Q:  More Short Term Memory Loss w/Each Manic Episode?

Dr. Phelps,

My son has recently gone through an intensive work up with a neuropsychiatrist trying to address the issue of short term memory loss. In talking to his wife, she mentione that the doctors were projecting a future in which memory loss would increase and he may be not able to work. His meds include depakote, and topamax. They have recently taken him off topamax. In discussin the issue of memory loss mention was made that with each "manic" episode a little more short term memory is lost. True? Accurate?

Larry


Dear Larry -- 
"....with each "manic" episode a little more short term memory is lost": a current working supposition, shall we say.  Lately it seems as though more evidence has accrued favoring this hypothesis.  However, there is also clear evidence that some degree of memory recovery is possible after severe mood episodes so the story is not quite as dark as the way it's being framed here.  Moreover, there's the hope that effective treatment can prevent subsequent episodes and thereby stop this kind of progression.  

When I have patients who aren't too sure they really need to be taking medications to prevent subsequent episodes, because, for example, their episodes have been mild and few and easily controlled... I tell them something rather like what you've put here; but, the point of this is, I tell them this is a working hypothesis and not a certainty and that therefore, as much as I might wish them to believe the worst and thus go with my recommendation to use a preventive approach, I cannot state with certainty that memory loss or other cognitive loss is part of the risk of having more episodes. 

Dr. Phelps

Published February, 2005