Discussions By Condition: I cannot get a diagnosis.

mysterious decrease in cognition, please help

Posted In: I cannot get a diagnosis. 0 Replies
  • Posted By: johnson
  • April 29, 2008
  • 05:16 PM

I have had a cognitive decline and a thinking impairment for more than a year now after smoking marijuana. I smoked it a year and a month ago. It was the fourth time I smoked marijuana and had gotten no effect except an increase in appetite, which is normal, until the time when I noticed a decrease in cognition. Upon smoking it I noticed a very strong dizziness and frames coming down, which is typical of when the pharmacology takes effect, I also however experienced a severe problem with comprehension. The dizziness and problem with comprehension lasted for more than 24 hours. The dizziness then went away, but I remained with a thinking impairment. I also had gone off prozac 4 months prior to this incidient and had noticed a 'fuzziness' of mind and comprehension but mild in comparison to the thinking problems I had after taking marijuana for the fifth time. I took risperdal after the event to make sure any psychosis triggered by pot would be in check.
The first symptom I noticed is that I couldn't read. I would lose the meaning and was unable to comprehend because I could not tie things together. For example, I could undersand perhaps a sentence, but a paragraph with its interconnections was beyond me. Nowadays, I can read more, but I have trouble recalling events unless specifically prompted and still have problems with comprehension. However, now, I have trouble with subtle interconnections. For example, in a novel, one statement may imply something about another. However, if I don't read it carefully and put a lot of effort in attention, I will miss this connection and simply take them as two seperate statements.
Upong taking neuropsych testing, grave deficits were noted in attention, planning, working memory and others. Mainly I had deficits in what is known as 'metacognition.'
Other symptoms include lack of appetite (I can go on for days without eating and feel fine), a disturbance of sleep (I feel half awake/ half asleep and a zombie during the day, not a stupor, but close to it), lack of need for sleep; I can stay up and not feel tired or lethargy. In my sleep, I notice that I am sometimes awake, but there are no thoughts in my my head so it seems like sleep. I have trouble with arousal, attention, etc.
This was confirmed with neuropsych testing. I have also taken blood tests, which were revealed to be normal, and have taken MRI and PET scans which show my brain to be normal. The neuropsychologist that tested me said I displayed symptoms of ADD but he didn't think I had it; I had not displayed any ADD signs in my childhood. I am currently 21 years of age. The neurospych testing was objectively determined to be a decline based on my performance on the SAT's. The decline was not a simple thing of percentiles, I had clear deficits in attention and metacognition that could not be explained away.
I have had this thinking impairment for a year and 2 months now and I am slowly grasping the fact that I may have to live with this for the rest of my life. I would GREATLY appreciate any help, I would be infinitely in gratitude and would be the happiest person in the world if this were resolved.
This has caused me great distress and sadness due to the fact that I may have to live like this. None of the creativity or thoughts that made me me are there anymore. I have severe lapses in comprehension.
I got an idea from ADD that it could be something wrong with my Reticular activating system. Especially with all the symptoms of disturbed sleep and loss of appetite. In theory, ADD is caused by a disturbance in norepinephrine in the RAS. And that thinking impairments and memory problems, as well as disturbances in conciousness have all been associated with dysfunction in this system.
I have taken risperdal .5-3.5 mg during this time period with slight changes, which could be slight improvements, but nothing that could ammount to a tantamount breakthrough. I have also taken well-butrin, but ceazed to take it after experiencing shaking. I have also experienced fast heartrate and confusion on risperdal. Another interesting tid-bit: after the marijuana incident, I re-took prozac after going off it 4 months prior....3 weeks in, I had a day where I was almost normal, but then I had a strong depressive emotion and it brought me back into the thinking impairment. I went back on prozac a couple months after that incident at 20mg-40mg with none of the same effects, perhaps I had grown tolerant and needed more toget the same pharmacological reaction. However, I never went beyond 40mg,and am currently thinking of going back on it on 80mg. Currently I am on risperdal 1.5 mg because my psychiatrist says it helps in increasing cognition and clearing the mind. However, the study that that logic is based on was done on skitsophrenics, and that has been ruled out in my case according the criteria in the DSM-V. So maybe it doesn't increase cognition, I don't know.
I don't know what it is, but I would be immensely in your debt if you helped me on this one. I have had ideas ranging from the RAS to it being a pharmacological reaction that needs balancing. Furthermore, is there brain damage that is not detectable by pet or MRI scan? I do not understand my situation and have not gotten a diagnosis. I would tremendously appreciate any help with this. If you fix it, you get my money, lol. In all seriousness, I would be the happiest person on Earth and I would be in your debt. But it will be ok if I cannot think well for the rest of my life, I will try to make the best of it.
However, please tell me if you have had a similar experience and what this could be. Thanks again.

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