Jump to content
CrazyBoards.org

untreated bp causes cognitive impairment


Recommended Posts

As many of you may know, untreated bipolar can result in cognitive problems. That is, memory loss, loss of executive function (the skill to analyze a problem, decide how to approach and solve it and complete a task) etc can be the result of untreated depression or bipolar. Those of us like me have had decades in which the bp was not treated. It is now known that untreated bipolar results in cognitive impairment. This results in reduction in IQ, memory problems and the above.

The good news is once you become stabilized, (I love my zyprexa) the decline can be halted and over time new neurons can grow in your brain. Thus you may see and improvement in your cognitive skills. For now you may want to have testing if your insurance covers it or you can afford it to see if you have any cognitive problems, etc. Also if there are problems then one can plan a way to deal with the deficiencies such as reliance on an ipod touch w reminders and scheduling etc.

Sometimes, it is difficult at times to determine whether the impairment is caused by a med or from untreated bipolar. (For example, lamictal causes me to be unable to find common words and got worse as I increased my dose). But it is worth considering that your med's side-effects may not be the reason (or at least not 100% of the reason) you cannot think clearly, unable to do some things or have a decent memory, or other cog. impairments. Thus you might want to not so easily dismiss a med thinking it is clouding your thinking, etc.

Also one can lose cognitive abilities from using steroids such as prednisone for Crohns etc. Also new literature has shown that some people may suffer cog. problems from depression, in some cases, just one deep depression.

Link to comment
Share on other sites

Um,

Can you provide a link on this theory? Or a study perhaps? An article?

Some sort of factual information would be appreciated.

Bipolar Disorder is the culprit for enough shit already.

In other words, I disagree. Or at least convince me.

edited for clarity

Link to comment
Share on other sites

Um,

Can you provide a link on this theory? Or a study perhaps? An article?

Some sort of factual information would be appreciated.

Bipolar Disorder is the culprit for enough shit already.

In other words, I disagree. Or at least convince me.

edited for clarity

No, the cognitive impairment with untxed BPAD is pretty well established. Ditto with lithium/neurogenesis/entrainment (you need the entrainment, not just the new growth.)

Some more-or-less random articles (these are not the seminal ones, just a quickie smattering) -

Brain-derived neurotrophic factor and neuroplasticity in bipolar disorder. Good review section, if you can get fulltext.

The Frequency of Cognitive Impairment in Patients With Anxiety, Depression, and Bipolar Disorder: An Unaccounted Source of Variance in Clinical Trials.

Persistent neuropsychological deficit in euthymic bipolar patients: executive function as a core deficit.

Neuropsychological deficits and functional impairment in bipolar depression, hypomania and euthymia.

Lithium:

In Search of the Holy Grail for the Treatment of Neurodegenerative Disorders: Has a Simple Cation Been Overlooked?

and the Human section has scads of references.

Shout out if you want more on this. I have heaps.

Link to comment
Share on other sites

unfortunately most docs are not educated about the cognitive impairments that are the result of bp, untreated and/or depression. in fact duke univ has an area which deals only with cognitive problems and their causes and attempts to treat it

1) [link=http://www.medscape.com/viewarticle/447412"'>http://www.medscape.com/viewarticle/447412" target="_blank]http://www.medscape.com/viewarticle/447412[/link]

2) science News

[rest removed due to fair use issues - it is fine to cite a few paragraphs as long as it is clearly marked as someone else's work, but an entire article could get us in trouble for copyright violations. -- resonance]

Link to comment
Share on other sites

If you could just post the link and short quotes, that might be more in keeping with fair use...

Also, most of the psyMDs and psyNPs I know are aware of the cognitive concerns in manic-depressive illness and depression, particularly the untreated forms.

Link to comment
Share on other sites

Nice work Sil. Although I still think a YMMV applies.

In fact if the OP had posted links in the first place I would have kept my mouth shut. I guess I'm kinda bitchy today.

No harm done, and thanks for the education.

However, I still maintain that since being diagnosed with this fucked up disorder, my cognitive abilities haven't suffered any more than when I drank and did drugs. In fact Lamictal made me so stupid I had to stop taking it just so I could focus enough to ply my trade. Again, YMMV.

edited grammar

Link to comment
Share on other sites

There's been some work looking at the impairment from the meds vs. the impairment from the disorder. The impairment from the meds, by and large, isn't permanent. The impairment from the disorder can be. The remodeling is... not ideal.

Then there are people like my family, who go around stomping about saying "This lithium makes me stupid," and actually they're just aware of the impairment that was already there. Since they're stomping around in post-doctoral programs, I tend to be unsympathetic to their claims of diminished powers. Right up til I feel the same way. ;)

I'll see if I can find the comparison studies tonight after I'm done stacking bales. (I just nipped in for water and a rest break.)

I'm good and impaired. And I didn't do a lot of drugs other than my brief 17-19yo acid run.

Link to comment
Share on other sites

i have a question:

you talk about the condition worsening without meds

followed by new neurons from stabilising with meds.

but, do we lose more neurons anyway from just having the condition

so, does the rate of impairment slow but not stop? In that case, are we getting worse anyway? just with less or different symptoms and renewed hope that our neurons might be growing?

Link to comment
Share on other sites

Let me preface this by saying I haven't spent nearly as much time keeping up on this as I should.

My limited understanding, and I'm fully prepared to be shot down here, is that there are mood-state dependent deficits (see the Neuropsychological article above) that get better with tx, but that there are also persistent subtle changes that are still around when euthymic.

Ongoing treatment with lithium and ?some antiepileptics seems to have the ability to reduce the long-term cumulative damage, in part by reducing the number of episodes, in part by regulating plasticity (by modifying growth and recruitment / entrainment.)

IIRC, there's an article that found the deficits very early on in the course of manic-depressive illness, but I don't recall one that looked at premorbid (before diagnosis) functioning. But, as I said, I haven't stayed up on this. It is a pretty obvious idea, to look at a group of kids or adolescents for neuropsych function and then follow them longitudinally, so I'm guessing someone's done it. I'm also guessing that some of those executive function deficits are present before there are any manifestations of the manic-depressive illness itself, the issue being one of reactivity, plasticity, and structure, rather than simple drain-bamage.

However, I am rather sleepless and punchy right now, so I'll have to look for that tomorrow with the comparison studies. I don't have the critical thinking skills right now to sort the good stuff out.

Link to comment
Share on other sites

I posted, way back when, a sticky in the Schizophrenia forum on brain mapping studies...there's some interesting info, including a link to an article on cognitive impairments in schizophrenia and bipolar and a light treatment on potential medication improvemnts.

http://www.crazyboards.org/forums/index.php?showtopic=904

Link to comment
Share on other sites

Here's another string of articles. Sorry these are coming in dribs/drabs, that's just how my brain works... (cough cough)

Anyway, that should be enough to get anyone started.

Cognitive impairment in bipolar II

Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunction. This was an interesting article, if you have access to full text.

Neuropsychological dysfunction, soft neurological signs and social disability in euthymic patients with bipolar disorder

Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder.

Do cognitive complaints in euthymic bipolar patients reflect objective cognitive impairment? This one I can't get fulltext (thank you budget cuts), looks interesting.

Earlier in development:

Sustained attention and executive functions in euthymic young people with bipolar disorder. Fulltext link on the abstract page.

Neurocognitive function in unmedicated manic and medicated euthymic pediatric bipolar patients. There's a fulltext link on the page - but the related articles are worth a go-through, so I used the abstract page.

And the kinfolk - fairly interesting stuff here.

Cognitive functioning in patients with familial bipolar I disorder and their unaffected relatives.

Cognitive function in unaffected twins discordant for affective disorder.

Impairment of executive function but not memory in first-degree relatives of patients with bipolar I disorder and in euthymic patients with unipolar depression.

Somewhat tangential / speculative articles on homocysteine effects:

Association of cognitive deficits with elevated homocysteine levels in euthymic bipolar patients and its impact on psychosocial functioning: preliminary results.Interesting. I'll have to download the fulltext to make sure there's no industry conflict.

The Impact of Homocysteine Levels on Cognition in Euthymic Bipolar Patients: A Cross-Sectional Study.

Link to comment
Share on other sites

Yeah, well...all I know is I had zero cognitive impairment all the year I was undiagnosed. Now however, with the Lamactil, Neurontin, and Wellbutrin, Im experiencing for the first time "not being able to find the word" while talking, forgetting what I was doing all the time, not being able to find my keys, etc etc...

But the meds have helped in other ways. People no longer run when they see me anymore.

I think for me it's the meds. You have to weigh it out. My IQ hasn't dropped even with the meds, it's the stuttering that is the last straw!

Looking for new meds,

~ Denise ;)

Link to comment
Share on other sites

Yeah, well...all I know is I had zero cognitive impairment all the year I was undiagnosed. Now however, with the Lamactil, Neurontin, and Wellbutrin, Im experiencing for the first time "not being able to find the word" while talking, forgetting what I was doing all the time, not being able to find my keys, etc etc...

Well yeah. Meds are very well known to mess with general mental functioning--hence nicknames like "stupamax, dopamax, morontin" and all the bitching about thinking difficulties people get after starting meds--just one more reason folks have trouble staying on meds.

I would like to say I had zero cognitive impairment when I got dx'ed too. But shit, while I was burnin'n'churnin', that don't mean I didn't lose a shitload of brain cells in the process. I'm still smart as a whip but i feel like I lost a lot of the potential that I had.

My IQ hasn't dropped even with the meds

Hrm, can ya prove it? Denial ain't just a river in Egypt...

Link to comment
Share on other sites

I felt much smarter pre: the rx.

Much, much, much smarter. Wow, just a whole hell of a lot more clever.

Objective examination of my written work suggests otherwise.

Feelings aren't truth.

Whenever I start to come out of it, I recognize just how fucking impaired I was or have been.

BTW, as much as topiramate makes me stoooopid at low doses (not at high doses), it's not actually a problem of inability to think, it's a problem of inability to remember what the hell I was thinking 2 minutes ago. Neutrino thoughts: they zip through, leaving a trace visible only on a cloud chamber.

My thought process, organization, and (yes) creativity are much better when I'm euthymic. The drugs screw with memory and retrieval for me. Well, that and they destroy my nice haze of narcissistic wonderfulness.

Link to comment
Share on other sites

i have a question:

you talk about the condition worsening without meds

followed by new neurons from stabilising with meds.

but, do we lose more neurons anyway from just having the condition

so, does the rate of impairment slow but not stop? In that case, are we getting worse anyway? just with less or different symptoms and renewed hope that our neurons might be growing?

Anecdote time!

I feel like I'm getting worse. Without the meds, you would see it more clearly.

But because of the meds, it's kind of being held off. But I feel like the symptoms get harder to control in general, even when I am not currently having an episode.

And still going through trying to find the right combination makes it seem like a race against time. Not to sound melodramatic. Which I'm sure I do.

But yeah, have to stop the Nothing before you can start wishing again.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...