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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 26. This is the beginning of the thread.
Posted by ed_uk on December 19, 2004, at 14:39:42
I have a big problem with excessive daytime sleepiness. I take a nap nearly every day and my motivation is poor.
Effect of caffeine....
Small dose=no response
High dose=excessive urination followed by a 'crash.' Very little stimulation :-(
I hate caffeine! I'd like to try Dexedrine but is no way that that my pdoc would prescribe it. You have to be prepubescent in the UK to be treated with a stimulant. Docs seem to think that stimulants are 1000% safer for children! Who are they kidding? Have the effects of amphetamines on the developing brains of children been thoroughly researched? No!!!
Pdocs seem obssessed with the idea that children respond very differently to stimulants than adults. Are they delusional? Has no one noticed that stimulants can improve concentration in adults as well? Has no one noticed that adults suffer from inattention as well? Unfortunately, stimulants are not necessarly 'calming' in children. Some children become severely agitated on stimulants- some adults respond similarly.
A statement from the Ritalin data sheet... 'The long-term safety and efficacy profiles of Ritalin are not fully known.' I bet child psychiatrists don't always tell parents!
Anyway, I still want to try Dexedrine. I can't keep spending so much time asleep. I feel like my brain is full of cotton wool. It's often hard to keep my eyes open.
Ed.
Posted by JACJ on December 19, 2004, at 15:31:13
In reply to Caffeine doesn't like me! My rant!, posted by ed_uk on December 19, 2004, at 14:39:42
Ed,
I totally believe that caffeine is so bad for one but I just recently started drinking tons of coffee again. I cut all caffeine out of my world and now that I am feeling better I started up again which is a no no. I read this book and it was about coffee toxins. It blew me away.I noticed I am more addicted now to caffeine and that is due to my replacing one addiction with another and it scares me. Any research you found about caffeine?; please let me know.
Thanks,
JACJ
Posted by ed_uk on December 19, 2004, at 15:55:58
In reply to Re: Caffeine doesn't like me! My rant!, posted by JACJ on December 19, 2004, at 15:31:13
Hi!
Sorry about the rant!
For me, caffeine is very un-addictive! This is how it works.....
I take some caffeine.....
It doesn't reduce my tiredness....
A few hours later I 'crash' and feel even more tired than I was in the first place.....
During the 'crash' the idea of taking more caffeine seems unpleasant, I just want to go to sleep!
Ed.
Posted by ed_uk on December 19, 2004, at 16:36:21
In reply to Re: Caffeine doesn't like me! My rant! » JACJ, posted by ed_uk on December 19, 2004, at 15:55:58
........ I can't go on being this tired and lazy. I'm tired and lazy when I'm not on any medication but citalopram makes it worse.
Ed.
Posted by linkadge on December 19, 2004, at 16:57:13
In reply to Shall I stop the citalopram and ask for Parnate?, posted by ed_uk on December 19, 2004, at 16:36:21
lower the citalopram and up the lofepramine.
Linkadge
Posted by ed_uk on December 19, 2004, at 17:23:27
In reply to Re: Shall I stop the citalopram and ask for Parnate?, posted by linkadge on December 19, 2004, at 16:57:13
Hi Link,
I've tried much higher doses of lofepramine but it doesn't reverse the SSRI apathy. I'm worried that if I reduce the citalopram my anxiety will come back... that's what happened the last time I reduced the dose.
Ed.
Posted by KaraS on December 19, 2004, at 17:42:32
In reply to Shall I stop the citalopram and ask for Parnate?, posted by ed_uk on December 19, 2004, at 16:36:21
> ........ I can't go on being this tired and lazy. I'm tired and lazy when I'm not on any medication but citalopram makes it worse.
>
> Ed.
I wonder how you would react to stimulants if coffee puts you to sleep. They might do the same. Stimulants put me to sleep as I've mentioned previously - yet coffee does wake me up (though the side effects can be hard to take.)I think Linkadge's suggestion makes sense. Also, have you tried another SSRI that isn't as sedating as citalopram? If those adjustments don't work out, then Parnate sounds very reasonable. But then, I'm sure you know all of this and you're thinking out loud more than anything else.
Kara
Posted by ed_uk on December 19, 2004, at 18:07:56
In reply to Re: Shall I stop the citalopram and ask for Parnate? » ed_uk, posted by KaraS on December 19, 2004, at 17:42:32
Hi Kara,
Coffee doesn't put me to sleep, I feel very tired when it wears off- this is despite the fact that it doesn't increase my alertness when it is 'working'.
I've tried plenty of different SSRIs, they're all basically the same for me!
Ed.
Posted by linkadge on December 19, 2004, at 18:19:17
In reply to Re: Shall I stop the citalopram and ask for Parnate? » KaraS, posted by ed_uk on December 19, 2004, at 18:07:56
If you say that citalopram helps your anxiety, I don't know if a swich to parnate is really what you want. You'd have to stop citalopram for like 2+ weeks and lofepramine. I tried parnate, and it was a good AD, but it is NOT the med for anxity and or OCD.
Linkadge
Posted by ed_uk on December 19, 2004, at 18:31:38
In reply to Re: Shall I stop the citalopram and ask for Parnate?, posted by linkadge on December 19, 2004, at 18:19:17
.... some people do find Parnate good for anxiety though.
ed
Posted by TheOutsider on December 19, 2004, at 18:42:10
In reply to Re: Shall I stop the citalopram and ask for Parnate? » linkadge, posted by ed_uk on December 19, 2004, at 18:31:38
Hey Ed
Sorry to hear of your predicament.
Believe me I feel exactly the same as you do about UK docs phobia of stimulents!
I found a really kind doctor in the UK who prescribed me Dexedrine, which worked like a charm!
Unfortunatly he was forced to retire (unsuprisingly).I have a few suggestion for you.
Firstly you could order provigil or selegiline over the net.
I personaly found selegeline somewhat helpful for motivation and energy, didn't like provigil, but then everyones different.I think maybe you should consider going to the US for stimulent treatment.
I'm thinking about it now as my social anxiety is driving me up the wall!
I've paid hundreds of pounds to no effect.....
Posted by KaraS on December 19, 2004, at 19:07:22
In reply to Re: Shall I stop the citalopram and ask for Parnate? » KaraS, posted by ed_uk on December 19, 2004, at 18:07:56
> Hi Kara,
>
> Coffee doesn't put me to sleep, I feel very tired when it wears off- this is despite the fact that it doesn't increase my alertness when it is 'working'.
>
> I've tried plenty of different SSRIs, they're all basically the same for me!
Did you say that the SSRIs are the only meds that will take away your anxiety? What about a sedating TCA? Those worked really well for me many years ago during my last high anxiety period? You could also take the lofepramine with one of those, right?>
> Ed.
Posted by linkadge on December 19, 2004, at 19:41:00
In reply to Re: Shall I stop the citalopram and ask for Parnate?, posted by KaraS on December 19, 2004, at 19:07:22
I'm not saying that the idea is totally out of the water, but I remember the hell of swiching from celexa to parnate.
The withdrawl is utter hell on earth. And for me, parnate was too overrated. It was a good dopaminergic (Ie wasn't apathetic), but I was very "blue" on it. 60mg of parnate didn't seem to cover the serotogenic aspect of even 20mg of citalopram, and you can't do much about that.
I would try some of the other augementation stategies you have:
Wellbutrin, Mirapex, Requip, more/stronger TCA,
Selegeline, stimulant, etc, modafanil, etc.In depression, apathy is usually takes the longest to resolve. Oftentimes, apathy is the result of chronic anxiety that has not remitted for a long time.
When I was anxiety free on celexa for about 10months, thats when the apathy started to abate.
Its your call, of course.
Linkadge
Posted by jujube on December 19, 2004, at 23:19:15
In reply to Shall I stop the citalopram and ask for Parnate?, posted by ed_uk on December 19, 2004, at 16:36:21
This probably isn't what you want to hear, but I am not going to suggest a med change. What I am going to suggest is that you try adding some NADH (about 7.5 mg or 10 mg) and some DMAE to your regime (both of which are natural supplements). Although it is early to be singing the praises of either supplement, I have been taking both of them for about 1 week now, and have noticed a definite improvement in my energy and motivation. Granted, I have forgotten to take my Celexa for about 5 days now, and had to reduce my dose of Anafranil to 25 mg (from 50 mg) because I was having a hard time coping with the constant dizziness, constipation and weight gain. So who knows. In the past, other babblers have used NADH and reported success. You might want to do a search.
What ever you decide, I wish you success and good mental health (and increased energy and enthusiasm).
Tamara
> ........ I can't go on being this tired and lazy. I'm tired and lazy when I'm not on any medication but citalopram makes it worse.
>
> Ed.
Posted by glenn on December 20, 2004, at 3:57:12
In reply to Re: Shall I stop the citalopram and ask for Parnate? » ed_uk, posted by jujube on December 19, 2004, at 23:19:15
Hi Ed,
I tend to agree with jujube, ask Larry Hoover he has lots of experience with NADH and his favourite, betaine (TMG),also you could consider the higher dose of pikamilon.
Away for a week now , have a good xmas.Glenn
Posted by ed_uk on December 20, 2004, at 12:21:23
In reply to Re: Shall I stop the citalopram and ask for Parnate?, posted by glenn on December 20, 2004, at 3:57:12
Hi....
Thank you all for your responses. I reduced my citalopram from 60mg down to 10mg a few days ago. I haven't had any withdrawal symptoms apart from increased dreaming and mild night sweats. I reduced the dose abruptly because I'm trying to revise for my January exams and I'm not getting anywhere, I can't get anything done. My eyelids are heavy and I love my bed.
I don't know why I'm even considering Nardil or Parnate. My pdoc is only familiar with SSRIs, I very much doubt that he will even had heard of Parnate. A few years ago, he was even shocked when I suggested nortriptyline. I am the first patient that he has even had on two ADs at once. There is virtually no chance that he would ever consider giving me any of the drugs that Linkadge suggested. I think I'm just going to have to manage without the citalopram, or maybe continue with 10mg/day. I know that I could achieve something if I was able to do more work, I've already had today's nap. Usually I sleep for a few hours during the day. Of course, my pdoc will interpret this as a sign of depression because he doesn't understand the side effects of SSRIs and depression seems to be the only condition that he is familiar with. I am not depressed or anhedonic, I'm just very sleepy, inattentive and unmotivated. I might try DMAE or another supplement. I havent't had any caffeine today, there isn't really much point!
Thank you,
Ed x
Posted by linkadge on December 20, 2004, at 14:14:30
In reply to Re: Shall I stop the citalopram and ask for Parnate?, posted by ed_uk on December 20, 2004, at 12:21:23
You seem like you're experiencing the same things I have been for the past few years. The SSRI's really do help in once sence, but they also exasperate other symptoms, such as apathy.
Linkadge
Posted by Bill LL on December 21, 2004, at 9:48:32
In reply to Caffeine doesn't like me! My rant!, posted by ed_uk on December 19, 2004, at 14:39:42
I think that most doctors take excessive tiredness very seriously. Provigil (modafinil) is very safe with minimal side effects and is very effective for your symptoms. Ask your doc for it. With exams coming up, this is a big problem.
Posted by ed_uk on December 21, 2004, at 9:59:47
In reply to Re: Caffeine doesn't like me! My rant!, posted by Bill LL on December 21, 2004, at 9:48:32
>I think that most doctors take excessive tiredness very seriously. Provigil (modafinil) is very safe with minimal side effects and is very effective for your symptoms. Ask your doc for it. With exams coming up, this is a big problem.
Hi,
My pdoc doesn't seem to appreciate the importance of excessive daytime drowsiness, he always views it as being a symptom of depression. The concept of somnolence in the absense of depression seems beyond him. I doubt that my pdoc is familiar with Provigil, I very much doubt that he has ever prescribed it. I would like to try it but like I say he is only really familiar with SSRIs. He's keeps telling me that SSRIs are stimulating, he doesn't seem to believe that they can cause drowsiness and apathy. I'd really like to try Provigil though. It's very rarely prescribed in the UK.
Regards,
Ed.
Posted by Bill LL on December 22, 2004, at 8:59:09
In reply to Re: Modafinil, posted by ed_uk on December 21, 2004, at 9:59:47
The idea that adults react differently to stimulants than children has in recent years proven to be false.
Will he at least prescribe Ritalin?
Posted by ed_uk on December 22, 2004, at 9:19:28
In reply to Re: Modafinil, posted by Bill LL on December 22, 2004, at 8:59:09
Hi,
In general, adults seem to tolerate stimulants better than children! No, he would not consider Ritalin :-(
Ed.
Posted by jparsell82` on December 22, 2004, at 19:54:18
In reply to Re: Modafinil » Bill LL, posted by ed_uk on December 22, 2004, at 9:19:28
I thought I'd offer up some suggestions for fatigue(non-prescription). Before I do though... don't they have Milnacipran(Ixel) in the UK? Couldn't you give that a try?
-Centrophenoxine or the cheaper DMAE can help attention and act as a mild psychostimulant... you'd have to experiment with dosages.
-Acetyl-L Carnitine + Alpha-Lipoic Acid will help energy and is good for your health anyways.
-Vinpocetine could really help. It enhances glucose and oxygen uptake from the blood by brain neurons and increases ATP production.
-TMG or DMG
-L-Tyrosine or L-Phenylalanine
-NADH... expensive though and I think it's overrated.
-DHEA boosts energy levels some and can also be helpful for anxiety.
-Rhodiola Rosea(works better than ginseng in my opinion)
-Creatine(the new creatine ethyl ester form you can take in capsules effectively)
-B-Vitamins
-I'm also going to include Aniracetam. For some people it's stimulating, some people it's the opposite and other people do not notice anything. You have to experiment around with the dosage of it because a low dose can be better than a high dose or vice-versa depending on the person. Aniracetam can be helpful for Social Anxiety(check out the first link below). I added a couple more informative links below also.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11412837
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11597608
http://www.bulknutrition.com/?articleID=95
Aniracetam source: www.uniquenutrtion.net
www.imminst.org/forumA lot of these substances above will work best and synergize when taken together. Good luck!
Posted by jujube on December 22, 2004, at 20:04:30
In reply to Re: Modafinil, posted by jparsell82` on December 22, 2004, at 19:54:18
These are great suggestions. I just started using NADH a week ago, and have found it works very well for me (a definite and real improvement in energy levels and motivation). I also added DMAE (250 mg) and, three days ago, started using Rhodiola. In addition, a few weeks ago, I had added Vitex (Chasteberry) mostly for hormonal balancing and PMS. Questions for you. What would be your opinion on my adding about 100 - 200 mg of DMG to take with the NADH in the morning as well as adding a dose of Acetyl L-Carnitine at perhaps noon? I was under the impression that DMAE and Acetyl L-Carnitine did almost the same thing. Would it be overkill to take both at the same time? Have you ever tried Pregnenolone? I was wondering if it might be a more multi-purpose supplement compared to the DHEA?
Thanks, and sorry for all the questions.
Tamara
> I thought I'd offer up some suggestions for fatigue(non-prescription). Before I do though... don't they have Milnacipran(Ixel) in the UK? Couldn't you give that a try?
>
> -Centrophenoxine or the cheaper DMAE can help attention and act as a mild psychostimulant... you'd have to experiment with dosages.
> -Acetyl-L Carnitine + Alpha-Lipoic Acid will help energy and is good for your health anyways.
> -Vinpocetine could really help. It enhances glucose and oxygen uptake from the blood by brain neurons and increases ATP production.
> -TMG or DMG
> -L-Tyrosine or L-Phenylalanine
> -NADH... expensive though and I think it's overrated.
> -DHEA boosts energy levels some and can also be helpful for anxiety.
> -Rhodiola Rosea(works better than ginseng in my opinion)
> -Creatine(the new creatine ethyl ester form you can take in capsules effectively)
> -B-Vitamins
> -I'm also going to include Aniracetam. For some people it's stimulating, some people it's the opposite and other people do not notice anything. You have to experiment around with the dosage of it because a low dose can be better than a high dose or vice-versa depending on the person. Aniracetam can be helpful for Social Anxiety(check out the first link below). I added a couple more informative links below also.
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11412837
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11597608
> http://www.bulknutrition.com/?articleID=95
> Aniracetam source: www.uniquenutrtion.net
> www.imminst.org/forum
>
> A lot of these substances above will work best and synergize when taken together. Good luck!
Posted by ed_uk on December 23, 2004, at 7:38:27
In reply to Re: Modafinil, posted by jparsell82 on December 22, 2004, at 19:54:18
Hi,
Thank you for your suggestions :-)
I went to the pdoc this morning but he refused to prescribe anything for my fatigue/apathy. He asked me whether I was depressed and I said no so he told me that I didn't have a problem. He never looks at my actual symptoms, he's too busy trying to search for symptoms of depression (which is, btw, virtually the only condition that he is familiar with!)
Anyway, I asked him to refer me to a different psychiatrist and he agreed.
I also went to a health food shop this morning. They only had....
DLPA
L-Carnitine
Rhodiola
B-ComplexThey didn't have any of the other supplements that you suggested. Maybe I should order some supplements from a catalogue.
Regards,
Ed.
Posted by jparsell82 on December 26, 2004, at 8:41:31
In reply to Re: Modafinil » jparsell82, posted by jujube on December 22, 2004, at 20:04:30
> These are great suggestions. I just started using NADH a week ago, and have found it works very well for me (a definite and real improvement in energy levels and motivation). I also added DMAE (250 mg) and, three days ago, started using Rhodiola. In addition, a few weeks ago, I had added Vitex (Chasteberry) mostly for hormonal balancing and PMS. Questions for you. What would be your opinion on my adding about 100 - 200 mg of DMG to take with the NADH in the morning as well as adding a dose of Acetyl L-Carnitine at perhaps noon? I was under the impression that DMAE and Acetyl L-Carnitine did almost the same thing. Would it be overkill to take both at the same time? Have you ever tried Pregnenolone? I was wondering if it might be a more multi-purpose supplement compared to the DHEA?
>
> Thanks, and sorry for all the questions.
>
> Tamara
>
I can't give any recommendations on the DMG... I've tried TMG which is almost the same but I would ask Larry Hoover for advice on it. I don't think it would be any problem adding it to your lineup though. I'm not sure whether Pregnenolene of DHEA is superior. Pregnenolene may be better for memory. If you have the money I would get 7-keto DHEA though. You may want to take week long breaks with it every once in awhile too.> > I thought I'd offer up some suggestions for fatigue(non-prescription). Before I do though... don't they have Milnacipran(Ixel) in the UK? Couldn't you give that a try?
> >
> > -Centrophenoxine or the cheaper DMAE can help attention and act as a mild psychostimulant... you'd have to experiment with dosages.
> > -Acetyl-L Carnitine + Alpha-Lipoic Acid will help energy and is good for your health anyways.
> > -Vinpocetine could really help. It enhances glucose and oxygen uptake from the blood by brain neurons and increases ATP production.
> > -TMG or DMG
> > -L-Tyrosine or L-Phenylalanine
> > -NADH... expensive though and I think it's overrated.
> > -DHEA boosts energy levels some and can also be helpful for anxiety.
> > -Rhodiola Rosea(works better than ginseng in my opinion)
> > -Creatine(the new creatine ethyl ester form you can take in capsules effectively)
> > -B-Vitamins
> > -I'm also going to include Aniracetam. For some people it's stimulating, some people it's the opposite and other people do not notice anything. You have to experiment around with the dosage of it because a low dose can be better than a high dose or vice-versa depending on the person. Aniracetam can be helpful for Social Anxiety(check out the first link below). I added a couple more informative links below also.
> >
> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11412837
> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11597608
> > http://www.bulknutrition.com/?articleID=95
> > Aniracetam source: www.uniquenutrtion.net
> > www.imminst.org/forum
> >
> > A lot of these substances above will work best and synergize when taken together. Good luck!
>
>
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