having trouble thinking

I've been treated for depression for 13 years.  Over the past few years I've noticed that i don't think how I used to.  I used to be a straight A student in high school, college GPA 3.5.  I've notice that I forget all sorts of things.  Few days ago my honey mentioned going to the movies.  If he didn't email me today i would have forgotten. I can watch reruns of law and order because i never remember how it turned out.  I don't always put 2 and 2 together as fast as I used to.  If I am distracted I often forget was i was doing before I was distracted.  I'm also tired alot.  Yet when I have trouble falling asleep.  Is this due to the depression or long term use of meds.  I've tried weaning off the meds but all attemps were unsuccessful in the long run.  Is it going to get worse as I continue to take antidepressants?  I've been taking Effexor, Lamictal and Trazodone.  

[Roger Gould, M.D.]

You might ask your  psychiatrist about reducing the medications slowly to see what happens, and start all over with the smallest dose...it sounds like a combination of medication and depression. Are you in talk therapy as well...you should be...

[Corley]

I have been treated for depression for the last 2 years with Effexor XR and my symptoms improved probably 85-90 % My neuropsychiatrist started me on the Lamictal dose pack in late May. He thought perhaps I was undiagnosed Bipolar-although I have never had a manic episode. I am tired even when I wake up and have great difficulty falling asleep and staying asleep. After about 1 month I began to have difficulty multi tasking and began to occasionally substitute words in my sentences. Now it has gotten worse. In the last 2-3 weeks-since I got to the max dose: I cannot multi task at work, I forget things, have difficulty concentrating and now frequently mix up my words. It is now noticable to my friends and family-unsolicited by me. I am an NP on the Trauma Team and my ability to juggle at least 6-10 issues is a must. I have leaped out of bed once, and yelled out once in response to dreams-not scary but unusual. Also my husband says I am having violent muscle twitching all night-bouncing off the bed at times. I am assuming it is the Lamictal; but since I have Crohn's, hypothyroidism, cholestecomy, appendectomy, open hysterectomy for DUB, a minor cardiac event and depression all since age 37-with no previous medical history at all, I am worried somehting else is going wrong with me. I am trying to get an appt with my Neuro psych MD it may take a couple of weeks. I am a 45 year old female on alida (extended release mesalamine), 6mp, synthroid, effexor xr, Lamictal, Premarin and zanaflex to help me sleep. ( I didn't like the way ambien and lunesta made me feel) Only the Lamictal is new. Do you think I need a Neurology work up for a new illness or is at Drug or Drug interaction problem? Do I need my psychiatrist or a neurologist ? I am so concerned my mind is deteriating or I may have a neurological disease.