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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Cognitive impairment


Senior Member
My cognitive impairment has gotten worse lately, and it's sucking any remaining joy out of life. I've always had some degree of brain fog, though that actually cleared up quite significantly when I switched to a Keto diet. I was overwhelmed by 'adrenal fatigue' and adrenaline rushes, which still made concentrating etc. difficult. However, ever since trying to treat my gut, things have been worse in a different way: I feel very 'glassy' mentally, like I'm stuck behind a screen, and I struggle a lot with processing information, no matter how alert I am. My mind feels very blank, and I have to force myself to take every action .. even simple typing feels laborious. I'm totally anhedonic and time passes so painfully slowly; coffee helps a little, but doesn't cut through that 'glassy' feeling, so that I'm ever actually present in reality.

I had these symptoms on SSRIs; I was born with ADD, and believe I'm sensitive to anything to increases serotonin. Lately, I've been taking Vitamin C, because it's the only thing that helps me physically -- i.e. I can sleep and am more stress-tolerant on it -- but the cognitive symptoms just get worse (I believe it increases serotonin?).

Anyway, I guess I was just venting. I don't think there's really a solution because anything that improves cognition (stimulants etc.) would probably kill me, and without the Vitamin C I'm so much worse off physically.
I've tried many things over the years for cognitive impairment and each drug has its own pluses and minuses. I don't think there's a good substitute for just trying a lot of different things and seeing what works. I have been on several SSRIs and spent years on Zooloft, but ultimately I couldn't live with the side effects.

I have POTS as well and I was looking at suggested medications from a presentation that Peter Rowe gave. I decided to try Ritalin. My doctor said that he prefers the time-release version Concerta. I've been on that for several years and it helps a lot with my cognitive impairment. It has provided the best trade-off between benefits and side effects. In the last year, though, I've been trying to reduce my dosage because I've been feeling overly stimulated.

I went on a ketogenic diet in August and I felt an immediate increase in both alertness and energy. I believe that being on the ketogenic diet is making it easier for me to cut back on Concerta.

My next experiment before I found Concerta was going to be Provigil. I have had some positive experiences using it short-term, although I don't know what it would be like long-term.

What works for me won't necessarily work for you. As I said, it's best to try lots of different things to find what works for you. It doesn't take a high dosage for people with cfs to figure out how these things are likely to affect us.