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Namenda for BP cognitive problems?


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My psychiatrist has suggested I might want to try to Namenda (a medication for currently used for Alzheimer's disease) to help with the cognitive problems I am having with my bipolar illness. She told me it is a way off label use, but some psychiatrists are now prescribing it for cognitive deterioration in affective disorders.

Has anybody heard of this? Has anybody tried it? If so, did it work?

I see is on the crazymeds main site, but it looks like an area that is just being developed.  There's no specific information on Namenda. And I can't find anything on using it for bipolar illness even via Google. But perhaps there is another name for it or I am spelling it wrong. (A great example of my cognitive dysfunction.) Without a good working memory, it's kind of hard to work.

Sorry if this is confusing. It seems like a potent medication, so I am a little leery of starting it.

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Should you or should you not take a drug that may be helpful but has no data either way thus far...

I did a search as well and couldn't see anything.  I did find an article awhile ago about the Mayo Clinic doing research into using memantine for other age-related causes of dementia.  Basically they found that patients with the second leading cause of dementia (Lewy body disease) had a reverse response (worsening of dementia symptoms) after receiving mementine.  This was my grandmother's experience. 

Anyway, for me would would all depend on how much risk I was willing to take on.  How bad are things?  If indeed there is evidence that would certainly help your decision.  Here's the continuum...elimination of symptoms, lack of change, worsening of symptoms.  It is a strong, new drug.  For me, the symptoms would have to be unbearable to take the risk of a new, unproven drug.  But that's me.  You've also got to wonder how susceptible your doctor is to the drug rep's marketing push...it is off-label so they technically can't recommend the doctor's use it for that, but I don't know what goes on in that room....It all depends on how much risk you're willing to take. 

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Thanks for your help and doing the extra research.

Basically they found that patients with the second leading cause of dementia (Lewy body disease) had a reverse response (worsening of dementia symptoms) after receiving mementine.  This was my grandmother's experience. 
Yikes!  That certainly makes me think twice. Sorry to hear it did not help your grandmother. I hope she is doing better now.

How bad are things?

I guess that relative to Alzheimer's it's not that bad. It comes and goes.  The worst part is I can't seem to tell when I am having problems, and when I am not. Unlike, say, when you drink too many beers, your brain gets kind of foggy, so you know you are not thinking too clearly. Right now, nothing in my brain gives me any hint that something is wrong.  So I end up having to triple check everything, which is maddening in and of itself, and very time-consuming. Or, I will completely forget what it is I just said (10 seconds ago) so I repeat myself, and people think I am demented. (Which I guess that that moment I am.)

I was hoping it was a side effect of some of the other medications I am taking, but my psychiatrist assured me this is what happens when you have bipolar illness for a long time.

Good point about the pharmaceutical sales representative. But I'm fairly sure my doctor is overly ethical regarding that.

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Hmmm...I was that way with Neurontin (morontin!).  I forgot where the bathroom was in my own house EVERYDAY...I had to withdraw from school while I was on it.  I couldn't carry on conversation!  Fortunately, I found other alternatives....

When did the mental problems appear in relation to when you began your med or added a new med?  Is your doctor totally unwilling to try another one?  Have you had a lot of med failures?

ETA:  Thanks for the concern about my grandmother...it hastened her disease progress and she hasn't been able to recover ;)   You just have to accept and go on as best you can...The doc who prescribed it when he should have known better lost his job at least.

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Yes! I had the exact same problem with Neurontin.  I would end up in places in my work building, and have no idea how I got there, or what I was there for.  It was embarrassing.  And not very efficient.  However, probably not as critical as having difficulty finding the bathroom. how sad that it also affected your ability to go to school.  It must have felt additionally alienating which is just not fair for somebody working so hard to get better.

alas, I too have been on oh gosh at least 30 different medications to try to control my refractory bipolar disorder.  It is hard to figure out what is caused by the bipolar problem and what is caused by the side effects of the medication.  Right now I am experimenting mostly with Lamictal, which seems to be THE medication of choice for bipolar.  I did notice a change in my cognitive capability when I start to go up on the Lamictal, but it usually wears off over time.  So the doctor and I are kind of concluding that it is the bipolar catching up with me, and interfering with my pre-frontal cortex and glutamate and causing the memory problems. (I am hoping I am saying the right terms.)

and I am so sorry for your grandmother's condition. have you considered taking legal action against the doctor? I might be tricky and time consuming, but it also might prevent another person from getting such poor care.  No pressure.  You have so much else going on, but it was just a thought.  I hope your grandmother is at least not in pain and she is very lucky to have a caring granddaughter such as yourself.

thank you so much for all of your help.  It is given me a different perspective on the issues I should be focusing on in making that decision.

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  • 1 month later...

I'm so glad somebody raised the issue of Namenda. I've been meaning to post about it, but just never gotten around to it. Here are my thoughts, for whatever they may be worth.

As you said, Namenda is currently FDA approved to treat Alzheimer's. It works by blocking the brain chemical glutamate (which is also what Lamictal does, it just does it in a different way. Don't ask me how, I ain't got no medickal edukayshun!).

Since March 2004 I've been taking it to treat my GAD/dysthymia. It's worked fairly well, with minimal side effects (I'll get to that in a minute). I'm not 100% well, but I'm well enough that I can go out & get a job & function in my daily life.

As for improving cognitive function, somebody in the now-defunct crazychat room told me that it's been used in foreign countries for precisely that purpose. (Don't remember the person's nick, but I think he might have been Australian.) If you're going to try & research it, don't look under Namenda because it's not called Namenda in other countries. Look under memantine--that's its proper name.

Now for the side effects: Headache, dizziness, constipation, increased libido (that's right, I said INCREASED libido!

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So the doctor and I are kind of concluding that it is the bipolar catching up with me, and interfering with my pre-frontal cortex and glutamate and causing the memory problems. (I am hoping I am saying the right terms.)

Shit.  I wonder if that's what's happened to me.  I've been having the worst problems with memory (long and short-term) over the past couple of years...I forget character names and key plot points of books I've just finished reading.  I have problems with word recall...my mind often feels "fuzzy" and disorganized.  Sometimes I know what I want to say but just can't get the words lined up to express it.  I've been hoping this is temporary, but you're saying it's a result of BP and I'm assuming it's irreversible ;)   I was hoping ADD medication might make a difference (recently dxed but pdoc didn't want to start me on multiple meds at the same time)...I wonder.

Forgot to say (duh huh) that I swear my mind was in better condition when I took NADH (10 mg. for about a year or so, then 20 mg. after developing somewhat of a tolerance) daily.  Expensive stuff, a little hard to find, and didn't work in the sublingual form, but I think it really did improve my cognitive functioning.  If you try it, take it on an empty stomach in the AM approximately a half an hour before breakfast.

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  • 3 weeks later...

I work in a nursing home and I'm in the Alzheimer section half the time.  Most people with alzheimer's are on atypical antipsychotics, esp. seroquel and zyprexa.  Sometimes its combined with an antidepressant. Funny, cause that's what I'm on too - an atypical AD + an AP.  Never heard of Namenda. 

Its weird your doc wants to put you on a med made specifically for alzheimer's.  There is no real cognitive issue with bipolar disorder - if you have cognitive impairments its usually caused by the medication's side effects (like memory loss ect)...  But hey I'm not a doc. 

PBF

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I looked into this drug awhile back because my dad's doc wanted him to try it for cognitive impairment related to early state vascular dementia. It's generally used for mild to moderate cognitive impairment. By the time one has progressed to the nursing home level, Namenda ceases to show any benefit.

Greeny

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Its weird your doc wants to put you on a med made specifically for alzheimer's.  There is no real cognitive issue with bipolar disorder - if you have cognitive impairments its usually caused by the medication's side effects (like memory loss ect)...  But hey I'm not a doc.

<{POST_SNAPBACK}>

My pdoc has never suggested any medication to help with my cognitive impairments related to my BP. I do have cognitive impairment side effects from meds, but I also have cognitive impairments not related to the meds. Luckily, with the help of a decent cocktail this year my cogntive impairments are improving some.

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My understanding (and again, I'm not a doctor) is that Namenda blocks glutamate in almost-but-not-quite the same way as Lamictal. So they could theoretically be used for similar purposes even though Namenda is an Alzheimer's drug and Lamictal is supposed to be used to treat epilepsy.

Sometimes I feel like I'm the only person in the world under the age of 50 who's on Namenda. And it frustrates me a little because I read so many posts here from people who are suffering big time & I wonder if this drug could potentially help them. I always knew this drug was off the beaten path as far as crazymeds were concerned, but I REALLY knew I was dealing with something obscure when I mentioned it to Kassiane in the chat room & she had to admit she'd never heard of it!  B)

Sorry if this is a little off-topic. I don't suffer from cognitive problems so I can't offer any input on that point. My point is that Namenda has the potential to treat conditions other than dementia. As I said in my earlier post, I've been on it for about 18 months with no major side effects. It hasn't made me completely well (I don't think ANY drug will ever make me completely well), but it's made me well enough that I can function normally (most of the time). And I sure feel a lot more comfortable about taking this than I would taking any of the SSRIs.

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  • 5 years later...

well yes, being that it completely has none of the side effects that amantadine has, which is probably the reason why it is so much more expensive than amantadine. man i mean schizophrenics have even more cognitive troubles than bipolar, in terms of being thrown on the brain deleters called antipsychotics.

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