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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by ed_uk on December 21, 2004, at 11:48:19
Has anyone ever suffered serious withdrawal symptoms from their prescribed stimulant? If so, did you take the stimulant as prescribed or did you misuse it by taking excessive doses? How did you cope with the withdrawal.
Stimulants are rarely prescribed to adults in the UK, I get the impression that stimulants are used much more frequently elsewhere.
Psychiatrists here tend to believe that there is a high risk that the prescription would be misused or that the patient would sell their medication. To what extent do you feel that this is true? Do you believe that stimulants are underprescribed or overprescribed in the country that you live in?
Have you ever been tempted to misuse your prescribed stimulant? Did you experience euphoria at the prescribed dose?
To quote the British National Formulary....
'Central nervous system stimulants include the amphetamines (notably dexamfetamine) and related drugs (e.g. methylphenidate). They have very few indications and in particular, should not be used to treat depression, obesity, senility, debility, or for relief of fatigue. The amphetamines have a limited field of usefulness and their use should be discouraged as they may cause dependence and psychotic states. They have no place in the management of depression or obesity.'
Ed.
Posted by linkadge on December 21, 2004, at 12:19:15
In reply to Stimulant Dependence and Abuse, posted by ed_uk on December 21, 2004, at 11:48:19
I took 20mg of CR ritalin, along with 10mg of celexa.
At the peak effect, I certainly did have a high when it was combined with celexa. The ritalin alone made me depressed.
However, I experinced extremelty *significant* crashing at the end of the day. It was terrable.
Linkadge
Posted by jujube on December 21, 2004, at 12:24:32
In reply to Stimulant Dependence and Abuse, posted by ed_uk on December 21, 2004, at 11:48:19
Ed,
I would think that a pdoc may be more inclined or willing to prescribe something like Provigil (Modafinil) rather than a true stimulant. If your pdoc is not educated in the use of Modafinil, then perhaps it is in your best interest to educate him (assert yourself as an active and knowledgeable participant in your own mental health care). I am sure you already have this information, but in case you don't, here is a brief description of Modafinil, which has a different chemical structure than other stimulants, and which is less likely to induce tolerance.
"Provigil etc. (Modafinil)
Provigil etc. (Modafinil) is a unique wake-promoting agent that is chemically distinct from traditional stimulants. Officially an Alpha1-adrenergic agonist medication (also known as an "eugeroic" drug), Modafinil was approved in 1998 (U.S. FDA) for the treatment of excessive daytime sleepiness associated with narcolepsy. A small number of clinical trials have also suggested that Modafinil also has memory-improving and mood-brightening effects. For these reasons it is now being used to augment treatment in depression patients who have had only a partial response to antidepressant therapy. Similarly, Modafinil has also found a number of other potential uses like reducing fatigue and cognitive problems commonly found in health conditions like Multiple Sclerosis, Chronic Fatigue Syndrome etc..Modafinil appears to be well-tolerated and to be free of side-effects like agitation, irritability, nervousness, euphoria or the potential for paranoid delusion and addiction that are common to other stimulants like amphetamines or cocaine. This may be because Modafinil targets very specific regions of the brain believed to regulate normal wakefulness, like the the neurotransmitter dopamine. As Modafinil has a fairly long half life of approximately 15 hours (the amount of time before half of the drug's peak plasma level is eliminated by the body), it can be taken once-daily - usually in the morning to avoid impacting night-time sleep"
Also, if you haven't already done so, have a look at the reviews at Remedy Find. Modafinil is rated higher than most of the medications that are used to treat depression. Some people are even using it as monotherapy. Here is the link:http://www.remedyfind/all_remedies.asp?id=13
I can relate to your frustration. The pdoc that I have been referred to for medication is also averse or reluctant to prescribe more than 1 drug at a time. I had raised Modafinil (Alertec in Canada) with him, and he seems to be avoiding addressing my request. It is not a pressing issue for me right now since the NADH and DMAE seem to be helping me. However, if the relief I have been experiencing with these two natural supplements is not sustained, I will be more assertive with the pdoc in terms of my needs.
Good luck to you, and take good care.
Tamara
Posted by ed_uk on December 21, 2004, at 14:37:36
In reply to Re: Stimulant Dependence and Abuse » ed_uk, posted by jujube on December 21, 2004, at 12:24:32
Hi!
I doubt that my pdoc would even consider prescribing modafinil... which is a shame because I would really like to try it. In the mean time I might try one of the supplements that you suggested.
Best Wishes,
Ed.
Posted by jujube on December 21, 2004, at 15:22:25
In reply to Re: Stimulant Dependence and Abuse » jujube, posted by ed_uk on December 21, 2004, at 14:37:36
It is such a shame when some pdocs can be so close-minded, and such a disservice to the patient who ends up receiving marginal or inadequate treatment.
If it is any comfort, I have noticed a definite improvement in my energy, motivation and mood since I started using NADH and DMAE, and it has only been a week. Plus, I have not had to use the NADH every day. I used it for four days in a row (increasing the dose from 2.5 mg to 7.5 mg), and have taken a break for the past three days. The other natural supplement I started taking was Vitex, which is supposed to work on dopamine, and is used by some women in particular for PMS. However, I did read a post on PB by a guy who was using Vitex for the dopamine effects. The other natural product you might want to consider is Picamilon. At doses of 50 mg, three times a day, it works as a very good anxiety supplement without sedation. At doses of 100 mg, three times a day, it apparently works as a stimulant without causing anxiety. I have not tried it yet. It is not available in Canada, and I think that one of the ingredients may be restricted for import to Canada. I am still checking on that since I would like to try it.
I just ordered more NADH, and will likely start using 10 mg 3 - 4 times a week. You might want to read some old posts by a guy named Ron Hill. He had very good results with NADH for a many months. His posts and posts by Larry about NADH encouraged me to give it a try before pressing my doc for Modafinil.
Good luck to you Ed. Hope your exams go well.
Tamara
> Hi!
>
> I doubt that my pdoc would even consider prescribing modafinil... which is a shame because I would really like to try it. In the mean time I might try one of the supplements that you suggested.
>
> Best Wishes,
> Ed.
Posted by TomG on December 21, 2004, at 15:43:21
In reply to Re: Stimulant Dependence and Abuse » jujube, posted by ed_uk on December 21, 2004, at 14:37:36
Ed, your doc may not be able to provide Provigil but the mother drug Adrafinil is used widely in Europe, and I think might even be sold over the counter. I was thinking of trying it when Provigil did nothing for my sedation. I found that I could order it over the counter at this UK website http://www.antiaging-systems.com/
Posted by ed_uk on December 21, 2004, at 16:56:48
In reply to Re: Stimulant Dependence and Abuse » ed_uk, posted by jujube on December 21, 2004, at 15:22:25
Hi,
Thank you very much for your advice. I am going into town on Thursday and I will look for the supplements that you suggested. I'm also seeing my pdoc on Thursday so I will see if he is willing to be adventurous and prescribe something other than an SSRI!
A few years ago, when I encouraged my pdoc to prescribe lofepramine in combination with citalopram I went to the hospital pharmacy to collect the prescription. My prescription caused immense excitement (almost to the point of convulsions) among the pharmacy staff because they'd never encountered a patient on two ADs at the same time before.... strange considering that it's a psych hospital. Anyway, I had to wait almost an hour for my prescription to be dispensed because the head of the department had to be involved, my 'notes' had to be acquired and my pdoc had to be contacted. My pdoc claims that he has now got a reputation for unusual prescribing!!! I no longer go to the hospital pharmacy, it's much more convenient to go to the pharmacy down the road where no questions are asked. I guess I should be applauding the pharmacy staff for questioning the safety of my prescription. Apparantly, they still think I'm at risk of the serotonin syndrome even though I've been on the combination for 2 years! Why does no one know that lofepramine is a norepinephrine reuptake inhibitor?
Ed.
Posted by ed_uk on December 21, 2004, at 16:58:58
In reply to Re: Stimulant Dependence and Abuse » ed_uk, posted by TomG on December 21, 2004, at 15:43:21
Hi Tom!
Adrafinil isn't available on prescription in the UK. I don't think it's available in pharmacies or health food shops either. I'll look at the website that you suggested.
Thank you,
Ed.
Posted by jujube on December 21, 2004, at 17:11:40
In reply to Re: Stimulant Dependence and Abuse..... to Jujube, posted by ed_uk on December 21, 2004, at 16:56:48
My pleasure Ed. Hope you can find the supplements. I think you might be pleasantly surprised by the NADH. Good luck with your pdoc too.
Take care.
Tamara
> Hi,
>
> Thank you very much for your advice. I am going into town on Thursday and I will look for the supplements that you suggested. I'm also seeing my pdoc on Thursday so I will see if he is willing to be adventurous and prescribe something other than an SSRI!
>
> A few years ago, when I encouraged my pdoc to prescribe lofepramine in combination with citalopram I went to the hospital pharmacy to collect the prescription. My prescription caused immense excitement (almost to the point of convulsions) among the pharmacy staff because they'd never encountered a patient on two ADs at the same time before.... strange considering that it's a psych hospital. Anyway, I had to wait almost an hour for my prescription to be dispensed because the head of the department had to be involved, my 'notes' had to be acquired and my pdoc had to be contacted. My pdoc claims that he has now got a reputation for unusual prescribing!!! I no longer go to the hospital pharmacy, it's much more convenient to go to the pharmacy down the road where no questions are asked. I guess I should be applauding the pharmacy staff for questioning the safety of my prescription. Apparantly, they still think I'm at risk of the serotonin syndrome even though I've been on the combination for 2 years! Why does no one know that lofepramine is a norepinephrine reuptake inhibitor?
>
> Ed.
This is the end of the thread.
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