Hello all,

I have some questions regarding antidepressants and stimulants and Post Concussion Syndrome.

First off, I'm 22 and prior to my concussion I had been on a poly-pharmaceutical regime for treatment of depression including; aropax,edronax,mirtazipine and Xanax. I had spent the earlier portion of this year withdrawing from these medications and working with a psychiatrist who engaged in talk therapies to get to the root of my issues.

Fast forward to September 27th and I unfortunately slip in my kitchen and have myself a concussion. The following weeks were filled with an onset of insomnia, panic attacks, symptoms of intense anxiety, mood swings and complex cognitive issues. I have seen several doctors and a functional neurologist who have started me on excercises and nutritional supplements, however I am taking a sedating antidepressant Mirtazipine. The current attitude of my Neurologist is to wait until the 6 month mark before judging whether or not a medication intervention is necessary.

Before the incident I was curious about starting a MAOI called Parnate with a dose of Ritalin (prescribed by a Psychiatrist). At the time I dismissed the new prescription as I wished to withdraw from medications completely. Now I am post incident and my attitude towards medications have changed. Had I not had the incident I believe I may have started the regime.

My question is this; what would the effects of these medications have on my brain in its Post Concussion Syndrome state? Should I avoid these medications or simply wait until my brain has had sufficient time to heal before considering starting them?

Any and all informative comments would be appreciated.

PCS+MDD,

Welcome to NeuroTalk.

Wow, you've been quite the pharmaceutical Guinea pig. You said you have tried nutritional supplements. What supplements have you tried ? Have you tried L-Tryptophan or 5-HTP or L-Theanine ? Have you read the Vitamins and Supplements sticky at the top ? I updated the Nov 8 post no. 101.

What are you doing to facilitate healing ?

What are all of the symptoms you are still experiencing ?

Hi Mark,

Supplement wise I am taking 5HTP, GABA, Fish oil, Curcumin Active, Vitamin C, Vitamin B complex, Vitamin A, Vitamin D and a Multivitamin.

I am also an avid drinker of Vegetable shakes and protein shakes.

In facilitating healing I have been given a range of excercises by my funtional neurologist, eye excercises, breathing excercises and gagging excercises. I also rested for a period of 2 weeks (no stimulation) and have only been engaging in light excercises.

Unfortunately , post incident I pulled a Chris Nowinsky, in that I went straight back to the gym and performed my heavy weightlifting.

Symptoms wise I am still suffering with;

Cognitive issues, Memory issues (terrible short term memory, difficulty accessing long term memories),
Personality Changes, Mood Swings (Previously I was cool, calm and collected regardless of scenario)
Difficulty talking/socializing/finding words ( I used to be outgoing, I know find it difficult to speak with my own family),
Fatigue/muscle weakness (also due to lack of exercises),
Anxiety! Constant anxiety, I have experienced anxiety in the past but these are intense symptoms, racing thoughts, random songs, noise sensitivity.
Im having great difficulty reaching deep levels of inner thought, prior to the incident I was engaging in deeper more profound thoughts, but now I find it difficult to put my mind on anything.
I constantly 'blank' out and have long periods of absence of thought.
I also find myself constantly licking my bottom teeth.

My sleep is non-refreshing, and if I didn't have the mirtazipine I would not be sleeping.

My Neuro told me that recovery will take a minimum of 6 months and advised my to engage in psychotherapy to help with the anxiety, (of course, recovery period is always a question mark) but although the symptoms I suffer with can be managed, Im still finding it difficult to deal with them.

Unless your vitamin B complex is a B-50 Complex or B-100 Complex, it is likely just better than worthless. Most B Complex vitamins provide very low dosages of B vitamins, usually based on the DA or RDA values. I would recommend a B-50 Complex plus B-12 in methycobalamin form (1000 to 2500 mcgs are common)

How much 5-HTP are you taking ?

The protein shake may be problematic if it is designed for weight lifters. Protein in high doses can be stressful on the system, especially with some of the common additives used by weight lifters.

Are your neuro and functional neuro both MD's ? Or a chiro trained by Carrick ?

The 6 month recovery time has no basis in medical research. Your recovery will take as long as it takes. Nobody can give you a prognosis.

I suggest you ask your doc for an 'as needed' script for an anxiety med to take the edge off the extremes. You should not be taking 5-HTP and mirtazipine at the same time. Do you take mirtazipine every day or evening before going to bed ?

If you are taking the mirtazipine, what medication intervention was your neuro suggesting ?

You critical need is your anxiety. Often, you need to get it reduced to allow the brain to try to heal. Your anxiety sounds very much like PCS induced anxiety. The injured brain loses the ability to shut out stimulation and leaves you in a fight or flight mode. Unless you are getting stuck with worry about your symptoms and risk of injury, I wonder if talk therapy will help much in the short term.

What do you do each day ? Job, school, family ? btw, Are you male or female ? I'm thinking male due to the weight lifting but ????

My best to you.

Hi Mark,

Thanks for getting back to me so soon, Ive been frequenting the forums since the injury and am very glad that you have responded!

The Mega-B Vitamin that I'm taking sounds like its just better than worthless, I will look into getting a B-50 complex and B-12 supplement tomorrow. I was taking roughly 100mgs a day, however I have ceased the 5 Htp for now as I rely on the mirtazipine for sleep (which I take in the evening).

The protein Im taking is a protein blend with BCAA's added. however I usually only take a 100% Whey protein by Bulknutrients and will be doing so again when my order arrives.

As for the anxiety medications, the only medications I'm aware of for an as needed basis are benzodiazepines, which I am avoiding due to my past history with them ( I was frequenting the benzo w/d's forums and mad in america.com before suffering this injury), so unless there is anything else which you could suggest I'm not sure what I could take unless I begin another psych med.

One of my neuro's is a MD ( A professor at one of the universities actually) and the other is a Chiro trained by Carrick. The neuro's opinion of the chiro was simply that the excercises 'may' help. Of course the chiro has told me that hes worked with cases similar to mine and believes he will have me back in shape within 6 months.

I understand that my body will take as long as it needs to heal and that I just need to do what I can for it.

Regarding therapy I dont think it will help much either, as Im not suffering with relative or thought-induced anxiety, but more of a symptomatic anxiety.

As for what I do, currently nothing at all aside from trying to heal! I had a couple of options life-wise that I was'going' to do, but am now unsure due to the difficulties caused by my symptoms. I was going to enrol in study for 2015 ( a uni preparatory program) or head back to the mines as an Emergency Response Team member (which is fairly stress free) however as previously mentioned, I am somewhat at a loss for both. My Chiro believes I should enrol in studying and do what I can, as there are methods of studying for those with a brain injury that would allow me to do what I can.

Family wise, I live with my mother who was a GP before falling ill with Bipolar/Major Depression (I believe her story if more of one of iatrogenic illness but thats another conversation entirely).

Finally, yes I am male.