Brief Answer:
Overmedication surely contributing to memory issue

Detailed Answer:
Good evening XXXX . My name is Dr. Saghafi and I am a neurologist who would like to help provide you with some direction to your problem. You are specifically referring "memory loss" along with being "physically tired."

Your medications include:

1. Zimovene x 2 tablets every night,
2. Tramadol x 8 tablets/24hrs.
3. Rivotril 0.5 mg x 3 tablets/24 hrs.
4. Atorvastatin 20 mg. x 1 tablet/24 hrs.
5. Effexor 225 mg. 1 tablet/24hrs.
6. Cardicor 2.5mg/24 hrs.
7. Eltroxin 25 mg /24hrs.
8. Nuprin 75mg/24 hrs.

You have not specified the mg. dosage of your Zimovene nor your Tramadol that I can see. In the U.S. Tramadol comes in 50mg tablets or if the ER (Extended Release) as 100, 200, & 300 mg. presentations. The maximum recommended dose is between 300-400mg. daily per manufacturer's instructions.

I hope you will agree with me that by listing your medications in this way you can more easily appreciate the fact that you are on far too many medications at once which have the property of either making you drowsy, sleepy, fatigued, or less anxious. The problem is that when so many drugs from different classes are mixed together their effects tend to be amplified or even MAGNIFIED. I am certain this is what is going on in your case which is has likely developed rather insidiously over time.

From another perspective you are taking 8 different medications daily (some of which will have the same overall physical effect on you). This totals to 16 tablets in 24 hrs. I am sure that your day pretty much revolves around arranging your medications and trying to keep up with the schedule so that everything is taken according to your routine and on time. This in and of itself can be the equivalent of a full time job let alone what you must have done to have raised 4 children, maybe some grandchildren, take care of a husband, a house, and possibly have worked.

Again, and to be simply as truthful as possible, in my professional opinion, you are taking medication which is unnecesary and simply too much of other medications resulting in memory impairments, fatigue, and even pharmacological exacerbation of your clinical depression (despite your taking antidepressants). You should sit down with your doctor and let them know that you need to be reduced on your medications and are interested in other measures to deal with issues of pain, anxiety, or insomnia since you've decided that you do not wish to forever be in a state of drowsiness with your memory function routinely being in some other time zone away from your body.

You should also know that neurologists typically do not like prescribing Tramadol for patients due to the risk of causing or unmasking convulsions and seizures. If you were my patient I would definitely be looking for alternative methods and/or medications to treat your pain symptoms of Raynaud's disease.

Ms. XXXX I do not believe your memory problems and physical fatigue are due to organic problems such as dementia or other type of brain syndromes in the face of what is referred to by clinicians as "polypharmacy."

If you were under my direct care I would be working closely with you to reduce unnecessary medications and trimming doses in favor of alternative approaches and methods for you to find relief from pain. Concurrently, we would be working to improve functionality and productivity which I am sure you would dearly love to have but cannot see how to obtain with all the ground clutter of pills being prescribed for you.

In conclusion, the first order of business then, is:

1. The reduction of any and all unnecessary medications and their replacement with good solid approaches to treating depression, anxiety, and pain.

It won't all happen in one day but I can tell you that of my patients who go through similar straights, success is based mainly upon determination and desire to change their lots.

2. If your physician is not of the opinion that your medications need serious adjustments then, I must take a firmer position that you really should find someone more willing to work holistically with you and less inclined to make the drug companies wealthier at the expense of your good health.

Please let me know if I can be of further assistance.

Otherwise, if you feel this information has been useful and will provide the necessary springboard for you to take the next step then, a brief amount of feedback and a star rating would be greatly appreciated on this transaction.

In addition, would you please CLOSE THIS QUERY as well which will signal to the network that we have satisfactorily addressed your concerns and completed the case.

Much luck and all the best to you and your family. Cheers!

This case required 59 minutes of physician specific review, research, and final draft compilation of responses with envoy.

---