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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by utopizen on March 11, 2004, at 23:09:59
Okay,
I've been on Ritalin, Adderall, Dexedrine, Dexedrine Spanules (a joke!) and have been on Desoxyn for a year now.
I thought they were helpful at first, and perhaps they were (all but Desoxyn were being used along with antidepressants for my social anxiety).
Now I feel I've gotten depressed, and have trouble eating three meals a day let alone waking up to go to class or doing my assignments at all. I've got two incompletes that went to F's that I haven't finished yet and am hoping both professors agree to "correct" the grade once I submit them my long overdue final papers.
I've never done a paper in my three years at college outside of an all-nighter-- I've gotten into the habit of forcing myself to feel like my brain is being stretched to its limit just to get it to complete something to the end.
I get sleepy if I try to read or write a paper in the day, and tricking my circadian rythms into believing it has energy is the only thing that has let me stay in college.
My sleep doc said Straterra+Provigil is synergistic for his patients, and I'd like to try it-- but I'm afraid of it not working on top of making me dead tired while I wait it out for a couple of months.
If I'm so concerned about the risk of feeling tired, should I try to stomach this risk by taking 40mg at bedtime for a week and then 80mg the second like many do?
The idea there is that my body will get adjusted more rapidly... so if I do get sleepy at 40 or 80mg, it'll force my body to adjust rapidly to the side effects.
I'm afraid if I try miniscule dose increases I'll just feel sleepy for a longer period AND take longer to notice any potential response. If I start next week, I should be able to get a good 2 weeks in before my next exam, and if I get and stay sleepy by then I suppose I could simply discontinue it a few days prior and the effect should go away?
I just figure if I try like 18mg increases every week all that will do is spread out the time I have side effects while taking more time before I can notice any benefit.
Posted by sb417 on March 11, 2004, at 23:33:46
In reply to Avoiding sleepiness with Straterra... strategy?, posted by utopizen on March 11, 2004, at 23:09:59
Is it possible for you to wait for a major med change until you have a semester break or a vacation? Do you have a spring break? It seems as if you've been on your current medication regimen for quite a while, and as unsatisfactory as it feels right now, it's still a known quantity. I wouldn't introduce any new variables until you have a break of at least a week or more. Remember also, if you switch to Strattera (or anything else, for that matter) after having been on stimulants, you are likely to experience fatigue and/or sleepiness, not just from the medicine itself, but from stimulant withdrawal. Instead of making a major change right now, can you speak with your doctor about ways to "stretch out" the current medications until you have a vacation? For example, can you take a weekend off from meds or even just one day of the weekend? Let yourself sleep and rest on as many days as possible, alternating those days with days when you do take meds. Then, when you finally have a vacation, you can try the medication change.
Posted by sb417 on March 11, 2004, at 23:43:01
In reply to Re: Avoiding sleepiness with Straterra... strategy? » utopizen, posted by sb417 on March 11, 2004, at 23:33:46
As far as "stretching out" the effectiveness of your current meds, I've seen a number of threads here over the past year or so on ways to stave off or prevent "poop out" of stimulants. I think taking Magnesium was one suggestion. Was Klonopin another? I've seen posts about taking dextromethorphan (sp?), but I wouldn't do that on a regular basis. I guess it works for some people, but DXM suppresses the cough reflex, which we have for a reason. I don't think it's a good idea to chronically suppress coughing unless you have a bad cough, bronchitis, the flu, etc. Have you tried combining stimulants with an antidepressant? For example, could you continue on one of the stimulants you're used to (Desoxyn, Adderall or Dexedrine), but start to gradually add on an antidepressant? That way, you wouldn't be making such a drastic change in the middle of the semester.
Posted by utopizen on March 11, 2004, at 23:48:24
In reply to Avoiding sleepiness with Straterra... strategy?, posted by utopizen on March 11, 2004, at 23:09:59
I should probably note that my pulmnologist who manages my sleep apnea (it's borderline and doesn't explain why I am so sleepy when I try to read or do work of any kind) has advised my sleep psychiatrist to put me on Straterra+Provogil together.
The idea is to "streamline" my meds so I can possibly discontinue Klonopin and Inderal-LA for my social anxiety and Desoxyn for my ADD/Sleepiness.
Given how many posts claim Straterra calms them down, I hope this means it will help my social anxiety-- or at least stop me from procrastinating things because I'm either so tired when I do work or I brood over the whole thing so much I don't bother to start it at all.
I failed Provigil at 400mg alone, but he claims the two have synergy to one another with his patients after some of them failed Provigil for their sleepiness.
So maybe even if Stratera caused me sleepiness (the only side effect that worries me) the Provigil would affect the part of the brain also affected by Straterra in such a way that this side effect is diminished and I receive the increased energy some posters talk about.
Many have claimed to get a regular sleep-wake cycle-- they feel tired when they're suppose to at bedtime, and awake in the morning with more energy.
I've heard some posters claiming "It's not like the stims." Well I haven't tried it, but keep in mind my sleep psychiatrist is using it for my ADD+Excessive Daytime Sleepiness and will combine it with Provigil.
The combo, apparently, is the secret ticket for ADDers who have comorbid sleeping disorders (if you can't read a book easily without falling asleep, this is you).
If Straterra helps me calm down a bit with my social anxiety, so I might need less or no Klonopin, and makes my ADD managable enough so that I feel I can complete assignments before the night before it's due, and it can help regulate my sleep-wake cycle and (hopefully) increase my appetite, I think this could really work out... I hope.
So... 40mg first week, 80mg second week. I figure I have to eventually get to these doses if I start low anyhow, and doing that will mostly just prolong the initial side effects and delay the results I can get with it...
Posted by King Vultan on March 12, 2004, at 7:58:53
In reply to Avoiding sleepiness with Straterra... strategy?, posted by utopizen on March 11, 2004, at 23:09:59
I don't know if you've considered desipramine, but I was on this for an extended period, and it did not cause me sleepiness as Strattera did, with fewer overall side effects than Strattera and a very similar therapeutic effect. Both of these drugs are norepinephrine selective reuptake inhibitors, but desipramine is a tricyclic antidepressant, albeit, with the fewest side effects in that class. Strattera is supposed to be a cleaner alternative to desipramine, but my own observation was that it mainly just wound up being a lot more expensive, with worse side effects.
Todd
Posted by Sad Panda on March 12, 2004, at 10:37:03
In reply to Avoiding sleepiness with Straterra... strategy?, posted by utopizen on March 11, 2004, at 23:09:59
Not stim related at all, but, are you getting enough quality sleep to get you through the day?
Cheers,
Panda.
Posted by Bill LL on March 12, 2004, at 10:42:28
In reply to Avoiding sleepiness with Straterra... strategy?, posted by utopizen on March 11, 2004, at 23:09:59
Provigil has a good reputation for increasing energy with little or no side effects.
Posted by utopizen on March 12, 2004, at 14:40:50
In reply to Re: Avoiding sleepiness with Straterra... strategy?, posted by Sad Panda on March 12, 2004, at 10:37:03
> Not stim related at all, but, are you getting enough quality sleep to get you through the day?
>
> Cheers,
> Panda.
>yup! but do have trouble napping in the mid-day...
This is the end of the thread.
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