating effect (precisely why they can relieve tension) but this is also means they do impair our ability to remember.
An example of second generation antihistamines are Claritin & Zyrtec. Unlike first generation antihistamines, these do not cross the blood-brain barrier as easily. Therefore, they relieve many effects of allergies, but do not have as many sedating properties or memory impairments associated with them. When it comes to anxiety though, Claritin & Zyrtec won't do you much good.
Here is the link again for original post below.
https://twoforsue.com/our-memory-is-threatened-by-these-6/

Memory loss is a common topic within the mental health world. I'm an RN that works in Mental Health & going to do my best to summarize some research on which mental health medications impact our memory and why they do.

I will Include the link to the original post that is probably easier to follow but also going to include all the info below.
https://twoforsue.com/our-memory-is-threatened-by-these-6/

Selective Serotonin Reuptake Inhibitors SSRIs
citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd
Drug class
This is a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain. Over 10% of the US takes an SSRI.
What Do SSRIs Do?
What does every medication within this class have in common? They all increase the level of Serotonin in your brain. Serotonin is a neurotransmitter. When you take a Serotonin Reuptake Inhibitor, you’re blocking the neurons from reabsorbing Serotonin, meaning there is more Serotonin available.
So what does Serotonin do? Well, A LOT. Serotonin influences our mood and emotional state, our digestion, appetite, our sleep cycle. It is found in your brain, in your intestines and even in your blood. One could argue that it impacts everything.
Did You Know?
Serotonin is even in animals, plants and fungus. While we can measure the levels in our blood we cannot measure the levels within our brain. Meaning we’re all in the dark as to how much is within our brain and whether or not it’s even correlated to the amount in our blood.
How SSRIs Impact Memory
Age and gender do not seem to influence the data that SSRIs are correlated with memory effects. Something that is important to mention, is that while research has shown that SSRIs are correlated with memory loss, that doesn’t exactly mean that they CAUSE it. Correlation and cause are two different things. Many people that take SSRIs also take benzodiazepines, drink, smoke, have genetic predisposition to memory loss, etc. Depression and anxiety themselves can even cause memory problems.
Summary
So, after reading through many articles, there overall wasn’t enough credible information to emphatically say that an SSRI causes memory loss. In fact, I came across more research that suggested SSRIs improve cognitive performance and memory. Some data also specifically supported that SSRI’s can improve memory for patients experiencing psychosis and depression.

Tricyclic Antidepressant TCAs
anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
Drug Class
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class. These existed before SSRIs, but they seem to cause more side effects. This has led to SSRIs being more commonly prescribed nowadays. TCAs are still often administered for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.
What do Tricyclic Antidepressants Do?
What do all TCAs have in common? Similar to an SSRI, tricyclic antidepressants impact neurotransmitters. But, in addition to serotonin, they also block the reabsorption of norepinephrine. They ALSO block acetylcholine receptors. These key differences create a cascade of effects in the body that do impact memory. These key differences are also the culprit for the common side effects in this drug class like dry mouth, blurred vision, and urinary retention.
Did You Know?
In 1945, the Sulphur bridge of the phenothiazine ring of promethazine was altered to synthesize G22355 ( a weak antihistamine and mild anticholinergic with sedative properties). The new 'invention' was tested as an antipsychotic. It was ineffective for schizophrenia, but did have antidepressant properties. Thus, the first clinically useful tricyclic antidepressant (TCA) was discovered.
How TCAs Impact Memory
There are multiple reasons why a TCA impacts our memory. The first reason is that we retain memory best when norepinephrine is released at an optimal rate. These drugs block the reabsorption of norepinephrine; which is known to be a moderator of memory. With too much of it, we are anxious and stressed, too little of it and we are drowsy and not as coherent. Either way, the drug has an impact on norepinephrine which directly influences how we store memory.
The second reason why this drug class impacts memory is because it competes with our natural antagonists on muscarinic, and histaminergic receptors. It is well documented that these drugs block muscarinic receptors (which is an acetylcholine receptor), and acetylcholine directly impacts learning and memory.

“Muscarinic acetylcholine receptors in the hippocampus and cortex underlie memory formation”

Summary
So, TCAs are a drug that research has linked with memory impairments and dementia. These drugs interfere with our bodies baseline of norepinephrine and acetylcholine. As with any drug; sometimes they create an optimal effect on a person, as for others, not so much. If a person is too excitable and anxious, a TCA can improve their quality of life (even could improve memory if their extreme anxiety was impairing it), while for another it can make them drowsy and leave a bad impression.
*Note each drug within the class impacts the degree of these effects a little differently.
If you’re feeling like doing a deep dive into some of the articles I read to gain clarity, by all means, click the links below!
Differential Cognitive Actions of Norepinephrine α2 and α1 Receptor Signaling in the Prefrontal Cortex
The effect of tricyclic antidepressants on cholinergic responses of single cortical neurones.
A brief history of antidepressant drug development: from tricyclics to beyond ketamine

Benzodiazepines
alprazolam, xanax, chlordiazepoxide, librium, clonazepam, klonopin, clorazepate, tranxene, diazepam, valium, lorazepam, ativan, oxazepam, serax, temazepam, restoril, triazolam, halcion
Drug Class
These are commonly considered anti-anxiety medication (though can be used for seizures, insomnia, and muscle spasms). They work by quickly slowing down important parts of our brain.
Let’s taco ‘bout it.
This drug class specifically targets the GABA-A receptor, enhancing its effect, which slows down our central nervous system; this makes us feel relaxed, because the drug has retarted a major gear in our system (sometimes this is EXACTLY what we need).
Did You Know?
Anesthesiologists often give Versed (a benzodiazepine) so patients will not remember surgery?
How Benzodiazepines Impact Memory
This drug class changes our mental state & while the drug is advantageously quick acting, the effects linger. Short-term memory is not as affected, but long-term memory is specifically impaired. The memory loss may occur because events are not transferred from short-term memory to long-term memory and thus not consolidated into memory storage. The effects are similar to the long-term effects of alcoholism (alcohol is also a CNS depressant). Both of these substances, used long term actually damage our brain.
This is why a rehab center isn’t going to allow the use of 'said drug' while ‘recovering’. This is why therapists often (but not always) stray away from patients taking 'said drug' while trying to work on trauma, recovery, etc. If the brain is not functioning & you're not able to remember anything, how can you work on it? The most effective aspects of benzodiazepines are precisely why individuals have a tendency to become dependent on them.
Now, don't shoot the messenger. Obviously, there is a time and a place for benzodiazepines. They're an actual life saver for the (hopefully) occasional panic attack. But how sadistic is that Benzodiazepines have addictive properties, which means that with repeated use we will need increasingly higher doses, making the dent in your memory more and more indisputable.
Full Disclosure
My mother was an addict, benzodiazepines being her drug of choice.
Do you know an addict whose drug of choice is a benzodiazepine? No SHAME, but if so, you can probably attest that they don’t remember shit.
How about an addict whose drug of choice is alcohol? All love here, but you can say for certain, they don’t remember shit.
There has even been a fair amount of data to support that the risk of Alzheimer’s is elevated in those taking the drug for over 6 months. One Harvard study even speculated that it would raise the risk by 84%! Seems unrealistic, but who am I to question Harvard; I'll add the link below if you're also feeling speculative.
Another point of concern is that this drug will inhibit your brain from initiating activity of GABA A (since the medication has so kindly been doing it). What this means is that after the drug is long gone from your system, your brain experiences a lag in restoring the normal GABA balance.
This is often what is referred to as “rebound anxiety” because your anxiety is likely to get worse, before it gets better after taking a benzodiazepine, especially if taken long term.
Take it from a nurse who works in mental health; it's not enjoyable being the bystander of a patient trying to escape their benzo addiction.
But this is why the mental health world is increasingly trying to move towards low dosing and only prescribing for a limited amount of time.
Now, Benzodiazepines are very dangerous to quit cold turkey, so please don’t go flush yours down the toilet after reading this.
When Benzodiazepines were first discovered they offered an immediate solution to the overwhelming crippling anxiety that many people face, but the harsh reality is that we’re now in a benzo addiction crisis. We’re learning over time, as a society and those changes don’t happen overnight. And trust me, as a mental health professional I myself occasionally grow infuriated at the amount of family doctors who prescribe copious amounts of benzodiazepines only to later turn the patient away after addiction has crippled them.
Harvard Article Claims Benzodiazepine use may raise risk of Alzheimer’s disease

“Right now I’m having amnesia and déjà vu at the same time. I think I’ve forgotten this before.” ― Steven Wright

Anti-Epileptics
topiramate, topamax, zonisamide, zonegran, levetiracetam, keppra, pregabalin, lyrica, clonazepam, klonopin, rufinamide, banzel, vigabatrin, sabril, phenytoin, dilantin, oxcarbazepine, trileptal, carbamazepine, tegretol, lamotrigine, lamictal, lacosamide, vimpat, valproic acid, depakote, phenobarbital, gabapentin, neurontin
Drug Class
Anti-seizure medications are commonly used for mood disorders and even anxiety in addition to epilepsy.
What Do They Do?
Epilepsy is caused by excessive hyperexcitability of the nervous system therefore, medications in this class are geared toward minimizing excitability. This drug class actually encompasses three different major classes

Blocking Sodium Channels
Enhancement of GABA Inhibition
Regulation of Synaptic Releases

Why it Impacts Memory
Overall, anticonvulsants work in different ways; trust me I rode the magic school for HOURS trying to gain an understanding of them to write this. Truthfully, we still have a lot to learn about them. Their impact is complicated and the effects range based on the dose and drug.
For instance, Topamax has pretty diverse pharmacologic actions, because of that, it has been linked with impaired concentration, cognitive dulling, psychomotor retardation, language and comprehension difficulties, rather extreme effects on short-term memory and working memory, poor verbal fluency and word-finding, reduced IQ scores, abnormal thinking and delayed cognitive speed. Because of this dark cloud of side effects, Topamax is sometimes referred to as 'Dope-A-Max'.
However, a more selective medication within the drug class such as Phenytoin or Tegretol are more specific to blocking sodium channels. Overall, they seem to have less impact on memory and cognitive function.
Many of these drugs listed above have an impact on GABA, and long term exposure to GABA agents can alter the functionality of GABA permanently, which means there are potentially permanent consequences to cognition, behaviors, and memory.
Phenobarbital has been linked to lower IQ, and worse effects than Depakote and Tegretol, however it is actually a barbituate. It’s effects are similar to benzodiazepines which you can read more about above.
Gabapentin, used for seizures and often mood disorders, belongs to it's own drug class. Still, it has been linked to memory impairment. Hence, the name, it also impacts GABA, which as mentioned several times now, certainly plays a hand in our ability to remember. At this point there isn’t enough research to say it’s linked to dementia though.
As far as drugs for epilepsy, Gabapentin is tolerated much better than many others. It’s also worth mentioning that this drug seems to have more short term effects on memory. Some will experience a disorienting feeling or short term memory loss while taking Gabapentin, but the reports of long term memory being impacted are reported less often.
Long Term Effects of Gabapentin

Antipsychotics
sometimes referred to as major tranquilizers or neuroleptics; risperidone, risperdal, quetiapine, seroquel, olanzapine, zyprexa, ziprasidone, zeldox, paliperidone, invega, aripiprazole, abilify, clozapine, clozaril, fluphenazine
Drug Class
Commonly used as the first line treatment for schizophrenia & sometimes used for mood disorders, depression, personality disorders, Tourette's syndrome & Huntington's disease
What Do They Do?
Most drugs in this class work to block Dopamine, though some do impact other chemicals in the brain.
Did You Know?
Oddly enough, memory seems to actually be improved when using an antipsychotic for a person with psychotic symptoms, though there are many that take medications within this class that are not psychotic. So let's talk about that more.
Why It Impacts Memory
First, let's skip back to the purpose of these drugs. Schizophrenia is the major psychotic disorder we use antipsychotics for. Some of the main symptoms are delusions, lack of motivation, unusual behaviors, and hallucinations. Dopamine has been thought to regulate our brains understanding of our surroundings and what it all means to us. So, it's to be expected that drugs within this class target Dopamine.
This class is broken up into two categories;
First Generation (old, typical): Block Dopamine-2 Receptors, which means they also block acetylcholine, histamine and norepinephrine. which do impact the complex way in which we store memories. *More movement disorders come with the old ones.
Second Generation: (new, atypical): Block Serotonin and Dopamine Receptors**.** Less risk of extra movements, increased risk of diabetes, high cholesterol, and weight gain.
What do they all have in common? They impact Dopamine. Long story short; A delicate balance of Dopamine is needed for memory to function. Since this class targets Dopamine, it's fair to say it has the potential to alter our memory. Whether that's a good or bad thing is specific to the patient, but it's typically an unwelcome effect.

Antihistamines
brompheniramine, dimetane, benadryl, diphenhydramine, carbinoxamine, clistin, clemastine, tavist, doxylamine, unisom, hydroxyzine, atarax, vistaril, promethazine, phenergan, triprolidine, triafed
Drug Class
Commonly used for allergies but also used for anxiety. Antihistamines are divided into different 'generations' & target different histamine receptors in our body.

H1 Receptors: Found Throughout the Body
H2 Receptors: Mostly Stomach Acid Secretion
H3 Receptors: Central Nervous System
H4 Receptors: Still Being Researched

What Do They Do?
We're actually still learning a lot about histamines but what we do know is that **anti-**histamines are usually anticholinergic; blocking receptors for choline. The problem is that we need choline to be readily available to have the ability to learn, understand and remember.
Why it Impacts Memory?
Being that antihistamines are often anticholinergic, they do impair our ability to think, learn and remember. Especially the first generation antihistamines that easily penetrate our brain. We already naturally produce less acetylcholine overtime. This is partly why as we age our ability to remember, think, and learn diminishes. It's widely known that anticholinergics impact memory, thinking, learning, and muscle function. It is also suggested that these drugs increase the risk of developing dementia.
Did you know?
The only drug within this class that can be given intravenously is Benadryl. Since Benadryl is a first generation, it impacts our body in many ways in addition to the reason why it's administered. Since first generation antihistamines are much less specific in their effects, they are affiliated with greater memory impairment. Though, being the only IV antihistamine available, it is still widely used in hospital settings.
Summary
Overall, the effects range. Regarding mental health specifically; Vistaril, hydroxyzine and Atarax are commonly prescribed for anxiety. While your risks are much less severe than benzodiazepines, these are FIRST generation antihistamines. Therefore, they do have a sedating effect (precisely why they can relieve tension) but this is also means they do impair our ability to remember.
An example of second generation antihistamines are Claritin & Zyrtec. Unlike first generation antihistamines, these do not cross the blood-brain barrier as easily. Therefore, they relieve many effects of allergies, but do not have as many sedating properties or memory impairments associated with them. When it comes to anxiety though, Claritin & Zyrtec won't do you much good.

Here is the link again for original post below.
https://twoforsue.com/our-memory-is-threatened-by-these-6/

Memory loss is a common topic within the mental health world. I'm an RN that works in Mental Health & going to do my best to summarize some research on which mental health medications impact our memory and why they do.
Memory refers to the mechanisms that are used to collect, accumulate, preserve, and later retrieve information. There are three actions involved in 'memory': processing, storing, and recalling.

I will Include the link to the original post that is probably easier to follow but also going to include all the info below.

https://twoforsue.com/our-memory-is-threatened-by-these-6/

Selective Serotonin Reuptake Inhibitors SSRIs

citalopram, celexa, escitalopram, lexapro, fluoxetine, prozac, sarafem, symbyax, fluvoxamine, luvox, luvox CR, paroxetine, paxil, paxil CR, pexeva, sertraline, zoloft, vilazodone, viibryd

Drug class

This is a very common drug class; prescribed to treat anxiety, depression, bipolar disorders, migraines, panic attacks, eating disorders, PTSD, OCD, and even chronic pain. Over 10% of the US takes an SSRI.

What Do SSRIs Do?

What does every medication within this class have in common? They all increase the level of Serotonin in your brain. Serotonin is a neurotransmitter. When you take a Serotonin Reuptake Inhibitor, you’re blocking the neurons from reabsorbing Serotonin, meaning there is more Serotonin available.
So what does Serotonin do? Well, A LOT. Serotonin influences our mood and emotional state, our digestion, appetite, our sleep cycle. It is found in your brain, in your intestines and even in your blood. One could argue that it impacts everything.
Did You Know?
Serotonin is even in animals, plants and fungus. While we can measure the levels in our blood we cannot measure the levels within our brain. Meaning we’re all in the dark as to how much is within our brain and whether or not it’s even correlated to the amount in our blood.
How SSRIs Impact Memory
Age and gender do not seem to influence the data that SSRIs are correlated with memory effects. Something that is important to mention, is that while research has shown that SSRIs are correlated with memory loss, that doesn’t exactly mean that they CAUSE it. Correlation and cause are two different things. Many people that take SSRIs also take benzodiazepines, drink, smoke, have genetic predisposition to memory loss, etc. Depression and anxiety themselves can even cause memory problems.
Summary
So, after reading through many articles, there overall wasn’t enough credible information to emphatically say that an SSRI causes memory loss. In fact, I came across more research that suggested SSRIs improve cognitive performance and memory. Some data also specifically supported that SSRI’s can improve memory for patients experiencing psychosis and depression.

Tricyclic Antidepressant TCAs

anafranil, clomipramine, asendin, amoxapine, elavil, amitriptyline, norpramin, desipramine, pamelor, nortriptyline, sinequan, doxepin, surmontil, trimipramine, tofranil, imipramine, vivactil, protiptyline
Drug Class
The word “tricyclic” refers to the three molecular ring shapes associated with this drug class. These existed before SSRIs, but they seem to cause more side effects. This has led to SSRIs being more commonly prescribed nowadays. TCAs are still often administered for things like anxiety, depression, migraines, panic disorder, eating disorders, mood disorders, insomnia, hormone disorders, bedwetting, and even nerve pain.
What do Tricyclic Antidepressants Do?
What do all TCAs have in common? Similar to an SSRI, tricyclic antidepressants impact neurotransmitters. But, in addition to serotonin, they also block the reabsorption of norepinephrine. They ALSO block acetylcholine receptors. These key differences create a cascade of effects in the body that do impact memory. These key differences are also the culprit for the common side effects in this drug class like dry mouth, blurred vision, and urinary retention.
Did You Know?
In 1945, the Sulphur bridge of the phenothiazine ring of promethazine was altered to synthesize G22355 ( a weak antihistamine and mild anticholinergic with sedative properties). The new 'invention' was tested as an antipsychotic. It was ineffective for schizophrenia, but did have antidepressant properties. Thus, the first clinically useful tricyclic antidepressant (TCA) was discovered.
How TCAs Impact Memory
There are multiple reasons why a TCA impacts our memory. The first reason is that we retain memory best when norepinephrine is released at an optimal rate. These drugs block the reabsorption of norepinephrine; which is known to be a moderator of memory. With too much of it, we are anxious and stressed, too little of it and we are drowsy and not as coherent. Either way, the drug has an impact on norepinephrine which directly influences how we store memory.
The second reason why this drug class impacts memory is because it competes with our natural antagonists on muscarinic, and histaminergic receptors. It is well documented that these drugs block muscarinic receptors (which is an acetylcholine receptor), and acetylcholine directly impacts learning and memory.

“Muscarinic acetylcholine receptors in the hippocampus and cortex underlie memory formation”

Summary
So, TCAs are a drug that research has linked with memory impairments and dementia. These drugs interfere with our bodies baseline of norepinephrine and acetylcholine. As with any drug; sometimes they create an optimal effect on a person, as for others, not so much. If a person is too excitable and anxious, a TCA can improve their quality of life (even could improve memory if their extreme anxiety was impairing it), while for another it can make them drowsy and leave a bad impression.
*Note each drug within the class impacts the degree of these effects a little differently.
If you’re feeling like doing a deep dive into some of the articles I read to gain clarity, by all means, click the links below!
Differential Cognitive Actions of Norepinephrine α2 and α1 Receptor Signaling in the Prefrontal Cortex
The effect of tricyclic antidepressants on cholinergic responses of single cortical neurones.
A brief history of antidepressant drug development: from tricyclics to beyond ketamine

Benzodiazepines

alprazolam, xanax, chlordiazepoxide, librium, clonazepam, klonopin, clorazepate, tranxene, diazepam, valium, lorazepam, ativan, oxazepam, serax, temazepam, restoril, triazolam, halcion
Drug Class
These are commonly considered anti-anxiety medication (though can be used for seizures, insomnia, and muscle spasms). They work by quickly slowing down important parts of our brain.

Let’s taco ‘bout it.
This drug class specifically targets the GABA-A receptor, enhancing its effect, which slows down our central nervous system; this makes us feel relaxed, because the drug has retarted a major gear in our system (sometimes this is EXACTLY what we need).
Did You Know?
Anesthesiologists often give Versed (a benzodiazepine) so patients will not remember surgery?
How Benzodiazepines Impact Memory
This drug class changes our mental state & while the drug is advantageously quick acting, the effects linger. Short-term memory is not as affected, but long-term memory is specifically impaired. The memory loss may occur because events are not transferred from short-term memory to long-term memory and thus not consolidated into memory storage. The effects are similar to the long-term effects of alcoholism (alcohol is also a CNS depressant). Both of these substances, used long term actually damage our brain.
This is why a rehab center isn’t going to allow the use of 'said drug' while ‘recovering’. This is why therapists often (but not always) stray away from patients taking 'said drug' while trying to work on trauma, recovery, etc. If the brain is not functioning & you're not able to remember anything, how can you work on it? The most effective aspects of benzodiazepines are precisely why individuals have a tendency to become dependent on them.
Now, don't shoot the messenger. Obviously, there is a time and a place for benzodiazepines. They're an actual life saver for the (hopefully) occasional panic attack. But how sadistic is that Benzodiazepines have addictive properties, which means that with repeated use we will need increasingly higher doses, making the dent in your memory more and more indisputable.
Full Disclosure
My mother was an addict, benzodiazepines being her drug of choice.
Do you know an addict whose drug of choice is a benzodiazepine? No SHAME, but if so, you can probably attest that they don’t remember shit.
How about an addict whose drug of choice is alcohol? All love here, but you can say for certain, they don’t remember shit.
There has even been a fair amount of data to support that the risk of Alzheimer’s is elevated in those taking the drug for over 6 months. One Harvard study even speculated that it would raise the risk by 84%! Seems unrealistic, but who am I to question Harvard; I'll add the link below if you're also feeling speculative.
Another point of concern is that this drug will inhibit your brain from initiating activity of GABA A (since the medication has so kindly been doing it). What this means is that after the drug is long gone from your system, your brain experiences a lag in restoring the normal GABA balance.
This is often what is referred to as “rebound anxiety” because your anxiety is likely to get worse, before it gets better after taking a benzodiazepine, especially if taken long term.
Take it from a nurse who works in mental health; it's not enjoyable being the bystander of a patient trying to escape their benzo addiction.
But this is why the mental health world is increasingly trying to move towards low dosing and only prescribing for a limited amount of time.
Now, Benzodiazepines are very dangerous to quit cold turkey, so please don’t go flush yours down the toilet after reading this.
When Benzodiazepines were first discovered they offered an immediate solution to the overwhelming crippling anxiety that many people face, but the harsh reality is that we’re now in a benzo addiction crisis. We’re learning over time, as a society and those changes don’t happen overnight. And trust me, as a mental health professional I myself occasionally grow infuriated at the amount of family doctors who prescribe copious amounts of benzodiazepines only to later turn the patient away after addiction has crippled them.

Harvard Article Claims Benzodiazepine use may raise risk of Alzheimer’s disease

“Right now I’m having amnesia and déjà vu at the same time. I think I’ve forgotten this before.” ― Steven Wright

Anti-Epileptics

topiramate, topamax, zonisamide, zonegran, levetiracetam, keppra, pregabalin, lyrica, clonazepam, klonopin, rufinamide, banzel, vigabatrin, sabril, phenytoin, dilantin, oxcarbazepine, trileptal, carbamazepine, tegretol, lamotrigine, lamictal, lacosamide, vimpat, valproic acid, depakote, phenobarbital, gabapentin, neurontin
Drug Class
Anti-seizure medications are commonly used for mood disorders and even anxiety in addition to epilepsy.
What Do They Do?
Epilepsy is caused by excessive hyperexcitability of the nervous system therefore, medications in this class are geared toward minimizing excitability. This drug class actually encompasses three different major classes

Blocking Sodium Channels
Enhancement of GABA Inhibition
Regulation of Synaptic Releases

Why it Impacts Memory
Overall, anticonvulsants work in different ways; trust me I rode the magic school for HOURS trying to gain an understanding of them to write this. Truthfully, we still have a lot to learn about them. Their impact is complicated and the effects range based on the dose and drug.
For instance, Topamax has pretty diverse pharmacologic actions, because of that, it has been linked with impaired concentration, cognitive dulling, psychomotor retardation, language and comprehension difficulties, rather extreme effects on short-term memory and working memory, poor verbal fluency and word-finding, reduced IQ scores, abnormal thinking and delayed cognitive speed. Because of this dark cloud of side effects, Topamax is sometimes referred to as 'Dope-A-Max'.
However, a more selective medication within the drug class such as Phenytoin or Tegretol are more specific to blocking sodium channels. Overall, they seem to have less impact on memory and cognitive function.
Many of these drugs listed above have an impact on GABA, and long term exposure to GABA agents can alter the functionality of GABA permanently, which means there are potentially permanent consequences to cognition, behaviors, and memory.
Phenobarbital has been linked to lower IQ, and worse effects than Depakote and Tegretol, however it is actually a barbituate. It’s effects are similar to benzodiazepines which you can read more about above.
Gabapentin, used for seizures and often mood disorders, belongs to it's own drug class. Still, it has been linked to memory impairment. Hence, the name, it also impacts GABA, which as mentioned several times now, certainly plays a hand in our ability to remember. At this point there isn’t enough research to say it’s linked to dementia though.
As far as drugs for epilepsy, Gabapentin is tolerated much better than many others. It’s also worth mentioning that this drug seems to have more short term effects on memory. Some will experience a disorienting feeling or short term memory loss while taking Gabapentin, but the reports of long term memory being impacted are reported less often.
Long Term Effects of Gabapentin

Antipsychotics

sometimes referred to as major tranquilizers or neuroleptics; risperidone, risperdal, quetiapine, seroquel, olanzapine, zyprexa, ziprasidone, zeldox, paliperidone, invega, aripiprazole, abilify, clozapine, clozaril, fluphenazine
Drug Class
Commonly used as the first line treatment for schizophrenia & sometimes used for mood disorders, depression, personality disorders, Tourette's syndrome & Huntington's disease
What Do They Do?
Most drugs in this class work to block Dopamine, though some do impact other chemicals in the brain.
Did You Know?
Oddly enough, memory seems to actually be improved when using an antipsychotic for a person with psychotic symptoms, though there are many that take medications within this class that are not psychotic. So let's talk about that more.
Why It Impacts Memory
First, let's skip back to the purpose of these drugs. Schizophrenia is the major psychotic disorder we use antipsychotics for. Some of the main symptoms are delusions, lack of motivation, unusual behaviors, and hallucinations. Dopamine has been thought to regulate our brains understanding of our surroundings and what it all means to us. So, it's to be expected that drugs within this class target Dopamine.
This class is broken up into two categories;
First Generation (old, typical): Block Dopamine-2 Receptors, which means they also block acetylcholine, histamine and norepinephrine. which do impact the complex way in which we store memories. *More movement disorders come with the old ones.
Second Generation: (new, atypical): Block Serotonin and Dopamine Receptors. Less risk of extra movements, increased risk of diabetes, high cholesterol, and weight gain.
What do they all have in common? They impact Dopamine. Long story short; A delicate balance of Dopamine is needed for memory to function. Since this class targets Dopamine, it's fair to say it has the potential to alter our memory. Whether that's a good or bad thing is specific to the patient, but it's typically an unwelcome effect.

Antihistamines

brompheniramine, dimetane, benadryl, diphenhydramine, carbinoxamine, clistin, clemastine, tavist, doxylamine, unisom, hydroxyzine, atarax, vistaril, promethazine, phenergan, triprolidine, triafed
Drug Class
Commonly used for allergies but also used for anxiety. Antihistamines are divided into different 'generations' & target different histamine receptors in our body.

H1 Receptors: Found Throughout the Body
H2 Receptors: Mostly Stomach Acid Secretion
H3 Receptors: Central Nervous System
H4 Receptors: Still Being Researched

What Do They Do?
We're actually still learning a lot about histamines but what we do know is that anti-histamines are usually anticholinergic; blocking receptors for choline. The problem is that we need choline to be readily available to have the ability to learn, understand and remember.

Why it Impacts Memory?

Being that antihistamines are often anticholinergic, they do impair our ability to think, learn and remember. Especially the first generation antihistamines that easily penetrate our brain. We already naturally produce less acetylcholine overtime. This is partly why as we age our ability to remember, think, and learn diminishes. It's widely known that anticholinergics impact memory, thinking, learning, and muscle function. It is also suggested that these drugs increase the risk of developing dementia.
Did you know?
The only drug within this class that can be given intravenously is Benadryl. Since Benadryl is a first generation, it impacts our body in many ways in addition to the reason why it's administered. Since first generation antihistamines are much less specific in their effects, they are affiliated with greater memory impairment. Though, being the only IV antihistamine available, it is still widely used in hospital settings.

Summary

Overall, the effects range. Regarding mental health specifically; Vistaril, hydroxyzine and Atarax are commonly prescribed for anxiety. While your risks are much less severe than benzodiazepines, these are FIRST generation antihistamines. Therefore, they do have a sedating effect (precisely why they can relieve tension) but this is also means they do impair our ability to remember.
An example of second generation antihistamines are Claritin & Zyrtec. Unlike first generation antihistamines, these do not cross the blood-brain barrier as easily. Therefore, they relieve many effects of allergies, but do not have as many sedating properties or memory impairments associated with them. When it comes to anxiety though, Claritin & Zyrtec won't do you much good.
Hope this helps clarify some of the impacts of memory and mental health medications. Leave a comment if there is a drug you're still wondering about.

Here is the link again for original post below.
https://twoforsue.com/our-memory-is-threatened-by-these-6/

Migraines pamelor

Diagnosis puzzle

1 Selective Serotonin Reuptake Inhibitors SSRIs

2 Tricyclic Antidepressants TCAs

3 Selective and Norepinephrine Reuptake Inhibitors SNRIs

4 Monoamine Oxidase Inhibitors MAOIs

5 Atypical Antidepressants

Selective Serotonin Reuptake Inhibitors SSRIs

Azapirones

Antihistamines

Benzodiazepines

Beta Blockers

Tricyclic Antidepressant TCAs

Antipsychotics

I will Include the link to the original post that is probably easier to follow but also going to include all the info below.

Selective Serotonin Reuptake Inhibitors SSRIs

Drug class

What Do SSRIs Do?

Tricyclic Antidepressant TCAs

Benzodiazepines

Harvard Article Claims Benzodiazepine use may raise risk of Alzheimer’s disease

Anti-Epileptics

Antipsychotics

Antihistamines

Why it Impacts Memory?

Summary