[SpaceCadet]

I'm going to try to keep this short. I thought I'd share my experience with taking Mirtazapine for the first time, to whoever has been prescribed it, or to people who are prescribed it in the future for depression and anxiety due to a concussion/TBI. For those of you that don't know me or don't know what I'm going through, I've been dealing with a lot of constant anxiety, intrusive thoughts and mild depression..due to symptoms of TBI.

I'd like to say, I seen results instantly. 20 minutes after taking only HALF of a 15mg pill, the sedation kicked in and I just felt more happier and relaxed. After about 30-45 minutes, I became extrememly sleepy and slept for about 15 hours. From what I read, that is normal the first time you take it.

My only concern is, when my brain fog kicks in..I wonder if it's going to make it worse...you know, because of the sedative effects. Or I wonder if it will just make me ignore it? I noticed when I feel sedated I kinda ignore and shrug off any symptom I'm having. I guess I'll soon find out.

[pcslife]

Interesting. When I am sedated I also ignore symptoms. Like when I wake up in the middle of night to use the bathroom, have a glass or two wine, when I am on Xanax etc., I tend to ignore my symptoms.

I have not noticed any one in the forum taking tetracyclic antidepressant. Keep posted how it works for you. I might ask my doctor for a prescription and try it out.

You may also want to look at Neurofeedback. It also helped me and thinking of going back again few months.

[Mark in Idaho]

Nick,

Good to hear you are finally getting some relief. As PCSlife said, let us know how you are doing in a few weeks when your body and brain have normalized to your dose.

PCSlife,

Are you combining Xanax and alcohol?

Have you discussed this with your doctor?

Please say the type of neurofeedback you are doing. There are many different types that are promoted, many improperly.

[pcslife]

Mark : I quit taking Xanax 6 or 7 months and on no brain medications now. Take something for stomach(IBS) and that is all besides B6, B12, Biotin and Folic acid.

I have been trying alcohol few weeks ago and I don't really enjoy anymore like I used to before TBI. So now I am cutting that too 2 or 3 times a week (one or two glasses of wine - beer doesn't work for some reason). Just want to find out how it all works in the brain.

http://www.brainwellnessandbiofeedback.com/

Neurofeedback - I tried before was someone who specialized in TBI and PTSD. She has lots of experience and office right next to NIH Bethesda, MD. Mary Lee Esty has a doctorate in health psychology and she is one the specialist who understands very well all this TBI/PCS. She even published a paper on this how Neurofeedback helped.

They did QEEG on me and found out how stressed my brain is. Each time after the session I felt immediately for the rest of the day my dizziness, headache, fatigue all goes down and even my smell and taste got better (smell and taste affected because of TBI but for the past few months it significantly got better - even that some smells and day it is 100%). I have no sinus, cold or any other issues.

I did Neurofeedback 2 months after my TBI so I think that may be too soon when my brain was still struggling.

http://www.neurofeedbackcenterva.com/

Now I plan to go somewhere close to home since I cannot drive that far and in D.C. area traffic is worse and tough to get some one to drive. The one very close to home also treat TBIs and when I spoke to them they seem to understand very well. Their case studies also looks interesting.

Thanks for your concern about Neurofeedback. I am also concerned because of the seizure side effect and makes me to think many times because right now I don't have any seizures and sure don't want in top of all the symptoms I have. I know it is hardly non-intrusive and they manipulate the brain waves which is quite serious. I really need to think about it.

[SpaceCadet]

I'll let you guys know in a few days or so how its working out for me. This is only my third night taking it - first two nights were half dosage as instructed by my psychiatrist...and I spent a lot of the last 2 days sleeping and eating, thanks to the wonderful sedative effects. Second night the sedative effects weren't nearly as strong as the first night (I couldn't even get out of bed the first night). I noticed a little anxiety today, but not nearly as much as before...so I know its doing something. Just won't know for sure until a week or so.

Hope all is well with everyone.

[Mark in Idaho]

pcslife,

As stated on the first web site, there are two forms of neurofeedback, passive and active. Mary Esty actually is mistaken. There is only "brain training" neurofeedback which she uses. The passive modality she also uses is neurotherapy.

The east coast therapist community has been trying to redefine passive neurotherapy as neurofeedback. LENS is not a form of neurofeedback. It has legal limitations per its exempt status from the FDA. A further correction is calling LENS non-invasive. It is invasive due to its claims to apply electromagnetic fields to the brain. That artificail stimulation from outside the brain is invasive.

The 'brain training' neurofeedback has a good history. LENS has a controversial history. Since it has been ruled 'exempt' by FDA standards as per the application from Len Ochs, it is not held to the reporting of adverse events an fully studied and FDA approved modality is subject to.

So, it would benefit the PCS/mTBI community if brain training neurofeedback was not combined with the passive neurotherapies such as FNS/LENS.

The risk of adverse events from brain training is very low to non-existent where the frequency and risk of adverse events from passive neurotherapy not reported except in anecdotal comments. Some of those adverse events have been severe, such a seizures, etc.

As I read Mary Esty's web site, I am appalled at the double speak.

She promotes FNS and its later version, LENS for treatment of TBI with the statement: "An NIH-funded study of neurofeedback treatment for mild/moderate brain injury appears in the June 2001 issue of the Journal of Head Trauma Rehabilitation. "

The abstract of that articles follows:
<Objective: To conduct a preliminary experimental evaluation of the potential efficacy of Flexyx Neurotherapy System (FNS), an innovative electroencephalography (EEG)-based therapy used clinically in the treatment of traumatic brain injury (TBI).

Participants: Twelve people aged 21 to 53 who had experienced mild to moderately severe closed head injury at least 12 months previously and who reported substantial cognitive difficulties after injury, which interfered with their functioning.

Design: Participants were randomly assigned to an immediate treatment group or a wait-list control group and received 25 sessions of FNS treatment. They were assessed at pretreatment, posttreatment, and follow-up with standardized neuropsychological and mood measures.

Results: Comparison of the two groups on outcome measures indicated improvement after treatment for participants' reports of depression, fatigue, and other problematic symptoms, as well as for some measures of cognitive functioning. Most participants experienced meaningful improvement in occupational and social functioning.

Conclusion: On the basis of these results, FNS appears to be a promising new therapy for TBI and merits more extensive evaluation.>

Oddly enough, the "more extensive evaluation" has never been done on either the FNS system nor the newer LENS system.

I am for the most part, impressed with the web site information provided by The Neurofeedback Center of Virginia. They properly present the modalities they offer. Unfortunately, they repeat the errors of LENS and ROSHI but it appears they do not use these controversial systems. They do properly limit the use of ROSHI as a relaxation enhancing treatment only. They do not mention the same limitations of the LENS system.

I think you best chances for improvement will come from the latter clinic.

pcs, when you combine alcohol and Xanax in the same sentence <When I ....have a glass or two wine, when I am on Xanax etc., I tend to ignore my symptoms.> I was concerned. Glad to hear you are off the Xanax.

My best to you.

[pcslife]

nwsmith1984 : Thanks for the update and please keep us posted. I almost felt the same effect like you when I tried Elavil. Slept a lot and couldn't got out of bed. But later on my body got used but didn't see much benefit for my symptoms. I was on Elavil for a long time but only 10 mg. It greatly helped for my Irritable Bowel Syndrome symptoms though. I sincerely hope this med works out for you since we all know how difficult to find the right medicine and right dosage.

Mike : Thanks very much for the detailed analysis and explaination. That is great you recomended the second place because that is where I was planning but was not really sure. Now I decided to go give it a try in the next few months. I have been on Vision Therapy (once a week) and this is my 7 th month. Can't really say it helped so I may have to stop and try Neurofeedback again.

[Mark in Idaho]

pcslife,

You ought to add somethings to your B6, B12 and such. Vitamin E and D are also needed plus Omega 3's. The compromised brain needs 4 to 10 times the RDA of many B's and 4 times RDA of the anti-oxidants.

Have you had any analysis of your upper back, C-6 to T-4? They can cause gastric upset when inflammed. I have a periodic paralytic ileum. It leaves me with a slow bowel/IBS. Hormones also can effect the bowel's function, especially in women.

My best to you.

[pcslife]

Thanks again Mark. I forgot to mention about Vitamin D which I have been consistently taking for past 6 months. I add Vitamin E too but when I tried Omega 3s my stomach upset so much I have to quit taking it.

I have mild degenerative disc disease at C3-C4 based on MRI. Going to see a Neurosurgeon this week and will ask him about upper back too since sitting is very uncomfortable for me and standing is ok.

Thanks again.

[Eowyn]

PCSLife,

What kind of Omegas did you try? If fish oil upsets your stomach, you could try Algal DHA. It is derived directly from the algae the fish get it from. Might be easier to digest?

I haven't had a lot of luck finding it in stores, but if you do a Google search for "vegan DHA" or "algal DHA," there are several Internet shops that sell it, including Amazon.