Meds that have worked for me
 

I'm just over a year post injury. Mostly I'm still dealing with some fatigue, some residual brain fog, and some ongoing visual issues (no longer much of an issue for day-to-day life, except for the fact that I still can't drive all that much).

I've been on a cocktail of meds the past while that has been making me feel better, so in case it's helpful for anyone, I thought I'd share what's worked for me. And of course, the usual disclaimers apply -- everyone's different, and every injury's different, so consult your doctor.

Zoloft: This has had a big impact in reducing my stress/anxiety related to my condition.

By way of context, I've generally been a low-stress type of person. Pre injury, co-workers would remark on how calm, cool and collected I was in the face of tight deadlines and stressful situations. Post injury, I didn't think I felt stressed out per se, but I certainly had some anxiety about my symptoms and how much of a recovery I would ultimately experience.

Once the zoloft kicked in, I realized that I had been more stressed about my injury than I'd thought. I now feel pretty chill and relaxed most of the time. Maybe a little too chill, but that's probably not a bad thing while I'm still recovering.

Lyrica: My doctor recommended Lyrica, as it helps promote deep sleep, as I believe there's some evidence that it's neuro protective (there's a study that mice who experienced a concussion while on lyrica had significantly fewer symptoms than the control group), and for my headaches and neck pain.

I'm taking a very low dose, 25 mg at night. I do feel like it makes me a little bit sedated, so I'm reluctant to go to a higher dosage. But even with just 25 mg, I've noticed quite a significant improvement in my head and neck pain.

Methylphenidate: As I mentioned, fatigue has been a key issue for me. It's felt like I've had a 24-7 flu ever since my injury. I know there's some controversy regarding the use of stimulants vs. letting your brain rest and heal. My own view on this is that so much healing happens during the first 6-12 months that's it's probably best to avoid stimulants during that time, if possible. But at 12 months post injury, I also have to deal with the harsh realities of trying to hold onto my job and paycheck.

I believe modafinil/provigil is considered to be the "cleanest" of the stimulants, but it didn't work well for me. I'd feel fantastic for a day or two, but after that, it would lose its efficacy and I would get weird symptoms, like tunnel vision and feeling spacey. I also tried Wellbutrin, but that ramped up my anxiety, and after a month or so I also started experiencing some weird symptoms. I've wanted to avoid adderall/vyvanse as I believe there are potentially some adverse consequences associated with long-term use.

So that brings us to methylphenidate, which I'm taking in the form of concerta. I'm on the minimum dose, at 18mg. From a cognitive and energy perspective, it makes me feel almost back to pre-injury levels, so it's been quite a dramatic improvement. It doesn't make me feel wired, just more normal.

The only drawbacks are that it does reduce my sleep quality by a bit, and I've found that I can't take it 7 days a week, because I eventually start to feel like I'm burning out. But something like 3-4 days on / 2 days off seems to be working for me. I obviously feel quite a bit more lethargic on the 2 days off, but it's tolerable. Overall, I feel like this has hugely increased my ability to stay employed. It's not recommended for people with high blood pressure, but thankfully I don't have that issue.