Best meds for impulse control?
 

Hi Gang,

As many of you know, my accident did major damage to my frontal lobe. Consequently, my impulse control is poor. I am desperate to get better control of my temper before I psychologically damage my child and/or destroy my marriage.

I am doing anger management, etc., but I think I need drugs, too. What would anybody suggest. Please keep in mind that I'm convinced (by legitimate studies)that SSRIs are bad for brain injury patients.

Thanks so much for your help.

Hey Hockey,

I just got interested and did a little online research. I'm going to pass along the links, but I'm not sure about them. I'll continue looking and maybe we can share what we find.

http://www.anxiety-and-depression-so...m/main/CAM.php

http://www.theclarocetstore.com/

http://www.tbirecoverycenter.org/frontallobe.htm

http://www.drugawareness.org/alternatives

I went through a little at a time, take your time to sift through. I don't know what you've tried, but I'd be interested to know.

I'm having more difficulty falling asleep and staying asleep lately. I'm also having more trouble with my daily fatigue. I think my meds are wearing off their effectiveness. I've also had a migraine for 3 days- aaarrrrrghghh!!

I take Neurontin (gabapentin) to settle my brain down. I don't know if it will help but is has very minimal side-effects and may be worth asking your doctor about. I know many who use Seroquel to stabilize the aggressive behavior that accompanies brain disorders. It is a major drug compared to Neurontin.

Since I added or started on B-2, testosterone, DHEA, fish oil and a massive dose D3 (5000 IU's), I sleep much better. I don't have the night mares and other stressful sleep symptoms.

I also have become much better an noticing the onset of the rages. I know I need to leave the situation immediately or there will be trouble. People think I am being rude, but it is a much better rude than the explosions.

Hope this helps you find a direction to pursue.

Thanks for the suggestions and research links Mark and Kate. I’m looking into all of it.

I was talking to my psychologist (who is good) about this and he said the problem is that there really aren’t any drugs that are great at controlling impulsivity without turning the patient into a zombie. Furthermore, he said that a lot of the cognitive therapy for impulsiveness doesn’t work well for PCS patients because it is based on the notion that, while there may be remorse afterward, the patient gets a rush from indulging themselves (gambling, starting fires, kleptomania, etc…). In those cases, aversion therapy can be helpful.

Of course, PCS patients don’t enjoy their outbursts. I sure as heck don’t get a “rush” from screaming at my little daughter. It just happens and it feels like an out of body experience. Like Mark, I’ve worked hard at identifying my triggers and try to get out of the situation if I feel a blow up coming. Unfortunately, that isn’t always possible and sometimes it happens so fast, I just don’t see it coming.

For me, and I bet many others, the temper/impulsiveness is the most difficult symptom of my brain injury. I’d also bet I’m not the only PCS patient who spends a lot of time wondering if my family wouldn’t be better off without me. Yet, there seems to be very little research being done on this problem.

The University of Minnesota has a research school dedicated to impulse control. While they’re doing all sorts of work on kleptomania, pyromania, gambling problems, sex addiction and substance abuse, they’re doing zip on TBI. Seriously, what’s the ratio of PCS folks to kleptomaniacs? This neglect is so frustrating.

Cheers

Hey Hockey,

Neurofeedback would be very helpful for you. Have you looked into it yet?

I would love to do neuro-feedback. My SOB neurologist laughed me out of the room when I suggested it, so there's no hope of getting any help covering it from public or private insurance. Frankly, we're flat broke and drowning in debt from my medical and legal bills. If it comes down to feeding your kid or treating yourself... SIGH

Cheers

Hockey,

Sorry to hear that about your neurologist. I went through the same experience with my old neurologist. I even tried to give him published research on it and he refused to read it. Unfortunately, some people can be very narrow minded at times...

Have you tried to find another MD who believes in neurofeedback? You would be surprised how many out there do. You might also want to contact Dr. Jonathan Walker MD out of Texas. He is a very well known neurologist and provider of neurofeedback. He may be able to find a doctor in your area that prescribes neurofeedback. I'll also check with the yahoo groups and forums I belong to.

You may also want to contact a neurofeedback clinician and tell them your story. You never know, he/she may be willing to do the neurofeedback on a sliding scale basis based on your ability to pay. Just a thought...

Hi, Hockey - I try to not say anything as I have learnt that I don't have a lot of control over what I say once I start - so I just don't start. Though I must admit that I don't practice that enough with my poor husband! I think that he knows that my brain is behind most of the tactless things that come out of it!

Unfortunately it also means that when I should really speak up I don't.

Sometimes I also take the approach that I am going to chose not to waste my energy on this by saying whatever! Hope you know what I mean. When my children were little and somebody had said or done something to upset them and they cried I remember saying to them that it was a waste of energy and tears crying about whatever it was and they would smile and agree.

Hope this helps - also children are a lot more understanding that you give them credit for - and alot more forgiving that adults are!

Lynlee

By the way - most of us posting on here have more understanding through our own research than the specialisst that we see - some of them are down right dangerous and have no idea of the damage they can cause due to their lack of knowledge.