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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Iago Camboa on June 3, 2002, at 6:21:32
I'm taking adrafinil 300mg/day for (mild, hereditary from my mother) narcolepsy and I've had much success with it (a nice boost of energy in all my life and no more frequent naps at telly or at the computer, though I can still nap even during the day if conditions are propitious - as yesterday after lunch...). I'm absolutely sure I'm doing it with so small a daily dosage because I take it together with clomipramine (112.5mg/day) and Xanax (2mg/day)...
All was very well indeed until I began to experiment unpleasant migraines with this medication and I wonder what is the cause of these. Of course I can take 250-500mg of paracetamol or equivalent dose of aspirin & skip the adrafinil one day and get the problem resolved for a while but I'd like to understand what is going on in my body...
You 'lady-experts' (IsoM, Katekite, Elizabeth, etc.) - and 'male-experts' as well of course - what is your opinion about this phenomenon? Has anybody felt this with the adrafinil or with its 'relative' the modafinil or even with the (much) more distantly related amphetamines?
Thank you so much for any input.Iago
Posted by IsoM on June 3, 2002, at 13:42:24
In reply to migraines on adrafinil or provigil anyone?, posted by Iago Camboa on June 3, 2002, at 6:21:32
Hello sweet Iago. You can tell I feel good, can't you?
My question for you in lieu of an answer is 'are you sure your migraines are related to the adrafinil?'
Reason being that at various times in my life (I'm close to your age, I'm 52), I've thought that something may have been causing or contributing to my headaches (migraines & mixed tension headaches). I've discontinued whatever, sometimes to have the headaches resolve - other times, not to notice a change. When I've again started what I thought was the cause, rarely have the headaches returned in response.
I've yet to find any real precipitating factor that causes my migraines. I think it may be a combination of different factors & when the total reaches a certain point, a headache can happen. But then, I get them for no discernible reason whatever - when everything appears perfectly fine & normal.
I've actually noticed, as a general trend, somewhat less headaches when I take stims of any type. It's because activity usually makes me feel better (dissipates over-all body muscle tension) & I'm more active & bouncy when I've taken stims. It's no guarantee, of course.
Your adrafinil dose is quite low. I, initially, thought that 300 mg would do me fine but after the effect of natural PEA wore off, I find that 900 mg is best. I may need the full 1,200 mg dose but it gets costly like that. I supplement with an occasional Dexedrine.
So going back to my question, can you think of any other possible factors accounting for your headaches? Sometimes, a great deal of detective work, intuition, & testing is needed to find an answer.
Posted by JonW on June 3, 2002, at 14:18:39
In reply to migraines on adrafinil or provigil anyone?, posted by Iago Camboa on June 3, 2002, at 6:21:32
Hi Iago Camboa,
I got horrible headaches from adrafinil, second only to wellbutrin. I suspected modafinil would be just as bad or worse, but to my wonderful surprise, NO HEADACHES! So if you are anything like me Provigil may turn out OK for you. I'd give it a try if I were you!
Jon
Posted by katekite on June 3, 2002, at 18:02:47
In reply to Re: migraines on adrafinil or provigil anyone? » Iago Camboa, posted by JonW on June 3, 2002, at 14:18:39
Oooh so nice of you to call me an expert... one of these days I'll solve myself and then I might agree with the designation.
Migraine is a topical issue for me as I think I've had one going now for about a week, very mild, induced by me trying to up my dose of Adderall. Now I'm back on ritalin. It better go away soon.
Migraines root cause is an alteration in blood flow to the head. Arteries are muscular tubes and the muscle tone is influenced by almost everything we take in pill form, and also by foods and drinks and sleep. Migraine occurs when an artery spasms (gets a muscle cramp, in a way) causing it to either dilate or constrict and causing pain through not enough or too much blood flow. Apparently the drugs you are on is making you more sensitive to natural triggers for them, or could be triggering them itself. This is very very common.
You could play with the doses of what you are on, change to provigil, or take something in addition to prevent them.
Here's a cut/paste of some things you could try as preventative agents... perhaps a tiny dose of one of them would allow you to continue the current regimen. Make sure you look up the potential interactions for any of them before trying it, and start it when not having a migraine, as they most likely do not stop migraines already in progress. This is from: http://www.neurohaven.com/migrain1.htm
"The prophylactic therapy of migraine has seen a wide variety of agents utilized, perhaps one of the most widely used being that of the beta adrenergic blocker Propranolol which is still considered a drug of choice for this indication. This drug, however, is contraindicated in patients with concurrent asthma. Alternatively a cardioselective beta blocker such as Metoprolol or Atenolol may be utilized.
Calcium channel blockers are known to inhibit arterial vasospasm and to block platelet serotonin release and aggregation. Verapamil is an example of this category of drug and is widely utilized in the prophylaxis of migraine. Of the calcium channel blockers, nimodipine (Nimotop ®) has the greatest selectivity for the cerebral vasculature but is approved only for management of vasospasm accompanying subarachnoid hemorrhage. Clonidine, an alpha agonist, has also demonstrated efficacy with regard to prophylaxis in the management of migraine. Cyproheptadine (Periactin ®) has been utilized successfully in the treatment of childhood migraine. Finally the tricyclic antidepressants also have been utilized for this Purpose though the tolerability of these drugs may vary widely from one individual to another. The most recent drug to be approved for the use of migraine prophylaxis is divalproex sodium (Depakote ®). This drug has been widely utilized over many years as an anticonvulsant but only recently came to be recognized as having efficacy with regard to migraine prophylaxis. This array of pharmacologic agents both for the abortive therapy and prophylaxis of migraine attacks offers numerous options for the clinician to choose from and hence to tailor treatment to the needs of each individual migraine sufferer."
kate
Posted by IsoM on June 3, 2002, at 18:26:10
In reply to preventatives, posted by katekite on June 3, 2002, at 18:02:47
I can't comment on many migraine medications as most haven't worked or just put me to sleep, but one, a beta blocker, brought on a severe attack of asthma. It lasted three days & wouldn't respond to any asthma medications. The weird thing is I don't have asthma or even any allergies. Maybe that's why the asthma meds didn't ease it.
So before taking a beta blocker, makes sure you don't have asthma, or any family history of asthma. It was no fun. I relaise my reaction was very unusual, but beta blockers are contraindicated for those with a history of asthma & respiratory allergies.
Posted by Iago Camboa on June 4, 2002, at 13:45:53
In reply to Re: migraines on adrafinil or provigil anyone? » Iago Camboa, posted by IsoM on June 3, 2002, at 13:42:24
> Hello sweet Iago. You can tell I feel good, can't you?
Hello dear Iso. I like you especially because you are much like me in that we both have a passion for life & we both feel happy with just a little bit more than being alive & full awake... I feel good, yes & I know you feel good too... Sometimes I think we could agree on a lot of things without uttering a single word... I also knew your age and know you have at least two sons (which only adds to the esteem I feel toward you)...
> My question for you in lieu of an answer is 'are you sure your migraines are related to the adrafinil?'
>
> Reason being that at various times in my life (I'm close to your age, I'm 52), I've thought that something may have been causing or contributing to my headaches (migraines & mixed tension headaches). I've discontinued whatever, sometimes to have the headaches resolve - other times, not to notice a change. When I've again started what I thought was the cause, rarely have the headaches returned in response.
>
> I've yet to find any real precipitating factor that causes my migraines. I think it may be a combination of different factors & when the total reaches a certain point, a headache can happen. But then, I get them for no discernible reason whatever - when everything appears perfectly fine & normal.
>
> I've actually noticed, as a general trend, somewhat less headaches when I take stims of any type. It's because activity usually makes me feel better (dissipates over-all body muscle tension) & I'm more active & bouncy when I've taken stims. It's no guarantee, of course.
>
> Your adrafinil dose is quite low. I, initially, thought that 300 mg would do me fine but after the effect of natural PEA wore off, I find that 900 mg is best. I may need the full 1,200 mg dose but it gets costly like that. I supplement with an occasional Dexedrine.I wonder the most on the tininess of my dose too. But I shall never do offense to Nature and if so it pleases it... Sometimes I think I feel my dose (I take it at about 8 a.m. every day) is wearing off (about noon time) and will need my 2nd pill, but I always have managed to 'recover' till now... I'm also thinking seriously about taking some d-amphetamine myself too... It's quite a lot of time since I last took it and I'm curious to learn if it still prevents me from sleeping (without a hypnotic) - I'm not so sure it will... I've even seen a new neurologist (a female) and I shall get a scrip for dexedrine next time I see her. The first time I scored her first prescription ever for 'our precious' adrafinil/Olmifon (of which existence she did not know - it is not available here (neither is Provigil, for that matter...)
> So going back to my question, can you think of any other possible factors accounting for your headaches? Sometimes, a great deal of detective work, intuition, & testing is needed to find an answer.
I think yes, I can think of other possible factors accounting for my migraines and I'm sure I'd make you laugh if I were to tell you all that has come to my mind about their possible causes... But that I will tell you personally when we will meet one day... It's a deal? Till then remember not to live one single day which is not full of your passion for life. Did I make myself understood? Do you agree?
Do take care my friend.
Very truly yours,
Iago
Posted by IsoM on June 5, 2002, at 1:30:30
In reply to Re: migraines on adrafinil or provigil anyone? » IsoM, posted by Iago Camboa on June 4, 2002, at 13:45:53
Oh, you make me curious now, but I won't prompt you to list the possible reasons.
Zest for life - yes. After my work finished this evening, my son phoned & asked if I could pick him up at his work. It was 9:30, dusk, & the evening was somewhat misty. I drove with the windows open & the sweet, slightly musty smell of hay & clover wrapped itself about me. Trees & shrubs, though still looking green, dark against the sky. The sky had lost its evening colour but patterned with masses of cloud amidst patches of clear. The atmosphere felt magical - like I had stepped back centuries despite asphalt, lights, & signs. I'm not sure what it was that gave it this surreal feel but I let it envelope me. It felt so wonderful, so alive.
It's not major accomplishments, or special events that I remember & treasure most, but simple times like this that have the greatest impact upon my limbic memory.
Posted by Iago Camboa on June 5, 2002, at 4:06:15
In reply to Re: migraines on adrafinil or provigil anyone? » Iago Camboa, posted by JonW on June 3, 2002, at 14:18:39
Posted by Iago Camboa on June 5, 2002, at 4:07:55
In reply to preventatives, posted by katekite on June 3, 2002, at 18:02:47
Hi Kate,
Very very first order info in a most clear, detailed & authoritative response to my query on the 'migraines on adrafinil'. IMHO you are getting indispensable & an obligatory reference in PB. I must confess I'm one of your interested readers and learn a lot with your every post!
You are also what I call a 'very healthy person' with very sound & well-founded opinions. Don't be offended but I think your husband is indeed a lucky man in having you...
It is also my opinion that people (mostly women, though a few males as well) who have ADD and use 'the perfect' stim fix are among the 'most successful' examples of the excelence of human species as a whole... Maybe because fully happy people are also the most helpful for the rest of mankind...All the very best for one of the 'best few'.
Iago
Posted by katekite on June 8, 2002, at 10:29:44
In reply to Re: preventatives, posted by Iago Camboa on June 5, 2002, at 4:07:55
Iago you sweet thing you. I'll leave my hubby for your sweet-talk any day.
Actually my husband is a saint. I'm always stressed out and right now cry multiple times a day (worried (ok, obsessively so) over my high cortisol meaning tumor maybe...aaaghk) and he is wonderful.
I get a feeling of control over my mental state by reading and educating myself as to what my options are -- the feeling of having a plan makes the difference for me between feeling adrift in an ocean with the waves too high to see over, and feeling I'm in the same situation but have a log to cling to which occasionally crests a wave so I can see the shore.
take care iago.
kate
Posted by Iago Camboa on June 10, 2002, at 5:49:53
In reply to Re: preventatives, posted by katekite on June 8, 2002, at 10:29:44
Kate, I'm glad to learn your husband is wonderful and supportive to you during this lower-mood episode of your life. I have a grown-up daughter myself (she is 21 and will hopefully graduate from uni next year) and feel fortunate to see her too have a good relationship with her boyfriend (he is 26 and I like the guy).
And I'm even gladder to see you are fighting 'tooth & nail' with all weapons you have at your disposal including acquiring more knowledge about that insidious foe by the name of 'cortisol'. I also past a depressive episode during which I was 'absolutely convinced' I had something 'bad' when I began to feel some (mild) prostatic disorder symptoms (my grandfather [father's father] having died from prostatic carcinoma, though at an advanced age), and after making all manner of exams to my kidneys, bladder & of course my prostate I found out no trace of a tumor (which I would previously 'swear' I had), not even any reason for surgery at least for the time being...
So my advice is: remember that what appears to be oftentimes is not and things turn out frequently of a benign character, so make absolutely all the most modern exams available (and fortunately you are in a place where you can have the best) AND don't lose heart at all.
The best of luck for you, my dear.
Do take care,
Iago
This is the end of the thread.
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