December 23, 2016
Day 1: Improved Cognition Study
Subject: 43 year old female with mental fog and attention issues. Patient complains of inattention and short term focus and cognition issues. Previous issues with anxiety and mild depression, possibly linked to chemically induced menopause. Patient is on tamoxifen estrogen suppression following successful breast cancer treatment and takes lowest dose available of coversyl for regulation of a bicuspid aortic heart-valve deformity. Previous attempts with diet and nutrition have not resolved these issues so medical intervention was requested by the patient after increased physical clumsiness resulted in minor physical injury due to poor attention (injury from falling down stairs).
Treatment: Patient has been prescribed a 27 mg daily dose of Concerta (slow release ritalin). Medication is to be taken with breakfast (no later than noon to prevent sleep interference).
Data collection/monitoring factors: Patient has been asked to keep a journal to note whether the medication appears to help with mood, attention span and general alertness. Patient has been advised to look for overly elevated heart rate and appetite suppression (common side effects), although since she has an unusually low blood pressure and strong appetite these issues would need to be significant to have a negative impact. Her partner has been asked to monitor her behavior and report to her if she is acting irrationally or overly-anxiously. Because the slow-release medication is non-addictive the patient may stop at any time, and missing a pill is not critical, but she should try to remain on for 1 month to get a good idea of whether the medication really works or not.
Project Length: Initial prescription is for 2 months. Patient will meet with her physician in 1 month's time to discuss if the treatment appears to be working.
Notes/Comments: Because this medication is not successful for treatment of this type of mental fog issues in all patients it will be important to monitor and adjust the treatment if necessary. Other options are available as far as dosage or other medications that will not conflict with her tamoxifen and cardiac medication (ie. adderall).
Patient will report back to this blog as to the success of this treatment. She is very hopeful and although she already feels more alert and mentally focused a few hours after taking her initial dose of medication, this could be a placebo effect. Time will tell.