![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by delna on July 10, 2001, at 11:28:25
LONG
Hi
I was wondering what u make of this:
I am on 300mg effexor and am totally fine.
I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal . had no job, life, friends for years and no desire to even get a life. SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
The only crippling problem is feeling sleepy all day. I have always had this prob with sleepiness and hypersomnia which is certainly not being caused by the venlafaxine.
Overall the drug has changed my life- I feel normal.
But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate. The doctor believes that the parnate should deal with this sleepiness ( although it is sedating in some people- probably me! ) This is a scary process as it involves withdrawing from effexor (which is tough) and going on a drug that may improve the depression as well as effexor but not help with the sleepiness infact it may sedate me more.I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
Shouldn’t he just add stimulants to effexor to control the sleepiness?
Thanks for listening
Any views welcome
delna
Posted by sl on July 10, 2001, at 11:43:56
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
>
> Thanks for listening
> Any views welcome
> delnaHeh. In a word, YES. What I found out AFTER my doctor changed me off the med I had about a 75% recovery on is this: If you're responding MOSTLY to a med, they're supposed to ADD something, not change you off it. (you can search online under partial response to find documentation)
My suggestion would be to add Wellbutrin, or up the dosage of Effexor to see if the stimulating effects clear out the sleepiness (my research says you could go as high as 375mg). They could even use Provigil, which is usually prescribed for narcolepsy, or Adderall which is a stimulant prescribed ususally for ADD.
Anyway, given what you've said, I side with you. ;)
Luck...
sl
Posted by Amy Blue on July 10, 2001, at 11:46:48
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
If Effexor is working so well, don't go off it. All docs have different opinions. I'm sure there is something you can take to augment the Effexor and treat the sleepiness. I don't know if Effexor/Wellbutrin is a safe combo but Wellbutrin is highly stimulating. If you took a small dose, like half what's considered therapeutic, it would probably give you more energy. I don't know where your doc is coming from - lots of meds make people sleepy but they still work on the problem. For example, Percoset makes people sleepy but it still relieves pain. Does that mean it's not working on the pain? No. And it's so HARD to find an A/D that works, it seems crazy to switch you if you're having such positive results. Good luck! If you're not satisfied w/ your doc then seek another opinion. I'm glad you're feeling so good on Effexor and have your life back!
Posted by kid_A on July 10, 2001, at 12:46:29
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
Threes a big difference between -wanting- to sleep all of the time, where I'm sure a lot of us have been... and just feeling sleepy because of medication... Definitely augment, dont quit the effexor if its working for you...> I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
Posted by SalArmy4me on July 10, 2001, at 14:40:38
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
Going on an MAOI could make you sleepier...despite what everyone says about Parnate, I and a few others were made drowsy by Parnate. Plus, there are plenty of other side-effects. I would say that going on an MAOI should be attempted only after the failure of Effexor, Remeron, Serzone, Wellbutrin, and a few tricyclics: http://www.vh.org/Providers/Conferences/CPS/19.html
Posted by Zo on July 10, 2001, at 15:08:39
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
> Shouldn’t he just add stimulants to effexor to control the sleepiness?Yes, he should. But he may be one of the old school, the timid ones, the ones who'll put the patient through bloody hell instead of doing something easy that works. My pdoc wouldn't hesitate a minute to do as you suggested, and I'm sure there's many others like him. They're either anti-cocktail, which is just plain dumb, or they're willing to actually think, and help.
Good luck,
Zo
Posted by noa on July 10, 2001, at 15:46:30
In reply to Re: is everything a sign of underlying dep???!!! » delna, posted by Zo on July 10, 2001, at 15:08:39
I agree--going off of effexor should only be done after other options have been explored. First of all, the effexor seems to work well for you. Second, withdrawal from effexor can be nasty. Third, it is still a big unknown about new ADs you might try.
You might also want to consider having a sleep study done. Narcolepsy is just one of many sleep disorders. The other two that I think are the most common are obstructive sleep apnea and periodic limb movement disorder.
If you snore, I think the apnea is a likely candidate.
It seems conceivable to me that the serotonin action of the effexor could lead to leg movements while you sleep.
What happens in either case is microarousals---tiny awakenings that you wouldn't be aware of but that severely disrupt the sleep patterns.
For more info, see http://www.sleepnet.com/intro.htm
Also, as others mentioned--it is possible that the effexor causes you to feel sleepy. I agree that it is worth exploring the stimulant option.
Also--have you had your thyroid tested?
Posted by Cece on July 10, 2001, at 21:52:38
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
Well, I think that your story is amazing, and I'm glad that you survived such hell. The question that you raise is very interesting.
I second all the suggestions made- monotherapy is out-of-date!
I want to also say that a sleep study (a complete one, which can only be found at a sleep disorders clinic) is a very good idea (ditto thyroid tests- again complete ones). Along the path of dealing with depression/sedation/ sleepiness, trying to sort it all out, I managed to finagle a sleep study at Stanford out of my HMO (doing so was a real coup). They diagnosed me with "Upper Airway Obstructive Disorder" which is a diagnosis that they developed there.
What it meant was, and this completely verified all my own perceptions, that my airway was not totally collapsing during sleep as in sleep apnea, but it was partially closing down and keeping my body on 'alert'. Consequently, I was not able to go into the deepest level of sleep which restores and refeshes the body.
As well as BP depression, I also have fibromyalgia, which from my experience and research I have come to believe is the consequence of disordered sleep. Nortriptyline (and earlier before poop-out, Trazadone) had helped this problem significantly- at its worst I could sleep many hours, wake up exhausted feeling like I had spent the whole night 'working in my dreams', and feeling like I had been run over by a truck- whether I was depressed or not.
The treatment for Upper Airway,etc is the same as for sleep apnea: sleeping at night hooked up to a device called a CPAP machine (Continuous Positive Airway Pressure)- this is not invasive like a respirator, it just maintains enough air pressure so that your airway stays fully open. This helped me a lot- didn't solve all my problems but made a big difference in the quality of my sleep and my alertness. I used it continually for a year, and now use it periodically when I feel an energy/fibromyalgia relapse.
I don't use it all the time anymore because my problem is not so severe (result of other meds? weight loss? I'm not sure), but also because it is a drag: I felt kinda like Bride of Frankenstein (I had no love life at the time, so no witnesses), it was hard for me to find a mask that fit me comfortably, and there is maintenance (you have to clean the mask daily with sterilizer). BUT, I am very grateful to have it, and as I write this, I think that I am due for another round on it.
I hope that you have access to good resources, including a more creative pdoc, and that your progress continues. You have come so very far- go for the whole banana!
Cece
> LONG
>
> Hi
>
> I was wondering what u make of this:
>
> I am on 300mg effexor and am totally fine.
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal . had no job, life, friends for years and no desire to even get a life. SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
> The only crippling problem is feeling sleepy all day. I have always had this prob with sleepiness and hypersomnia which is certainly not being caused by the venlafaxine.
> Overall the drug has changed my life- I feel normal.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate. The doctor believes that the parnate should deal with this sleepiness ( although it is sedating in some people- probably me! ) This is a scary process as it involves withdrawing from effexor (which is tough) and going on a drug that may improve the depression as well as effexor but not help with the sleepiness infact it may sedate me more.
>
> I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
>
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
>
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
>
> Thanks for listening
> Any views welcome
> delna
Posted by Elizabeth on July 11, 2001, at 1:56:53
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal. had no job, life, friends for years and no desire to even get a life.
This sounds somewhat typical of severe, early-onset depression.
> SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
Same problem here with MAOIs (SSRIs didn't do anything that I noticed).
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
Great! What dose?
> Overall the drug has changed my life- I feel normal.
That's a panacea for anyone who's been in your position.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
Would you describe this as "brain fog?"
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate.
I don't know if that's such a good idea -- you're doing so well on Effexor otherwise, it seems like a bad plan to tinker with it. Also, Parnate isn't always as stimulating as its reputation would lead you to believe. (I would expect the Parnate to help with your depression, but it just might not be worth it.)
I'm also not sure I agree with your pdoc about the fatigue being related to the depression. Drowsiness can be a side effect of Effexor, although activation is more common.
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
Maybe, but it can just as easily be a med side effect. Only you can tell for sure (consider the quality of the sleepiness compared to fatigue in depression, relation to dose timing, etc.). Narcolepsy is more than just daytime sleepiness (it involves daytime attacks of REM sleep -- often provoked by emotions -- with cataplexy, not constant daytime sleepiness.)
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
I think that seems like a reasonable idea. Provigil seems like a good bet since it has helped you in the past. Mirapex (a dopaminergic antiparkinsonian drug) may also be helpful for you. If those fail, there are always the standard psychomotor stimulants (Ritalin, amphetamine, Cylert). This seems much more reasonable than expecting you to go through the washout period to try a MAOI which may or may not solve the daytime fatigue problem.
-elizabeth
Posted by Elizabeth on July 11, 2001, at 2:00:14
In reply to Re: is everything a sign of underlying dep???!!! , posted by Amy Blue on July 10, 2001, at 11:46:48
> I don't know if Effexor/Wellbutrin is a safe combo but Wellbutrin is highly stimulating.
Good point (and yes, it is a safe combo; it's been used often).
> I don't know where your doc is coming from - lots of meds make people sleepy but they still work on the problem. For example, Percoset makes people sleepy but it still relieves pain.
I never took Percocet (oxycodone + Tylenol) specifically, but opioids in general are stimulating for me, not sedating -- just as Effexor (which has a reptutation for being stimulating) is sedating for delna).
> And it's so HARD to find an A/D that works, it seems crazy to switch you if you're having such positive results.
What she said!
-elizabeth
Posted by Elizabeth on July 11, 2001, at 2:02:24
In reply to Re: MAOI, posted by SalArmy4me on July 10, 2001, at 14:40:38
> I would say that going on an MAOI should be attempted only after the failure of Effexor, Remeron, Serzone, Wellbutrin, and a few tricyclics: http://www.vh.org/Providers/Conferences/CPS/19.html
In cases of atypical depression, I disagree. It has been well established that tricyclics (at least) do not work as well as MAOIs in atypical depression; tricyclics are, however, at least as toxic as MAOIs (sometimes depending on individual patient characteristics).
Also, I know I'm not the only one who finds MAOIs easier to tolerate than tricyclics.
-elizabeth
Posted by SalArmy4me on July 11, 2001, at 2:30:52
In reply to Re: MAOI » SalArmy4me, posted by Elizabeth on July 11, 2001, at 2:02:24
> In cases of atypical depression, I disagree. It has been well established that tricyclics (at least) do not work as well as MAOIs in atypical >depression;
You're right-- MAOI's work better in atypical depression, but all the literature refers to people going from failed trials of TCA's to MAOI's and not starting a MAOI before a trial of TCA's. Maybe that shows that clinicians trust TCA's more than MAOI's as far as safety is concerned:
"A review of 10 studies reported that 62% (138/221) of patients that had failed a treatment trial of a TCA responded to a MAOI (Thase and Rush 1995). Following is a description of a selected group of reports.
Quitkin et al (1981) reported, retrospectively, that 76% of 40 patients with bipolar depression treated with a first or second-generation agent responded favorably to treatment. The authors indicated that 6 of 8 non-responders to standard antidepressants responded to a MAOI. They recommended MAOI, not another type of "cyclic" antidepressant, be used as second-line treatment when ECT is deemed unsuitable in non-responders.
Georgotas et al (1983) found that 13/20 (65%) patients responded to an average phenelzine dose of 48 mg/d (80% MAOI inhibition) in a 2 to 7 week open trial. All were TCA-resistant elderly patients and their final HRSD scores were < 10.
Pare (1985) reported that 15/26 (58%) DSM-III-diagnosed patients with depression, who had failed successive four-week trials of a first and second-generation antidepressant, respectively, responded to a trial of tranylcypromine.
Roose's et al (1986) reported all patients who failed to respond to an adequate trial of TCAs responded to MAOIs or ECT.
A double blind, placebo-controlled study reported that 17/26 (65%) TCA-failures improved with phenelzine 72 + 8 mg/d (McGrath et al 1987).
Nolen et al (1988) in an open randomized trial studied 67 patients that failed > imipramine 150 mg/d for 4 weeks. Serum concentrations were not reported. Forty-five (58%) of the patients responded to a subsequent trial of tranylcypromine.
Amsterdam and Berwish (1989) in a case series of 14 patients that failed an average of 5 different treatments reported that all patients responded to high doses of tranylcypromine. Average doses were 114 mg/d (+ 14)."
Treatment of Refractory Depression
University of Iowa Clinical Psychopharmacology Seminar
http://www.vh.org/Providers/Conferences/CPS/11.html
Original Author(s): Bruce Alexander, Pharm.D.
Latest Reviser(s): Bruce Alexander, Pharm.D., and Eric Kutscher
Creation Date: 1996
Last Revision Date: January 2000
Peer Review Status: Internally Peer Reviewed
Posted by paulk on July 11, 2001, at 16:07:15
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
I was in a similar situation and am now doing much better on Nardil. There seems to be something with Effexor that made me sleepy if the dose was too high. I did best at 75 mg,.
You might have your doc try adding some Adderal – but first and for most have your thyroid checked.
Posted by Elizabeth on July 11, 2001, at 16:18:57
In reply to TCA before MAOI » Elizabeth, posted by SalArmy4me on July 11, 2001, at 2:30:52
> You're right-- MAOI's work better in atypical depression, but all the literature refers to people going from failed trials of TCA's to MAOI's and not starting a MAOI before a trial of TCA's. Maybe that shows that clinicians trust TCA's more than MAOI's as far as safety is concerned:
And maybe they should rethink that assumption. The MAOI-food interactions are much better understood than they were in the '70s and '80s; for patients who are able to follow the dietary restrictions, MAOIs are quite safe.
-elizabeth
Posted by Snuffy on July 12, 2001, at 11:50:36
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
> LONG
>
> Hi
>
> I was wondering what u make of this:
>
> I am on 300mg effexor and am totally fine.
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal . had no job, life, friends for years and no desire to even get a life. SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
> The only crippling problem is feeling sleepy all day. I have always had this prob with sleepiness and hypersomnia which is certainly not being caused by the venlafaxine.
> Overall the drug has changed my life- I feel normal.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate. The doctor believes that the parnate should deal with this sleepiness ( although it is sedating in some people- probably me! ) This is a scary process as it involves withdrawing from effexor (which is tough) and going on a drug that may improve the depression as well as effexor but not help with the sleepiness infact it may sedate me more.
>
> I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
>
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
>
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
>
> Thanks for listening
> Any views welcome
> delna
Boy, can I really relate to your situation!!! I am on 300mg effexor, 450mg wellbutrin and 200mg seroquel. I live each day in a "brain fog" (like Elizabeth mentioned). I have been asking my pdoc for something that would clear up my head and get rid of the sleepiness. Like yours my pdoc said that my sleepiness is likly a sign that the depression issue has not been resolved.Based on some research on this web sight and others I suggested Adderall. She said we will try ritalin sr because it is short action and adderall is long lasting and she did not want to interupt my sleep ha ha. I have just started today and can't give any report if it works or not yet. Also I discovered that my insurance will only pay for it if it is perscribed for people through 14 years old. So, I paid $96 for one month of 2x20 mg per day. Add that to my copays for everything else (including blood preasure meds) and I'll go broke long before I get "normal".
Posted by AMenz on July 12, 2001, at 13:31:57
In reply to is everything a sign of underlying dep???!!! , posted by delna on July 10, 2001, at 11:28:25
I would not do that. You have found a drug that works and that doesn't cover one symptom. Why don't you look into Modafinil, Adrafanil here on the board and ask questions of people that have actually taken them.
I took parnate for many years. It is an anxiety producing drug. It is a drug I took and hated.
Don't fiddle with the success of the drug which has already helped.
> LONG
>
> Hi
>
> I was wondering what u make of this:
>
> I am on 300mg effexor and am totally fine.
> I mean I used to have severe depression, sleep all day(20hrs at least), never leave the house and had no future plans and was perpetually suicidal . had no job, life, friends for years and no desire to even get a life. SSRIs didn’t help much- I felt less anxious and self destructive but I had no enthusiasm- so I continued the same lifestyle.
> With effexor I love doing stuff eg working making friends and am full of life and plans. I am enthusiastica
> The only crippling problem is feeling sleepy all day. I have always had this prob with sleepiness and hypersomnia which is certainly not being caused by the venlafaxine.
> Overall the drug has changed my life- I feel normal.
> But so sleepy. But I don’t sleep excessively like when I was depressed. I still jump up to go to work in the morning. I just feel sleepy at work and not 100% alert.
> My psych insists that the sleepiness indicates that the depression (atypical) is still there and wants to switch me to parnate. The doctor believes that the parnate should deal with this sleepiness ( although it is sedating in some people- probably me! ) This is a scary process as it involves withdrawing from effexor (which is tough) and going on a drug that may improve the depression as well as effexor but not help with the sleepiness infact it may sedate me more.
>
> I argued that I have no signs of atypical depression any more. I’m sleepy but I am not lethargic, apathetic, tired, sad etc anything. And also when provigil kept me awake those few days that it worked ,I was 100% good. Efficient and functional
>
> I know I don’t have narcolepsy as the symptoms don’t quite match but I feel that if the low mood, apathy, depressive symptoms have gone and I am happy and raring to go, how can he say that the sleepiness is a sign of unresolved depression??
>
> Shouldn’t he just add stimulants to effexor to control the sleepiness?
>
> Thanks for listening
> Any views welcome
> delna
Posted by Elizabeth on July 12, 2001, at 19:56:45
In reply to Re: is everything a sign of underlying dep???!!! » delna, posted by Snuffy on July 12, 2001, at 11:50:36
> Boy, can I really relate to your situation!!! I am on 300mg effexor, 450mg wellbutrin and 200mg seroquel. I live each day in a "brain fog" (like Elizabeth mentioned). I have been asking my pdoc for something that would clear up my head and get rid of the sleepiness. Like yours my pdoc said that my sleepiness is likly a sign that the depression issue has not been resolved.
FWIW, I met somebody who said that the Alzheimer's drug Aricept (donepezil, a cholinesterase inhibitor) helped her with brain fog. I don't know much about her illness otherwise, though.
> She said we will try ritalin sr because it is short action and adderall is long lasting and she did not want to interupt my sleep ha ha.
It's better to start with a shorter-acting drug in case of adverse reactions, yeah. You might switch to Adderall, Concerta, or Dexedrine Spansules (sustained-release d-amphetamine) if the Ritalin SR pans out.
BTW, about the money thing: Ritalin SR isn't much longer-acting than plain Ritalin, which is a lot cheaper even if your insurance doesn't cover it.
-elizabeth
Posted by jojo on July 14, 2001, at 12:39:37
In reply to Re: is everything a sign of underlying dep???!!! » Snuffy, posted by Elizabeth on July 12, 2001, at 19:56:45
> > Boy, can I really relate to your situation!!! I am on 300mg effexor, 450mg wellbutrin and 200mg seroquel. I live each day in a "brain fog" (like Elizabeth mentioned). I have been asking my pdoc for something that would clear up my head and get rid of the sleepiness. Like yours my pdoc said that my sleepiness is likly a sign that the depression issue has not been resolved.
>
> FWIW, I met somebody who said that the Alzheimer's drug Aricept (donepezil, a cholinesterase inhibitor) helped her with brain fog. I don't know much about her illness otherwise, though.
>
> > She said we will try ritalin sr because it is short action and adderall is long lasting and she did not want to interupt my sleep ha ha.
>
> It's better to start with a shorter-acting drug in case of adverse reactions, yeah. You might switch to Adderall, Concerta, or Dexedrine Spansules (sustained-release d-amphetamine) if the Ritalin SR pans out.
>
> BTW, about the money thing: Ritalin SR isn't much longer-acting than plain Ritalin, which is a lot cheaper even if your insurance doesn't cover it.
>
> -elizabethBTW, there is only one short acting stimulant, as
far as I know, and that is Dexedrine 5 mg tablets.
Posted by Cece on July 14, 2001, at 21:16:54
In reply to Re: is everything a sign of underlying dep???!!! » Snuffy, posted by Elizabeth on July 12, 2001, at 19:56:45
Hi-
I had brain fog for a long time- despite reducing doses of sedating meds. I tried Aricept, didn't do a thing for me, and made me feel a little weird (sorry, don't remember details of weirdness- it was awhile ago).
The fog didn't break for me until early this year when in a close space of time I started taking Adderall 10mg/day, and T4 Thyroid Levothroid 50mcg/day. I had already been taking T3 thyroid (Cytomel 10mcg/day) for several years as an AD augmenter.
Since I started taking both of them close together, it's hard to say if both did the trick, or if one or the other was the real helper.
I had never had the full battery of Thyroid tests before and always had tested 'borderline okay'. When I had complete tests, I came in 'borderline low'. Some pdocs use Thyroid meds as ADs even if tests are normal.
Re the Adderall- v. hard to say if I'm ADD- maybe, but not classically so. I actually don't care whether I am or not, I just care that this med has helped me.
Cece
>
> FWIW, I met somebody who said that the Alzheimer's drug Aricept (donepezil, a cholinesterase inhibitor) helped her with brain fog. I don't know much about her illness otherwise, though.
>
Posted by Elizabeth on July 15, 2001, at 16:52:10
In reply to Re: is everything a sign of underlying dep???!!! » Elizabeth, posted by Cece on July 14, 2001, at 21:16:54
> I had brain fog for a long time- despite reducing doses of sedating meds. I tried Aricept, didn't do a thing for me, and made me feel a little weird (sorry, don't remember details of weirdness- it was awhile ago).
I asked my pdoc about Aricept. He wasn't impressed by it (for Alzheimer's, anyway) but said it might help reduce anticholinergic side effects (a major problem for me).
> The fog didn't break for me until early this year when in a close space of time I started taking Adderall 10mg/day, and T4 Thyroid Levothroid 50mcg/day. I had already been taking T3 thyroid (Cytomel 10mcg/day) for several years as an AD augmenter.
That sounds so jittery!
> Since I started taking both of them close together, it's hard to say if both did the trick, or if one or the other was the real helper.
That's the trouble with trying things all at once. OTOH, if you can't wait, you have to.
> I had never had the full battery of Thyroid tests before and always had tested 'borderline okay'. When I had complete tests, I came in 'borderline low'. Some pdocs use Thyroid meds as ADs even if tests are normal.
That's true. I've always thought maybe I should try T3 or T4, although my TSH has always come back normal (I was taking lithium for a while so I had it tested regularly).
> Re the Adderall- v. hard to say if I'm ADD- maybe, but not classically so. I actually don't care whether I am or not, I just care that this med has helped me.
In what way?
-elizabeth
Posted by Cece on July 15, 2001, at 22:47:04
In reply to Re: is everything a sign of underlying dep???!!! » Cece, posted by Elizabeth on July 15, 2001, at 16:52:10
Hi Elizabeth- replies to some of your comments, and question:
> >Cece: I had brain fog for a long time- despite reducing doses of sedating meds.
The fog didn't break for me until early this year when in a close space of time I started taking Adderall 10mg/day, and T4 Thyroid Levothroid 50mcg/day. I had already been taking T3 thyroid (Cytomel 10mcg/day) for several years as an AD augmenter.
>
>Elizabeth: That sounds so jittery!
Cece: I wouldn't be taking it if it were jittery for me! The next step up of Levothroid (75mg) did in fact give me unpleasant side effects (racing heart, feeling overheated), so I stayed at 50mg which is just fine. More than 10mg/day of Adderall makes me feel slightly wired, but 10 is just fine---for me.
>> >Cece: Re the Adderall- v. hard to say if I'm ADD- maybe, but not classically so. I actually don't care whether I am or not, I just care that this med has helped me.
>
> Elizabeth: In what way?
> Cece: Well, like I said above- brain fog broke, like the sky opening. Also, I have started being able to make decisions (not ready for all of them yet however!), have more energy, wake up faster in the morning, more outgoing.
I am also slowly increasing Lamictal, have gone really slowly and sat at the same level for awhile a couple of times- after a bit over a year, I am at 250mg. and am increasing by larger increments. I am getting less and less depressed as I increase- am aiming right now for 300, and may sit there for awhile. I hope to be able to start to try dropping other meds out of my mix if the Lamictal really proves to be a real stabilizer and AD. Perhaps the Adderall will turn out to have been a temporary fix, but it really has helped get me moving in positive ways.Cece
Posted by Elizabeth on July 16, 2001, at 21:36:21
In reply to Re: is everything a sign of underlying dep???!!! » Elizabeth, posted by Cece on July 15, 2001, at 22:47:04
> >Elizabeth: That sounds so jittery!
> Cece: I wouldn't be taking it if it were jittery for me!Obviously. :) What I meant was it's hard to imagine that cocktail *not* being jittery!
> Cece: Well, like I said above- brain fog broke, like the sky opening.
Ahh. I remember Cylert helping with that some. Buprenorphine and morphine have, too. The only times I tried other stimulants, I was taking MAOIs (Nardil or Parnate) at the same time and got jittery (among other things).
> I am also slowly increasing Lamictal, have gone really slowly and sat at the same level for awhile a couple of times- after a bit over a year, I am at 250mg. and am increasing by larger increments. I am getting less and less depressed as I increase- am aiming right now for 300, and may sit there for awhile.
That's great that it's helping you. It didn't do a thing for me (up to 500 mg), but it was very tolerable.
-elizabeth
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