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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7847
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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After successfully having chemo therapy for stage two

Customer Question

After successfully having chemo therapy for stage two testicular cancer I have been left with "chemobrain". I am not depressed, but do "fail" the test for repeating a story. I was first prescribed escitalopram (Lexapro) but had bad side effects. I now have filled a prescription for bupropion 150 mg but I am reluctant to take any pills especially after checking online and hearing about addiction and withdrawal problems. I don't take any regular drugs except prilosec every other day for a hiatal hernia.How “rational’ is it for me to refuse to take antidepressants (they seem to have side effects and create new problems)?
Thank you. XXXXX Orenstein
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. Rick, MD replied 11 months ago.

Dr. Rick, MD :

Hi. Dr Rick here. I completed an Internal medicine internship in NYC and have two decades of clinical experience. How can I assist you today?

Dr. Rick, MD :

Hi Professor,

As you know, there is no such thing as a free lunch. This is true in medicine.

Dr. Rick, MD :

Bupropion is a drug with a long history of efficacy and safety. In my opinion, you should not worry about what you hear, especially when it comes to addiction/withdrawal, concerning this drug.

Dr. Rick, MD :

I think you have a much better chance of being helped by trying this medication then ending up with any of the horrible (and rare) side effects you have read and heard about.

Dr. Rick, MD :

So. What is the take home message: Give bupropion a try. I really think you will be OK and, quite possibly, see an improvement in your symptoms.

Dr. Rick, MD :

Does this make sense to you?

Dr. Rick, MD :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7847
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and 6 other Medical Specialists are ready to help you
Expert:  Dr. Rick, MD replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Expert:  Dr. Rick, MD replied 11 months ago.

Dr. Rick, MD : Hi. Dr Rick here. I completed an Internal medicine internship in NYC and have two decades of clinical experience. How can I assist you today?
Dr. Rick, MD : Hi Professor,

As you know, there is no such thing as a free lunch. This is true in medicine.
Dr. Rick, MD : Bupropion is a drug with a long history of efficacy and safety. In my opinion, you should not worry about what you hear, especially when it comes to addiction/withdrawal, concerning this drug.
Dr. Rick, MD : I think you have a much better chance of being helped by trying this medication then ending up with any of the horrible (and rare) side effects you have read and heard about.
Dr. Rick, MD : So. What is the take home message: Give bupropion a try. I really think you will be OK and, quite possibly, see an improvement in your symptoms.
Dr. Rick, MD : Does this make sense to you?
Dr. Rick, MD : I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 11 months ago.

Dear Dr. Rick,


Thank you for your answer but I asked the question via this website


because I thought it was British and wanted to find out what doctors in Britain suggest. I have on internet investigation gotten no sense that


chemobrain is helped with anti-depressants.


If you can find out what the practice is in Britain I would appreciate that


information.


Once again thank you!

Expert:  Dr. Rick, MD replied 11 months ago.
Hi Alex,

I will opt out and hopefully a physician from the UK will be able to assist you.

I wish you the very best.
Expert:  Dr. Thomas, MD replied 11 months ago.
Hello from JA
I have run programs to alleviate this problem.

So I have a lot of direct experience in this.

Unless you are depressed, anti depressants are not going to help.
If you are, they will.

They do not effectively treat "chemo brain".

In fact regular medicine does not have any great pill to treat this, and in fact pills do not treat it.

Efficacy has been shown in some small studies for acupuncture, oddly enough.

In addition, brain training will help....so a neuropsychologist could easily help you with this. Even using a web site such as lumosity can help.

In addition, we have found that certain vitamin supplementations for 6 weeks can help in many cases....a B 100 sustained release complex, magnesium, acetlyl L carnitine, D ribose and COQ 10. Among others, but it is better to work with a functional medicine doctor in this respect.
We just trained a group in the UK last year.
Call here for names.
www.functionalmedicine.org.

Please let me know if you have further questions.
Please don’t forget a positive rating.
Customer: replied 11 months ago.

Dear Dr. Thomas,


Thank you so very, very much. This service first put me through to


an american doctor who did not have the relevant specialty, I have never used this service and felt that I should credit him. However your reply was to the point and highlights the difference between the UK and the US approach. Right now I think I will try out my neurologist-psychaitrist drug reccomendation (as soon as I get over a cold). But if I have any negative reactions I will give up on it..


I am connected with Wolfson College and regularly visited Oxford for many years, but have not gotten over since I was initially diagnosed with cancer in the summer of 2012.


Once again thank you so very much for your helpful UK advice which I will follow up on.


Sincerely yours,


Alex Orenstein

Expert:  Dr. Thomas, MD replied 11 months ago.
HI
Unfortunately you rated the first expert
I am not paid unless you give me a positive rating.
Please don't forget to do that
Customer service can help you with any problems.

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