Significant Decline in Cognitive Function Post-Psychiatric Hospitalization
Greetings. I'll get straight to the point: I am living with several mental health challenges, which I've detailed below. At 26 years of age and assigned male at birth, I’ve been fortunate to avoid physical ailments or any head trauma throughout my life. I also have never used illicit substances outside of what has been prescribed to me, which means no marijuana or methamphetamines. Lately, I've been grappling with serious memory problems as well as broader cognitive difficulties, including a notable lack of concentration and frequent confusion. As a child, my memory was exceptional, but after the onset of schizophrenia in 2020, I began to experience a gradual but significant decline in my cognitive abilities. I was hospitalized twice due to my condition: once in 2021 and again in 2023. The initial hospitalization brought no noticeable improvements, but following my latest stay, I experienced a stark and concerning reduction in my cognitive capacity, which I recognized almost instantly. During my time at the psychiatric facility, a range of medications were prescribed to determine their efficacy. Unfortunately, I have forgotten many of the names of these medications, though I do recall an increase in my antipsychotic medication, risperidone, to either 4 or 5 mg taken twice daily. A critical detail from my recent experience is that prior to my admission, I had been on a benzodiazepine for anxiety for almost a year. While I can’t recall the exact name of the medication, it was certainly a benzodiazepine. Typically, the protocol for discontinuing such drugs involves a gradual tapering process. However, during my stay in the psychiatric unit, no benzodiazepines were provided, and my prescription was abruptly halted. After a couple of days without it, I felt extremely unwell; my memory seemed to vanish, my vision deteriorated, and I began to experience hallucinations in addition to the ones associated with my schizophrenia. Unfortunately, my cognitive functions have not returned to their previous state. While there was slight improvement in my memory a few weeks following my discharge, I am nowhere near the level I was at prior to my hospitalization. I often forget entire discussions shortly after they've occurred, and I frequently misplace items. To manage daily tasks, I find myself relying heavily on a note-taking application on my phone and computer, merely to remember to refill prescriptions or remind myself of conversations. I have brought these issues up several times with my psychiatrist. Since my last hospitalization in 2023, we have been working on significantly reducing my dosage of antipsychotic medication down to 0.5 mg twice daily. I have also been diagnosed with ADD and prescribed Adderall and Guanfacine to assist with my focus. Despite these adjustments, I am not seeing a significant change. While the stimulants like Adderall do seem to enhance my cognitive abilities temporarily, it still falls far short of what I experienced previously. I am sharing this in hopes of gaining a little clarity, as I feel quite lost. Are my declining cognitive skills solely attributed to schizophrenia? I understand that this disorder can lead to such issues, but the drastic change observed during my time in the psych ward is troubling. I was in a severe state of psychosis throughout that stay. Could the abrupt cessation of the benzodiazepine be the culprit? I'm uncertain. Any insights or suggestions would be greatly appreciated. Sending positive vibes to everyone. Below is a complete list of my diagnoses and the medications I am currently taking: - Schizophrenia - OCD - ADHD - Autism - Depression - Social anxiety disorder - Childhood onset fluency disorder Medications I am on: - Risperidone 0.5 mg twice a day - Adderall 5 mg twice a day - Guanfacine 1 mg twice a day - Sertraline 100 mg once a day
Answers (1)
3/19/2025, 10:50:48 AM
OpenHealth AI
Thank you for sharing your detailed experience. You're navigating a complex landscape of mental health conditions, and it's understandable to feel concerned about the significant decline in cognitive function you've noticed, especially after your recent hospitalization.
Main Points
- Cognitive decline post-hospitalization could be influenced by multiple factors, including medication changes and the impact of schizophrenia.
- Abruptly stopping benzodiazepines can lead to withdrawal symptoms, which may affect cognitive function.
- Continuous dialogue with your psychiatrist is crucial to address these concerns and adjust your treatment plan.
Explanation
Cognitive difficulties can arise from several sources. Schizophrenia itself can lead to problems with memory and concentration. Additionally, the sudden discontinuation of benzodiazepines can result in withdrawal effects, which might include confusion, memory problems, and changes in mood. This could explain the drastic cognitive changes you experienced after your hospitalization. The combination of managing medications like risperidone for schizophrenia and now adding stimulants for ADD can also complicate how you feel cognitively, as different medications have distinct effects on brain function.
Next Steps
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Communicate with Your Psychiatrist: Since you've already mentioned these symptoms, it's essential to have an open conversation about your cognitive decline. Discuss the possibility that the withdrawal from benzodiazepines might be impacting your cognitive abilities and explore the potential for a gradual reintroduction if necessary.
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Monitor Your Cognitive Function: Keeping a diary of your daily experiences with memory and focus can be helpful. Note specific instances when you struggle and any changes you notice over time. This can provide valuable insights during your discussions with your healthcare provider.
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Consider Cognitive Rehabilitation Strategies: Engage in activities that support cognitive function, such as:
- Puzzles and memory games (like Sudoku or crosswords).
- Mindfulness practices to enhance focus and reduce anxiety.
- Structured routines to help reinforce memory (e.g., consistent times for medication and tasks).
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Evaluate Medication Effects: Pay attention to how each medication affects you, and report these to your psychiatrist. It might take time to find the right balance of medications that will help you feel stable while minimizing cognitive side effects.
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Stay Organized: Use digital tools like apps or calendars effectively to manage tasks and reminders. This can help reduce the cognitive load and provide a sense of control over your daily activities.
It's important to acknowledge that recovery in cognitive function can take time, and it might require adjustments to your treatment plan. You are doing significant work by monitoring your symptoms, and seeking clarity is a positive step forward. Remember to be patient with yourself throughout this process. Sending positive thoughts your way as you navigate these challenges.
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