Steven1: Impaired cognition and memory

[Steven1]

 Hello everyone, I hope you are well.

 

I don't want to take too long with my story, but I hope you read it in full because I really need you.

 

I am a young man who loves life. I was born smart. I have emotional and social intelligence, which makes me good in my relationships with society, and my academic level in school is excellent.

 

Sorry for my simple language because English is not my mother tongue.

 

My story with antidepressants began at the age of 17. It was an experiment for 3 weeks, no more. A year later, I took Sertaline for a month and it caused me withdrawal symptoms, but at that time I did not know that this was withdrawal.

 

I took Cipram for 4 months and then stopped it suddenly. I will list the dates below:

 

Sertaline 10 mg for a month in 2019

Sertaline 10 mg for 2 months 2020

Mild Withdrawal effect when stop Sertaline and improve gradually and at that time I don't know this is withdrawal

 

Cipram 20 mg in Nov 2022 to April 2023 

April 2023 stop cipram immediately (cold turkey)

Now I have withdrawal symptoms that completely disrupt my work 

I am now studying in the Faculty of Medicine, which is a difficult faculty, and my mind does not help me. I do not have the scientific imagination as I used to, and I do not have the ability to memorize and I forget what I read quickly. My level of understanding and awareness has decreased 40% I want to consult you about is that I intend to prepare for the American equivalent exams (USMLE ), which are difficult exams and the amount of information is enormous. I am afraid that I will prepare for the exam and my mind will fail me, or that I will study well and my memory will fail me on the day of the exam 

Are there any experiences with the American equivalent exams USMLE during withdrawal? 

 There is another point I want to ask here:

 

I have studied in my life and I got tired and now I have memory gaps. I forgot simple mathematical operations because of the medications. I forgot the poetry I memorized because of the medications. I only remember a little of all the sciences I studied. The same goes for my social personality and the linguistic vocabulary that I use for public speaking and in the street. I forgot everything. I am no longer good at talking to people and I cannot be funny(before medication the most love me form first ). Many events in my life have lost  and I do not remember anything from them.

 

Is it because I am taking medications that I am losing all of this? It is my life!!! I have lost my life!! I spent a long life forming my personality, learning to speak and accumulating vocabulary. All of it was lost and vanished because of the medications. It is my life.

 

What makes matters worse is that my colleagues and people my age are becoming more mature and understanding, while I am becoming more stupid and forgetful.

 

What should I do?

 I didn't tell you how my sex life was ruined to what extent

I have been off medication for a year and five months

 

I shortened the story a lot so that everyone can read it

 

Thank you all

 

Please answer me, should I stop my academic life even though I have nothing else or should I continue with it and my memory and retention will return

 

Edited September 8 by Emonda
Name to title

[Steven1]

Idon't know is my introduction is posted or not the dealing with site is not clear to me 

[Steven1]

Hello everyone, I hope you are well.

 

 

I don't want to take too long with my story, but I hope you read it in full because I really need you.

 

 

 

I am a young man who loves life. l am 20 years .I was born smart. I have emotional and social intelligence, which makes me good in my relationships with society, and my academic level in school is excellent.

 

 

 

Sorry for my simple language because English is not my mother tongue.

 

 

 

My story with antidepressants began at the age of 17. It was an experiment for 3 weeks, no more. A year later, I took Sertaline for a month and it caused me withdrawal symptoms, but at that time I did not know that this was withdrawal.

 

 

 

I took Cipram for 4 months and then stopped it suddenly. I will list the dates below:

 

 

 

Sertaline 10 mg for a month in 2019

 

Sertaline 10 mg for 2 months 2020

 

Mild Withdrawal effect when stop Sertaline and improve gradually and at that time I don't know this is withdrawal

 

 

 

Cipram 20 mg in Nov 2022 to April 2023 

 

April 2023 stop cipram immediately (cold turkey)

 

Now I have withdrawal symptoms that completely disrupt my work 

 

I am now studying in the Faculty of Medicine, which is a difficult faculty, and my mind does not help me. I do not have the scientific imagination as I used to, and I do not have the ability to memorize and I forget what I read quickly. My level of understanding and awareness has decreased 40% I want to consult you about is that I intend to prepare for the American equivalent exams (USMLE ), which are difficult exams and the amount of information is enormous. I am afraid that I will prepare for the exam and my mind will fail me, or that I will study well and my memory will fail me on the day of the exam 

 

Are there any experiences with the American equivalent exams USMLE during withdrawal? 

 

 There is another point I want to ask here:

 

 

I have studied in my life and I got tired and now I have memory gaps. I forgot simple mathematical operations because of the medications. I forgot the poetry I memorized because of the medications. I only remember a little of all the sciences I studied. The same goes for my social personality and the linguistic vocabulary that I use for public speaking and in the street. I forgot everything. I am no longer good at talking to people and I cannot be funny(before medication the most love me form first ). Many events in my life have lost and I do not remember anything from them.

 

 

Is it because I am taking medications that I am losing all of this? It is my life!!! I have lost my life!! I spent a long life forming my personality, learning to speak and accumulating vocabulary. All of it was lost and vanished because of the medications. It is my life.

 

What makes matters worse is that my colleagues and people my age are becoming more mature and understanding, while I am becoming more stupid and forgetful.

 

 

What should I do?

 

 I didn't tell you how my sex life was ruined to what extent

 

I have been off medication for a year and five months

 

 

 

I shortened the story a lot so that everyone can read it

 

 

Thank you all

 

Please answer me, should I stop my academic life even though I have nothing else or should I continue with it and my memory and retention will return

[LotusRising]

Hi @Steven1

 

Welcome to SA,

 

On 9/8/2024 at 9:41 AM, Steven1 said:

Please answer me, should I stop my academic life even though I have nothing else or should I continue with it and my memory and retention will return

 

I can't say whether or not you should continue with your academics, but if your memory and retention is related to the abrupt discontinuations (which it could be), it should return with time.

 

Do you have any other symptoms? Have noticed a 'windows and waves' pattern to your symptoms?

[LotusRising]

@Steven1

 

I've moved your other post to your thread here. Please do not create new topics. You can post all your questions right here in your thread.

 

You'll see I commented above.

[Steven1]

On 9/10/2024 at 3:41 AM, LotusRising said:

I've moved your other post to your thread here. Please do not create new topics. You can post all your questions right here in your thread.

 

You'll see I commented above.

Thank you lotusRising i will do as you saying i am very  good luck to meet you and all survivingantidepressant members 

[Steven1]

On 9/10/2024 at 3:39 AM, LotusRising said:

can't say whether or not you should continue with your academics, but if your memory and retention is related to the abrupt discontinuations (which it could be), it should return with time

There is no doubt that what is happening to me is because of the medication. I had a high level of awareness and a strong memory before taking the medication. Now I cannot remember the events of yesterday. There are many events in my life that I do not know which came first and which came after this, in addition to the events that I have completely forgotten

I am 17 months off 

The waves come and go but I don't see very clear windows and when I drink milk or sugar I get into a state of sharp waves

[George969]

I am in the same spot and 22 months off. I did a slow taper while it seems you did cold turkey. I am just accepting the situation and doing what I can, meaning I have to leave work for a few months now. Unfortunately, you cannot predict when it will get better but it will. I feel better than a few months ago but my cognitive functions are more or less the same, with minimal improvement. Some other things have improved in the meantime. I believe I would start seeing some good improvements at 2 years and a half off as I have seen many stories going this way. 

[Franco12]

Hola, @Steven1

 

English is also my second language, so my text may fail to find quality articulation.

 

I found your story moving. The collateral damage from these drugs can be immense, overwhelming, and downright horrifying. I also have "my soul in tatters" . mi alma hecha jirones, como tendemos a decir en mí provincia - due to the administration of these medications, due to the lack of honesty or integrity - moral defect - or lack of training - epistemic deficit - of those who prescribe those medications. Those who supposedly offer their lives to help people in vulnerable conditions (in situations of anguish, illness, sleep deprivation, grief) end up becoming the greatest antagonists, and they seem unequivocally more concerned with nurturing their social status than with honestly challenging their practices. A reprehensible shame on them.

 

That said, people tend to report significant improvements over time. Fortunately, we have numerous testimonies from people who have fully recovered, or partially recovered but fully functional now in terms of  abstract thinking and forming-memory. One has to develop a steely tolerance to heroically navigate the early stages of recovery, but typically (on average) those faculties tend to reboot into spring condition with enough time,patience and hyper-hard work. Perhaps not all people recover full scale, but certainly a significant percentage does, and we never know in advance what recovery curve we will have over time. It is always better to be optimistic (and there are numerous reasons to support this propensity for optimism) and plan our days and weeks on the assumption that recovery is possible. I like user Charlie Brown's catchphrase. Recovery comes, just wait. ⭐

 

I can share some tips that helped me academically to survive despite the numerous discontinuation syndromes (caused by the reckless empty-heads that prescribed and des prescribed drugs to me). I will send a second message in the afternoon (Argentina time), I will surely have time to write quietly. Now I have to clean my home, tomorrow is my birthday!!!! After spending years in darkness and self-marginalization, merciful destiny allowed me to make new friends. And they asked me if I would invite them   !!!!! I would never have imagined, in the toughest weeks and months, that I would have people willing, much less actively interested, in attending my modest birthday celebration. 

[Steven1]

On 9/12/2024 at 11:42 AM, George969 said:

I am in the same spot and 22 months off. I did a slow taper while it seems you did cold turkey. I am just accepting the situation and doing what I can, meaning I have to leave work for a few months now. Unfortunately, you cannot predict when it will get better but it will. I feel better than a few months ago but my cognitive functions are more or less the same, with minimal improvement. Some other things have improved in the meantime. I believe I would start seeing some good improvements at 2 years and a half off as I have seen many stories going this way. 

I am also like you, my cognitive awareness has not improved significantly, but I feel a little better. I do not know if there is a specific time when the symptoms will end completely, or if they will gradually come on like this, but if it is gradual, it seems that it will take a longer time, based on the improvement we are noticing. 

Have you lost your ability to speak and can't recall words quickly? And do you type words and reverse the letters on the keyboard?

[Steven1]

10 hours ago, Franco12 said:

English is also my second language, so my text may fail to find quality articulation.

 

I found your story moving. The collateral damage from these drugs can be immense, overwhelming, and downright horrifying. I also have "my soul in tatters" . mi alma hecha jirones, como tendemos a decir en mí provincia - due to the administration of these medications, due to the lack of honesty or integrity - moral defect - or lack of training - epistemic deficit - of those who prescribe those medications. Those who supposedly offer their lives to help people in vulnerable conditions (in situations of anguish, illness, sleep deprivation, grief) end up becoming the greatest antagonists, and they seem unequivocally more concerned with nurturing their social status than with honestly challenging their practices. A reprehensible shame on them.

 

That said, people tend to report significant improvements over time. Fortunately, we have numerous testimonies from people who have fully recovered, or partially recovered but fully functional now in terms of  abstract thinking and forming-memory. One has to develop a steely tolerance to heroically navigate the early stages of recovery, but typically (on average) those faculties tend to reboot into spring condition with enough time,patience and hyper-hard work. Perhaps not all people recover full scale, but certainly a significant percentage does, and we never know in advance what recovery curve we will have over time. It is always better to be optimistic (and there are numerous reasons to support this propensity for optimism) and plan our days and weeks on the assumption that recovery is possible. I like user Charlie Brown's catchphrase. Recovery comes, just wait. ⭐

 

I can share some tips that helped me academically to survive despite the numerous discontinuation syndromes (caused by the reckless empty-heads that prescribed and des prescribed drugs to me). I will send a second message in the afternoon (Argentina time), I will surely have time to write quietly. Now I have to clean my home, tomorrow is my birthday!!!! After spending years in darkness and self-marginalization, merciful destiny allowed me to make new friends. And they asked me if I would invite them   !!!!! I would never have imagined, in the toughest weeks and months, that I would have people willing, much less actively interested, in attending my modest birthday celebration. 

First of all let me congratulate you on your new year, happy new year

as you said, everything is terrible, the destruction is terrible, the pain is terrible, everything is terrible, and everything related to medications is terrible, and doctors made us hate them more and more, with all due respect to doctors, but medications are hell and change the course of a person’s life completely. I read your record and I think you stopped months ago. You have to be patient and isolate yourself so that you do not feel compared to anyone, and I wish you a healthy recovery journey. I am happy with you all, and what do you study and how did you avoid the effect of medications on your academic problems of weak memory and cognition?

[George969]

12 hours ago, Steven1 said:

I am also like you, my cognitive awareness has not improved significantly, but I feel a little better. I do not know if there is a specific time when the symptoms will end completely, or if they will gradually come on like this, but if it is gradual, it seems that it will take a longer time, based on the improvement we are noticing. 

Have you lost your ability to speak and can't recall words quickly? And do you type words and reverse the letters on the keyboard?

Yes, I believe it might take another year to feel “normal” hence why I am taking time off work and back in my home country. 
 

I used to struggle with speaking and thinking a lot while having conversations but not anymore, I might forget what I wanted to say once every 3 months while last summer I would always forget it. 

[Steven1]

10 hours ago, George969 said:

Yes, I believe it might take another year to feel “normal” hence why I am taking time off work and back in my home country. 
 

I used to struggle with speaking and thinking a lot while having conversations but not anymore, I might forget what I wanted to say once every 3 months while last summer I would always forget it. 

I hope this passes quickly, nothing but waiting 😔 I want you to tell me that my mind will return to being smart and quick to memorize 😭😭

[Franco12]

Response to Steven, part one.

 

Hola Steven ! @Steven1

 

Thank you very much for the good birthday wishes. It was a truly splendid day. I also started this new year by multiplying my efforts, eating even cleaner, more order in training, nurturing my social ties, etcetera, etcetera. I hope to maintain the good dynamic, and a year from now I will be grateful for that self-commitment. 

 

Here are some suggestions that, modestly, helped me significantly. It is perhaps necessary to clarify one of the aspects of the discontinuation syndrome: in the most acute phase of the discontinuation syndrome, I practically could not study. Separately from the nature of my habits, the first weeks (maybe five or six weeks) of discontinuation syndrome the emotional disturbance was of such a degree that I could not in any way assimilate information. Regardless of the degree of commitment, the hours of study, the systematic application of information retention techniques, the interference was so overwhelming that I could not attend to the content of the text. If you are currently in that state, I simply entrust you to be patient, your current state of mind, or your current cognition, most likely are not representative of the state you will have in a few months or years.  I know it is enormously frustrating to wait, and one feels angry at the unfairness of medication administration, or reckless discontinuation. However, it is important to cultivate waiting. With the right tools and circumstances, we should gradually get better.

 

If you are slightly better (perhaps you are in a similar situation to me: still with a high degree of dysfunction, but better than the earlier months of discontinuation) and you have finished the acute phase of discontinuation, and you have a sufficient degree of concentration for facing academic texts, I share here some elements of great importance in my preparation.

 

1. Elimination of friction, elimination of stress. Our mind is notoriously stressed by the iatrogenic condition of discontinuation syndrome. It is essential to limit to the maximum of our capacity, even more so for academic performance, those exogenous factors that can generate stress. For example, I had a relatively conflictive relationship with my father and my brother verbally, since I was constantly irritable due to discontinuation syndrome, and they also have a volatile character. The best solution was to apply silent communication: all exchanges with my brother and father are through text. If they need to communicate with me, or I need to communicate with them, we do so through written text exchange, messaging or on paper. With this system the risk of family discussion is practically zero. By having less domestic stress, I can later be more lucid in study sessions. Making a constant examination of our surrounding environment I think is essential to study discontinuation syndrome.

2. Social media deletion: Social media is naturally addictive. They are deliberately designed to generate addiction, and for users to spend as much time as possible there. From notifications, to overwhelmingly personalized feeds, to the application icons themselves. If a person is normally susceptible to developing addiction to social media, a person with discontinuation syndrome is infinitely more vulnerable. I myself suffered from the constant flow of interruptions in study sessions due to that inner need to check something new on social media, becoming a huge distraction.

3. Elimination of any form of stimulation with adult content. Pornography can greatly impair our cognitive faculties. For more information about my process of discontinuing adult content, I may recommend my discontinuation thread. You will surely find it in my profile (I only have two entries: my presentation, plus the thread about discontinuing adult content).

[Franco12]

 

I will send the second and third part of the answer shortly. I hope the tips are helpful to you.

 

«I hope this passes quickly, nothing but waiting 😔 I want you to tell me that my mind will return to being smart and quick to memorize 😭😭»

 

Over time, cognitive disturbances due to discontinuation syndrome tend to improve significantly, but in the meantime it may be important to cultivate acceptance of our transitory situation. Do you practice any form of meditation? @Steven1

[Franco12]

PART II

 

Nutrition. Since the first episodes of discontinuation syndrome at the dawn of 2020, I was always tempted to attribute my suffering exclusively to the administration of psychotropics. And certainly, the administration or discontinuation of these medications can seriously affect how we think, reason, perceive, behave, etc. However, this condition does not give us immunity to other factors. Our condition begins in the discontinuation syndrome, but it does not end there. Other habits need to be examined. Correct nutrition, with high levels of vitamin B12, micronutrients, protein content, etc., is essential for the process of restoring our faculties, and also to avoid further stressing our body - mind.

Meditation practice. I particularly prefer to practice meditation after high intensity, 3 - 4 hour study sessions. There is evidence to suggest that deliberate relaxation after high-stress study episodes (swinging between high-intensity work and high-intensity rest) helps strengthen memory consolidation. Perhaps mindfulness training per se is beneficial for personal well-being, but in terms of learning, the most appropriate alternative is undoubtedly after study sessions. ¿Are you familiar with doctor Jon Kabat Zinn's books?

Pomodoro method: Also in relation to intermittency. I apply a specific variant, which consists of using a 25-minute interval of high-intensity study, doing five minutes of intermediate low-intensity training, another 25-minute study session, and so on. Huberman - from my perspective he is not a particularly valuable disseminator - however, he has a particular video on protocols for learning optimization that I think is well done, and has profitable recommendations in terms of knowledge assimilation.

Re-elaboration of expectations. I think it is relevant to psychologically work on the aspect of our own perception of academic performance. Naturally, perhaps for a few months (perhaps for a few years) we will not have the academic performance that we had under normal conditions, in our prime. It is important to be aware of this, and to apply tools with discipline that allow us to organically counteract  parcially this situation of  enormously adversity. If our mood allows, if our mind is prepared for more effort, perhaps we need to multiply the hours of study, perhaps we need to experiment with new methods, perhaps we need a few months with zero performance expectations - and simply fulfill our responsibilities to the best of our ability, and see what results we get, without expecting anything in particular. An honest examination of our situation can help us prevail in the medium and long term, which is what reallly matters at the end of the day

 

 

PD: By the way, to address your question,  I am studying a career as a teacher in biological sciences.

 

 

 

[Steven1]

On 9/18/2024 at 4:30 PM, Franco12 said:

PART II

 

Nutrition. Since the first episodes of discontinuation syndrome at the dawn of 2020, I was always tempted to attribute my suffering exclusively to the administration of psychotropics. And certainly, the administration or discontinuation of these medications can seriously affect how we think, reason, perceive, behave, etc. However, this condition does not give us immunity to other factors. Our condition begins in the discontinuation syndrome, but it does not end there. Other habits need to be examined. Correct nutrition, with high levels of vitamin B12, micronutrients, protein content, etc., is essential for the process of restoring our faculties, and also to avoid further stressing our body - mind.

Meditation practice. I particularly prefer to practice meditation after high intensity, 3 - 4 hour study sessions. There is evidence to suggest that deliberate relaxation after high-stress study episodes (swinging between high-intensity work and high-intensity rest) helps strengthen memory consolidation. Perhaps mindfulness training per se is beneficial for personal well-being, but in terms of learning, the most appropriate alternative is undoubtedly after study sessions. ¿Are you familiar with doctor Jon Kabat Zinn's books?

Pomodoro method: Also in relation to intermittency. I apply a specific variant, which consists of using a 25-minute interval of high-intensity study, doing five minutes of intermediate low-intensity training, another 25-minute study session, and so on. Huberman - from my perspective he is not a particularly valuable disseminator - however, he has a particular video on protocols for learning optimization that I think is well done, and has profitable recommendations in terms of knowledge assimilation.

Re-elaboration of expectations. I think it is relevant to psychologically work on the aspect of our own perception of academic performance. Naturally, perhaps for a few months (perhaps for a few years) we will not have the academic performance that we had under normal conditions, in our prime. It is important to be aware of this, and to apply tools with discipline that allow us to organically counteract  parcially this situation of  enormously adversity. If our mood allows, if our mind is prepared for more effort, perhaps we need to multiply the hours of study, perhaps we need to experiment with new methods, perhaps we need a few months with zero performance expectations - and simply fulfill our responsibilities to the best of our ability, and see what results we get, without expecting anything in particular. An honest examination of our situation can help us prevail in the medium and long term, which is what reallly matters at the end of the day

 

 

PD: By the way, to address your question,  I am studying a career as a teacher in biological

Hello brother, I apologize for the delay. I was busy with my mid-year exams. You are a good person. I knew that after I read your article. You explain it to me with complete sincerity. Thank you. As for pornography, I quit it and I do not watch it, but with the excuse, I have developed deformities in my penis after the medication. I apologize for mentioning this, but has it happened to you? Yes, quitting pornography helped me a lot in my studies. I used the Pandora method before, but what is the book of Dr. Jon Kabat Zinn's books? I have not heard of it. I will follow all your advice, but my last date of taking the medication was a year and 5 months ago. What kind of withdrawal is this that lasts like this? 😭 What about your work as a teacher? Didn't you forget part of the curriculum after the medication and things that you were good at in your work and now you don't know?

[Franco12]

RESPONSE TO STEVE. PART I.

 

Hello Steve, good week! 🌟

 

«I have developed deformities in my penis after the medication. I apologize for mentioning this, but has it happened to you?

 

I personally did not experience - neither during the treatment, nor in the discontinuation process - unwanted bone or muscle morphological alterations. Let's say, no change in terms of the structure of the genital organs. I did experience, apparently transiently, SSRI sexual dysfunction, but for the most part those symptoms went into remission with partial discontinuation of medication. They were especially accentuated during the administration of a psychotropic commercially labeled “antidepressant,” called paroxetine, and then gradually the tendency was to return to normal functioning.  

 

I do not know, in your particular case, if it is related to the administration of psychotropic alterers (as you say, if these changes have emerged immediately after the administration of the medication, it is likely that there is some connection. Correlation does not necessarily imply causality, it is known, but taking into consideration the cascade of metabolic, mitochondrial, tissue, psychotropic - monoaminergic alterations that these medications trigger with sustained administration, and also taking into consideration that some people anecdotically, in treatment with drugs labeled as antidepressants, report changes in the same nature, I think it is sensible to draw, hypothetically, some relationship between both factors).

 

I know of some people who experienced significant structural modifications: a person - that I found on reddit - who, after the administration of psychotropic medications (in that specific profile overlapping of numerous alterers) lost a considerable volume of bone tissue in his jaw, and Naturally, this circumstance had drastically modified the physiognomy of his face and appearance. I also found, in isolation, some people who had experienced, as you mentioned, some penile (or genital in general) morphological modifications). Also people who report loss of testicular volume. Although I can refer anecdotically to some cases, I do not know what mechanisms may be involved, and what to do to prevent or remedy them.  

 

They are certainly less frequent reactions than unwanted effects in the order of functionality: for every case I read about morphological modifications, I found dozens of cases with dysfunctionality in terms of libido, arousal, genital numbness, etcetera, etcetera, etcetera.

 

If I can find those forums (I don't remember exactly in what context I had read those posts, but probably in some Reddit subforum about medication discontinuation), I will quote them to you here in SA. Perhaps one of those people can give you more information about what mechanisms may be at play, and what exactly to do to find reversibility to those unwanted changes. Did you consult with a urologist? Maybe can give you valuable information. 

[Franco12]

Hello Steve. ⭐

 

@Steven1

 

Please allow me to apologize for the delay in response. Unfortunately I had a few weeks of some emotional instability, and I had to partially give up participating in the community for a few days. Since the situation has improved significantly, and I already feel myself gradually recovering natural composure, I think it is necessary to reactivate my participation. I hope that my answer can contribute, even minimally, to counteract the uncertainty.

 

Secondly, any assertion in this comment should be reviewed by another platform administrator, with experience, training and intuition more adequately calibrated (by years of reading). Everything I will say is merely feedback from a person who has recently, and unsystematically, been learning about psychotropics and unwanted modifications in cognition mechanisms.

 

Symptoms of dysfunction in terms of cognition may appear during the administration of medication (anecdotally, the administration of medications commercially labeled as antipsychotics seem to cause alterations more quickly than antidepressants, but this does not exclude that some people may also experience alterations from the first SSRI tablets, or other pharmaceutically legitimized drugs with the euphemism of “antidepressants”), or in the process of discontinuing medication. I particularly tend to, perhaps unconsciously, emphasize disturbances in the tapering, deprescribing, and discontinuation process from personal experience. Other people tend to perceive markedly significant alterations in terms of cognition while taking psychotropic drugs.

 

As mentioned earlier, although protracted withdrawal symptoms have been regarded as pharmacologically implausible in the past (‘the drug is out of your system’), this understanding has been updated to recognise that drug-induced neuro-adaptations may require an extended period to return to their pre-drug state, rather than resolve when the drug is eliminated from the body.'*?7 Consistent with this, RCPsych has updated its position,?® and a corresponding update was made to the NICE guidelines,” to indicate that withdrawal symptoms can last for ‘months, or longer’.

 

On the other hand, the discontinuation syndrome, that is, the undesirable effects emerging during partial discontinuation, or after discontinuation is completed or time after discontinuation has been resolved, unfortunately seems to have an indeterminate and unpredictable duration. The persistence of symptoms for a period of time greater than one year is not indicative that the person has completed their period of re-adaptation to discontinuing the drug. What percentage of patients are experiencing long-lasting discontinuation syndromes? What percentage of patients are at risk of developing severe forms of discontinuation syndromes? According to recent publications that I was able to find, these questions do not have, today, clarifying answers. In any case, the persistence of symptoms beyond 1 year is not indicative that the person has definitively ended their period of abstinence. Why some people remain without significant disturbances in the discontinuation process, and other people experience countless adversities in another question whose answer is still in an embryonic state.

 

What about your work as a teacher? Didn't you forget part of the curriculum after the medication and things that you were good at in your work and now you don't know?

 

Anecdotally, I can say that I read dozens of cases of people who experienced improvements three years, four years, five years (even longer), after discontinuing medication. Some of them had experienced dysfunction as a result of the prescription, and this unwanted effect had constituted an enormous incentive for discontinuation.

 

"What about your work as a teacher? Didn't you forget part of the curriculum after the medication and things that you were good at in your work and now you don't know?"

 

Without a doubt. I have noticed, on certain occasions, the impossibility of explaining myself fluently on topics that I have studied carefully in previous years, and which I mastered magnificently. Such a circumstance, as might be expected, is tragic in nature for people who have dedicated an enormous portion of their early youth to academic training. Here it is important to point out that this also happens to normal people, who are not, nor have ever been, undergoing treatment with psychotropic drugs. A few months ago I was frankly baffled when a teacher asked a basic question about biology I, a curricular area that my classmates and I had accredited a few years ago, and the vast majority, even the most outstanding students, could not answer clearly to an basic question. In any case, I am convinced that in those of us who have been affected by the application of psychotropic drugs, the loss of information from the “hard drive” of memory can, at times, be significantly more abnormal. For example, I met a person who, after a prolonged time on antipsychotics, completely forgot how to play a musical instrument, after years of laborious practice to reach the level of excellence and professionalism.  Would such a manifestation occur under normal conditions? Probably not. I positively know the dramatically negative influence that the administration of psychotropic drugs, which I am still experiencing, can exert on cognition, and which can affect not only current learning abilities, but already crystallized knowledge.

 

In any case, in your particular case, I am sure that remediation is occurring, whether or not there are currently appreciable or ostensible results in psychocognitive terms. The gradual, arduous recovery of homeostasis after discontinuation and complete deprescription of psychotropic drugs is the inevitable direction in providing our body with the care necessary for the restoration of normal health. I am entirely optimistic that you will be able to recover a large percentage, perhaps a complete recovery, of the state of cognition prior to the administration of psychotropic drugs, but I cannot, and probably no one on the forum can, make a prediction regarding when and in what way it will occur. It is something highly individual and not generalizable.

 

As far as I can extend my opinion, there are no rigorous scientific publications that can shed light on the question of the loss of crystallized knowledge. A personal assessment, based purely on my unique experience, is to perceive a noticeable improvement, restoration of knowledge during recovery with time and natural remediation of the damages caused by the medication. I am also in the early recovery process, just in the first instance, so it is premature for any support deduction. However, I can say that I am more fluent in certain topics than in previous months, even without having had any training intervention in these months after discontinuation. It is difficult to capture in words, but it would give the impression that one has more accessibility to previously crystallized knowledge as one is in recovery.