Cognitive problems

McLean A Jr, Cardenas DD, Burgess D and Gamzu E (1991). Placebo-controlled study of pramiracetam in young males with memory and cognitive problems resulting from head injury and anoxia. Brain Injury, 5, 375-380. 

There is less risk of developing motor complications from monotherapy with dopamine agonists than from L-dopa. Because younger patients are more likely to develop motor fluctuations, dopamine agonists are preferred in this population. Older patients are more likely to experience psychosis from dopamine agonists therefore, carbidopa/L-dopa may be the best initial medication in elderly patients, particularly if cognitive problems or dementia is present. 

What has been difficult to determine is whether the neuropsychological problems are consequences of the abuse, or whether some of these cognitive problems may have preceded drug use. For example, many people who have drug problems also exhibit signs of hyperactivity or attention problems, but it is unclear whether these problems preceded the drug use or whether the drug use caused... 

There is some good news, in that brain function begins to improve in most cases when drug abuse is stopped, and the improvement may continue for many months. Improvement often begins after the detoxification period, when mental confusion and some acute cognitive problems often improve rather dramatically. Other cognitive problems, some of which can be subtler and more difficult to detect, may persist for several months or years, as mentioned but eventually many are reversible. 

Cognitive problems in drug-using clients are easily detected. True or False ... 

Engelhart et al., 1999). This instrument assesses many more areas of cognitive function than does the MMSE. I Iowever, as a screening tool, it too has limits to what it can tell you. My recommendation is that if a client of yours screens positive for a cognitive problem on one of these measures, you refer that client for a comprehensive neuropsychological workup as part of the treatment plan. Note that sometimes a person will screen positive during detoxification, but will clear cognitively after that period is finished. You should probably retest after detox has been completed if the client screens positive while in detox. 

The hardest part for me is no longer having the ability to work on something from start to finish because of the cognitive problems I ve developed. I ll start a project that should take me two hours, and three weeks later it still isn t finished. Once I got sick from exposures in a hotel and accidentally left my computer there and lost it. I ve also lost a new camera and a wallet from putting them down and leaving them when I was having reactions. 

Finally, patients with schizophrenia also experience a variety of intellectual or cognitive problems. This includes poor memory, poor attention, and learning difficulties. 

Nicotine also affects the developing fetus. Adverse effects of chronic nicotine consumption during pregnancy include reduced infant birth weight, attention deficit disorders, and other cognitive problems. Nicotine receptors are expressed early during development, and it is not clear what other effects nicotine exposure during development has on the fetus. 

Probably the greatest saboteur of interpersonal cognitive problem... 

At a BAL of 30-80 mg/dl, there are increases in motor and cognitive problems (80 mg/dl is the legal intoxication limit in California). 

---