Angela Wrote – I’m taking Cymbalta and Abilify for depression. I need them, but ever since I’ve been taking them I’m going downhill cognitively. I can’t concentrate or keep my attention on anything. I forget things right away and can’t get the words I want from my brain to my mouth. Can it be the drugs causing this?
Dear Angela,
Many antidepressants and neuroleptic medications – Cymbalta and Abilify are examples – have anticholinergic properties. That means they block the neurotransmitter acetylcholine in the central and the peripheral nervous system. Acetylcholine acts as a chemical transmitter at the junctions between nerves and muscles where it stimulates muscle contraction. It also modulates the firing of neurons and is important in memory and learning.
Drugs with anticholinergic effects interfere with the action of acetylcholine in the brain. The cognitive, memory, and concentration problems you described are all possible side effects due to these effects. In other words – yes, they can make you stupid. The good news is that these effects are not permanent, and you are not doing irreversible damage to your brain. Most likely, the symptoms you are currently having are as severe as they are going to get. You said you badly need antidepressants, so the trick is finding a balance between the mood treatment you need and the side effects you can tolerate. It may be that adjusting your dosage or trying a different medication may decrease some of the cognitive problems. The class of antidepressants called MAOIs (Monoamine Oxidase Inhibitors) do not have anticholinergic properties, but they come with their own troubling side effects, and users must follow a strict low tyramine diet – no cheese, red wine, or most aged foods. There are a lot of meds out there. You and your doctor may have to do some experimenting to find the right combination for you.
Unfortunately, no medication is without side effects. You will have to decide how much you are willing to tolerate for adequate control of your mood disorder. If you do stop taking the medications, your acetylcholine receptors will return to normal over a few weeks. However, it is not advisable to stop taking these drugs suddenly. You risk a miserable discontinuation syndrome. Your doctor can help you lower the dose gradually to minimize these effects.
Wren
Answer Wren 