Cognitive Issues in Neurosurgery: Medications and Recovery Concerns

Cognition

Hello, when I visited the doctor, he explained to me that my previous abstract thinking, such as understanding that movies and novels are fictional, is difficult for me to grasp.
He questioned why I should watch them and why I can't comprehend concepts like "100." He mentioned that this might be due to my obsessive-compulsive disorder.
After taking the medication Risperdal at night, I felt extremely fatigued the next day, very tired, dizzy, and lethargic, not wanting to move.
As a result, I slept for an entire day, and now, after a day and a half, I still feel the same.
Since there is still a long time until my next appointment, I would like to ask if I should continue taking the medication.
Could such severe side effects indicate potential harm to my brain? Additionally, I would like to know if cognitive decline caused by my mental illness will recover after the mental illness improves.
Is it necessary to use medication? (I am concerned that brain cells do not regenerate, and I worry that cognitive decline due to mental illness may cause permanent damage.) Thank you for your guidance.

pp, 20~29 year old female. Ask Date: 2002/05/18

Dr. Ding Xianwei reply Neurosurgery

The use of Risperdal for your condition seems reasonable, as similar psychiatric medications can produce the aforementioned symptoms.
If the symptoms are severe enough to impact your daily life, please consult your physician to discuss the effects of this medication.
Mental illnesses, like hypertension and diabetes, also require management, so effective control is essential for recovery.

Reply Date: 2002/05/18

More Info

Cognitive issues following neurosurgery, particularly after traumatic brain injuries or conditions like aneurysm ruptures, can be complex and multifaceted. Your concerns about the effects of medications, such as Risperdal, on cognitive function and overall recovery are valid and warrant careful consideration.

Firstly, it’s important to understand that cognitive recovery after brain injury is often non-linear and can exhibit fluctuations. Patients may experience periods of clarity followed by confusion or cognitive deficits. This variability can be influenced by several factors, including the extent of the injury, the specific areas of the brain affected, and the individual’s overall health and psychological state. In your case, the abstract thinking difficulties and challenges in understanding narratives may stem from cognitive impairments related to your condition or the effects of medication.

Risperdal, an atypical antipsychotic, is commonly prescribed for various mental health conditions, including obsessive-compulsive disorder (OCD). While it can be effective in managing symptoms, it is also associated with side effects such as sedation, fatigue, and cognitive dulling. The symptoms you describe—extreme tiredness, dizziness, and a lack of motivation—are not uncommon with this medication. If these side effects are significantly impacting your daily life, it is crucial to discuss them with your prescribing physician. They may consider adjusting your dosage or switching to an alternative medication that may have a more favorable side effect profile.

Regarding your concerns about potential brain damage from medication, it’s essential to clarify that while some medications can cause cognitive side effects, they do not typically cause permanent brain damage. However, prolonged use of certain medications can lead to tolerance or dependency, which may complicate recovery. The brain has a remarkable capacity for neuroplasticity, meaning it can adapt and reorganize itself, especially after injury. Therefore, even if there are cognitive deficits currently, there is potential for recovery, particularly if the underlying mental health issues are effectively managed.

As for the question of whether cognitive decline due to mental illness can be reversed, the answer is nuanced. Many individuals experience improvements in cognitive function as their mental health stabilizes. Engaging in cognitive rehabilitation, therapy, and supportive activities can also facilitate recovery. It is not always necessary to rely solely on medication; a combination of therapy, lifestyle changes, and social support can be beneficial.

In summary, your cognitive recovery journey may involve some trial and error regarding medication management. It is crucial to maintain open communication with your healthcare provider about your experiences with Risperdal and any side effects you encounter. They can help tailor a treatment plan that addresses both your mental health needs and cognitive recovery goals. Additionally, consider exploring cognitive rehabilitation strategies and support systems that can aid in your recovery process. Remember, recovery is often a gradual process, and with the right support, improvement is possible.

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