Cognitive issues and stimulants
Since having worse and worse short term memory and attention difficulties, I was considering asking my care team for a trial of a stimulant. I’m at 3 1/2 years on tamoxifen and now over 50, so not sure if time on therapy plus dwindling estrogen is the cause. Has anyone had success overcoming cognitive difficulties with a stimulant?
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I have been on stimulants for a couple of years now for ADHD. They help with my (very) short term memory - like - did I just wash my hair or was I about to wash my hair? But they do not do anything for medium/longer term memory (mine has always been not great and is probably worse now, not due to the stimulants I don't think but to other meds and menopause.
They do help me with attention regulation - mainly being able to switch attention over something that is immediately gratifying in terms of stimulation to things that I actually want to do or to get done.
I think you should ask your care team about them if you think they might help. Just some things to keep in mind - different stimulants work differently/better or worse for different people. Some people thrive on ritalin, some on adderall, some on vyvanse, some on modafinil. Also, there are different forms (mostly immediate action or slow release) for ritalin and adderall. You also can't really predict your best dose based on age/size, etc. It really is trial and error. Hopefully your care team knows enough about stimulants to make good recommendations for you and help you with dosage and medication adjustment. They can introduce their own issues too. But the good thing about stimulant meds i that they basically kick in instantly - so you have pretty fast feedback on how they are working for you (sometimes the first couple of days can be a honeymoon period and slightly misleading) and you can stop any time.
Also, I would say that stimulants are best when you use the help they give you to develop, practice, and make habits of ongoing modification and support systems for yourself. For example, they help me get out of the house and get moving, they help me build cleaning habits, develop note taking habits, etc., that all help me on days when I don't take them or if I ever lost access to them (not unrealistic given the various supply shortages, regulatory processes, and the healthcare system). It's not something that 'fixes' me, but it helps me kind of accommodate myself. (I'm also a special education teacher, and I think about it as both a scaffold in itself and something that helps me build in scaffolds, accommodations, and modifications, for myself that help me accommodate to life demands and live my better life).
BUT another thing you might want to consider/explore is whether your sleep quality has taken a hit. This is something that can also happen from treatment and meds, and just physiological changes as we grow older. UARS is very underdiagnosed (in slender women especially), for example, and you think you are getting a full night's sleep but you aren't actually getting quality rest. Poor sleep definitely impairs cognitive function and memory.
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Such great ideas! I think trying a short acting stimulant could be helpful with building routines and habits. I take a tiny sleep aide maybe twice every two weeks, and while I think it is having an effect on memory the next day, going several days without being able to sleep more than four hours does, too. I’ll check into getting a sleep study, too. Thanks for sharing your experience!
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@waves2stars you might also gain some good insight from this podcast episode!
We hope this helps!
—The Mods
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