Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 03-27-2013, 09:43 AM #1
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Default NP recommending medication now

My neuro psychologist is recommending I start taking effexor to help with my anxiety/panic attacks and possible depression. I have been trying to increase time spent out of my house and have been very unsuccessful due to my brain "shutting down" from being overloaded. She said this is an anxiety response and the emotional center of my brain is stronger than the thinking part and is overwhelming it.

I'm probably not explaining this well! Anyhow, she says I need to calm the emotional response in order to allow the thinking part to heal and get stronger so that it will not be overwhelmed anymore. If I keep letting the emotional center react then it will get stronger and stronger (from being used) and the thinking part will keep shutting down and not get better.

I don't like medication. I don't want to take it but I feel she's right and I have no choice here. She says that once the brain heals I might be able to stop taking the medication again. Has anyone here recovered and been able to go off their medication? Any opinions about effexor? I'm going to do some searches but thought I'd put the question out to you guys.

She also recommends I get a very small prescription (10 pills) for Ativan for times when I know I will be overloading my brain and this way I can shut off the emotional center so it does not get stronger and I can get through whatever it is I have to do. I know benzos are not recommended but this sounds like a great way to get through something we have to do and absolutely can't avoid that will be too much for us.

I have very low tolerance to medications. When I was experimenting with drugs to try to cure my fibromyalgia I had a lot of bad reactions to anti-depressants and this is scaring me but I don't feel I have any choice to get better.

Any thoughts appreciated! I hope you are all having a good day.

CC
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I'm a 39 year old, female, accountant. On July 2, 2012 I crashed my bike at the end of a 65KM road ride. I was fine that day but woke up the next morning to my current world.

Ongoing symptoms include: dizziness, blurred vision, light and noise sensitivities, cognitive problems, uncontrollable emotions/depression/anxiety, headaches (but they're getting better), mental and physical fatigue, difficulty communicating and sleep disturbances.

Currently seeing a fabulous Neuro Psychologist and vestibular physiotherapist and hoping to soon see a neuro ophthalmologist. I am currently doing 20 minute stationary bike rides daily, 20 minutes of meditating, 15 minutes of Lumosity and lots of resting. I have not been able to work or drive since the accident.

The things that have helped me the most since the accident are vestibular therapy, gel eye drops (for blurred vision, sensitivity and dryness), amitriptyline (10mg), and meditating. I am finally starting to see some slight improvements and am hopeful!

My brain WANTS to heal itself... I just have to let it and stop trying to get better!
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Old 03-27-2013, 10:17 AM #2
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Cyclecrash,

If its any help I was also uncertain about taking medication, I have only been on Cymbalta for a few weeks and it has helped with both the emotional side and the pain, and now I am going back to work. I know little about antidepressants, so can only comment on Cymbalta, which helped me straight away. From what I have been told the psychological side influences the physiological symptoms of PCS, so if you can get the emotional side calmer hopefully your symptoms will reduce in turn, as one feeds into the other and vice versa. Best of luck!


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Originally Posted by cyclecrash View Post
My neuro psychologist is recommending I start taking effexor to help with my anxiety/panic attacks and possible depression. I have been trying to increase time spent out of my house and have been very unsuccessful due to my brain "shutting down" from being overloaded. She said this is an anxiety response and the emotional center of my brain is stronger than the thinking part and is overwhelming it.

I'm probably not explaining this well! Anyhow, she says I need to calm the emotional response in order to allow the thinking part to heal and get stronger so that it will not be overwhelmed anymore. If I keep letting the emotional center react then it will get stronger and stronger (from being used) and the thinking part will keep shutting down and not get better.

I don't like medication. I don't want to take it but I feel she's right and I have no choice here. She says that once the brain heals I might be able to stop taking the medication again. Has anyone here recovered and been able to go off their medication? Any opinions about effexor? I'm going to do some searches but thought I'd put the question out to you guys.

She also recommends I get a very small prescription (10 pills) for Ativan for times when I know I will be overloading my brain and this way I can shut off the emotional center so it does not get stronger and I can get through whatever it is I have to do. I know benzos are not recommended but this sounds like a great way to get through something we have to do and absolutely can't avoid that will be too much for us.

I have very low tolerance to medications. When I was experimenting with drugs to try to cure my fibromyalgia I had a lot of bad reactions to anti-depressants and this is scaring me but I don't feel I have any choice to get better.

Any thoughts appreciated! I hope you are all having a good day.

CC
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Old 03-27-2013, 10:17 AM #3
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Sounds like odd advice, in a way. The brain is overloaded and that is why one feels overwhelmed.

If you (or the NP) has not seen this, it helps to explain a bit what happens. I don't have anxiety ....but I do hate not being able to function because of a physical reaction in my brain!
http://www.brainlinemilitary.org/con...y_pageall.html

Would love a drug that makes it all better! Let us know!
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 03-27-2013, 10:21 AM #4
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Hi C.C,
Your post was helpful to me. That is what happens to me also. I try and leave the house and get shut down by symptoms. The way you explained it makes perfect sense. I try to force myself to tolerate it and that ends up worse. I think the Ativan will help a lot. I know many people that need this help with sudden anxiety and this medication is very effective. I have also tried a lot of anti depressants for my chronic pain and had very bad reactions. I know how you feel about being scared to try the medication. If I was to try out any other medication at this point it would be Effexor. I have heard a lot of people say that this medication really helped them. I think it is a little different then most the anti-depressants. I think it is more for anxiety but has anti depressant qualities. You just get to the point after so long that you have to try medication you know? Anything that helps us to live a more normal life is good. I don't think anyone is stuck on any kind of medication ever. You have to know how to come off the medication the right way by cutting down gradually and stepping off slowly. The problems happen when people try to abruptly discontinue the medication.
I hope that these medications help you. As always I am pulling for you.
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Had MVA in 2006 resulting in post concussive syndrome manifested by cognitive impairment, chronic pain/ fatigue. Chronic pain of head, neck, back, left leg.
Other problems include REM sleep behavior disorder, nocturnal frontal lobe epilepsy, chronic migraines associated with nausea/vertigo, episodes of passing out, hypoglycemia, liver dysfunction (had accidental overdose of acetaminophen in 2009) had liver and kidney failure, hernia, degenerative disc disease with compression of nerve root, PTSD, and other problems associated with functioning problems from traumatic brain injury (light, sound sensitive, easily overloaded, easily distracted, cannot focus, anxiety problems etc.)
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Old 03-27-2013, 10:34 AM #5
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Thanks everyone for the advice and well wishes.

Interesting article Mokey. I'm going to go back and read it some more. I just wanted to mention that she is saying it is definitely a physical response caused by the overloading creating an anxiety response which pulls all the blood away from the brain to allow a fight or flight. When the blood is pulled away the confusion sets in and the brain "shuts down".

One answer would be to avoid all situations that cause this.. and believe me I'm trying but EVERY attempt to leave the house or try something new is causing this reaction and it's getting stronger and stronger. We need to retrain the brain that these are not Scary things I'm doing and that it does not require a flight/fight response. Kind of like Vestibular therapy training where you're teaching your body that it does not need to be dizzy in this situation.

I have also been having more moodiness to the point my husband has said he's had enough and talked about leaving. Something needs to be done. I can't seem to move forward on my own. I'm doing meditation, what little exercise I can on the stationary bike, and using cognitive therapy techniques but it's just not enough.

I think if I didn't have the eye problems and dizziness I would be able to exercise more and wouldn't have as much overstimulation and dizziness. Hopefully when those are all better I can come off the medication again.

Thanks again for all the support. You guys are my biggest support and I don't know what I would do without you all!

CC
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I'm a 39 year old, female, accountant. On July 2, 2012 I crashed my bike at the end of a 65KM road ride. I was fine that day but woke up the next morning to my current world.

Ongoing symptoms include: dizziness, blurred vision, light and noise sensitivities, cognitive problems, uncontrollable emotions/depression/anxiety, headaches (but they're getting better), mental and physical fatigue, difficulty communicating and sleep disturbances.

Currently seeing a fabulous Neuro Psychologist and vestibular physiotherapist and hoping to soon see a neuro ophthalmologist. I am currently doing 20 minute stationary bike rides daily, 20 minutes of meditating, 15 minutes of Lumosity and lots of resting. I have not been able to work or drive since the accident.

The things that have helped me the most since the accident are vestibular therapy, gel eye drops (for blurred vision, sensitivity and dryness), amitriptyline (10mg), and meditating. I am finally starting to see some slight improvements and am hopeful!

My brain WANTS to heal itself... I just have to let it and stop trying to get better!
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Old 03-27-2013, 12:21 PM #6
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The post from the Military site is optimistic.

The reserve portion of the pie is very optimistic, actually - I would guesstimate the it is more realistic that any of our reserves is more likely 2/3's less than they portray.....especially you mom's out there.

That would then be more to the degree they are saying "Your energy reserves at this point are almost nonexistent. "

But it is a good article.

Biggest problem for any of us I have found, is getting family members to actually read what is being said, getting past the first few phrases and seeing the whole.

I have gotten to the point that they can believe me or not......I am me now, and this is what they have to deal with, and I am working forward from here as best I can.

I gave them their life as they have gotten used to, and now they will deal with my new me, while I adjust to my new me, and I will give all the fight I can to return to as much new me as I can as, close to my old normal as possible.

Anxiety, Depression, Loss of whatever I lose, Lapses or not, Shrieks in the ears, Insomnia or whatever..........I will move on.

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Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
Medication update: Topamax 200mg twice daily it seems to minimize daily headaches to a 1-2/10 quality(I still know they are there); and acute headaches erupt without warnings.
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Old 03-27-2013, 01:08 PM #7
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Well said Concussion. So glad you are back. That is right. We are trying to adjust to our new selves and they can deal with it or hit the road. I am through with trying to make them understand. They can either read the information and try to understand or think whatever they want. I don't have the energy to worry about them anymore.
So sorry you are going through this in your relationship C.C.
We have it hard enough without all this pressure from family members. Don't they think we are trying as hard as we can?
I am grateful for all of you. I would have no support if not for you guys.
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Had MVA in 2006 resulting in post concussive syndrome manifested by cognitive impairment, chronic pain/ fatigue. Chronic pain of head, neck, back, left leg.
Other problems include REM sleep behavior disorder, nocturnal frontal lobe epilepsy, chronic migraines associated with nausea/vertigo, episodes of passing out, hypoglycemia, liver dysfunction (had accidental overdose of acetaminophen in 2009) had liver and kidney failure, hernia, degenerative disc disease with compression of nerve root, PTSD, and other problems associated with functioning problems from traumatic brain injury (light, sound sensitive, easily overloaded, easily distracted, cannot focus, anxiety problems etc.)
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Old 03-27-2013, 04:07 PM #8
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Hi CC,

Very sorry to hear of continued struggles and particularly the stress of ultimatums from your partner who is clearly going through immense stress as well. Feeds a cycle of emotion in itself!

I have no experience with Effexor but I've been on antidepressants before in my life, for post partum and again after my divorce. I successfully weaned off each time as well without significant problems. I believe that sometimes we need chemical assistance when our tissues no longer produce the chemicals we need to cope. That's how I explain it to myself. It's no different than if I had a damaged thyroid I'd need synthetic thyroid medication... My brain isn't performing as it should so I may benefit from chemical help.

Not sure any of that makes sense, I'm pretty dim today but I'm trying.

The logic and reasoning given to you for trying this, seems a bit weird to me but maybe I just don't understand. In the end all that matters is how you feel, and if you're ready to try some medication to move forward. It doesn't seem like status quo is an attractive option, what with anxiety and relationship stresses making things worse.

Thinking of you and wishing you peace in your heart with whatever path you choose.
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About it: October 26, 2012 I fell backward on an icy parking lot at work. I was on Workers Comp for 9 months. My PCS : everyday headaches became once in a while headaches, and neck pain became manageable. Still have occasional mild dizziness, sometimes fullness in the ears, convergence insufficiency, sequencing struggles, short term memory struggles, verbal processing delays. CT neg, MRI neg. Therapies: prism glasses, acupuncture, icing neck, resting, supplementing, Elavil 20mg at bedtime.

NEW: Completed 12 weeks of physical therapy and returned to work full time.

About me: I'm a marketing manager, a mom with a blended family and wife to a heart attack survivor. I believe my brain injury taught me more than it cost me. I'm grateful to still be me!
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Old 03-27-2013, 04:36 PM #9
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A bit about Effexor, and all those drugs.

They are needed when they are needed.

Mark has reached his decided end-point and has decided to wean off.

A key about Weaning/Withdrawing from any of those medications is to do it with control - he has chosen his method - with much fore-thought; others with Paxil have taken a much slower withdrawal plan, but to each their own - as long as it works without the withdrawal syndrome raising its ugly head.

1. Effexor is slow to reach its working dosage in many, and takes time to have noticeable effect in many; in some its fairly quick, in others its weeks; don't give up , be patient as long as you are not having ill effects.

2. Effexor is a decent drug in those for whom it works, once its effect is showing effect.

3. Again, if/when you are ready to stop it, do not do so suddenly - withdrawal syndrome is not nice; unless its an emergency and done with your physician's help to cover the ill effects from the syndrome effects - have him aware you demand his attention at all times, at the ready.

4. Do not let them substitute the new drug, Pristiq, in its place - it is the drug company's (same company that makes Effexor), replacement since Effexor is ready for the generic market - Effexor can have dosage increases with increase effects noted if / when necessary; however that has not been the case with Pristiq in any study to date. (Note: what I mean is- sometimes when you are on a drug awhile, the current dose seems not to do what it use to do, so your doc increases the dose a bit for more effect, and it works again; well with Pristiq, the studies haven't shown that to occur with it.

Hope any of this is helpful.

Best Wishes.

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Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
Medication update: Topamax 200mg twice daily it seems to minimize daily headaches to a 1-2/10 quality(I still know they are there); and acute headaches erupt without warnings.
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Old 03-27-2013, 07:42 PM #10
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Default I haven't read all the posts

Because my eyes are bugging me, so forgive me if this has already been said, but i wanted to makes sure you know that you should never stop taking Effexor cold turkey. You need to be weaned off of it under a Drs. supervision. I took Effexor for depression many years ago before I ever had a concussion. It didn't work out for me, but the way these drugs are, it's different for everyone. Even when I was weaned off, I had some pretty bad symptoms. Apparently if you go cold turkey it'll make you sick. Don't let that stop you from trying it. I have taken antidepressants off and on for my entire adult life. Sometimes they can be really helpful. Just because one doesn't work for you doesn't mean another one won't help you!
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I have recovered my cognitive function, and I've overcome severe vertigo through sensory integration therapy. Wellbutrin has helped me escape depression. I have recently had a few stress-related migraines, as well as headaches stemming from eye strain. I'm also dealing with tinnitus, lack of stamina, extreme light sensitivity, and eye pain. Diagnosed with 9 different vision issues: convergence insufficiency, pursuit eye movement deficit, egocentric visual midline shift, photophobia, visual information processing delays, accommodative insufficiency, saccadic eye movement deficit, lack of coordination, and central peripheral visual integration deficit.

*First concussion: October 2010. I was pregnant and got rear ended. I associated my mild PCS symptoms with baby brain and blamed my light sensitivity on allergies and dry eyes.
*Second concussion: December 2011. I hit my head on a wooden beam, saw stars but did not lose consciousness, and I had very disturbing PCS symptoms but didn't go to the doctor.
*Third concussion: August 2012. I caused a car accident as a result of PCS symptoms. Thankfully no one was injured but me. My husband confronted me, and I finally sought help and took medical leave from work. My symptoms worsened, and I developed severe vertigo.
*Fourth concussion: November 2012. I was riding in a car with a friend and we were hit head on by a driver who lost control of her car. I didn't have a big increase in PCS symptoms.
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