![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 5 to 29 of 29. Go back in thread:
Posted by fairywings on January 8, 2006, at 19:47:06
In reply to Treatment-resistant insomnia and I'm sick of it!, posted by vbAgent on January 8, 2006, at 1:37:03
hi vb, i have ADD and allergies too. I take several meds that have a stim. effect. Have you tried Ambien? Some on the boards seem to think it does a better job for sleep. I have trouble with getting to sleep some nights, but Ambien is pretty good for me.
fw
Posted by vbAgent on January 8, 2006, at 19:51:19
In reply to Re: Treatment-resistant insomnia and I'm sick of it! » vbAgent, posted by fairywings on January 8, 2006, at 19:47:06
Everyone, thank you for responding. ;-]
Posted by 4WD on January 8, 2006, at 22:13:07
In reply to Re: Treatment-resistant insomnia and I'm sick of i, posted by vbAgent on January 8, 2006, at 15:04:50
> blueberry, thanks for responding.
>
> Correct, Adderall is a powerful medication. Evident in my post, I am more comfortable taking it (and Lunesta) than a stigmatized drug like Seroquel.
>
> Something else I'm considering that may affect sleep is allergies. I do have rather bad allergies coupled with perennial allergic rhinitis. If I do not take Nasacort AQ (or similar corticosteroid nasal spray) and Zyrtec along with a decongestant then I really cannot breathe through my nose; it's always very stuffy. Sometimes I get nauseous from all the buildup.
>
> So, maybe if I stop ignoring allergies and nasal congestion (like someone who ignores sleep apnea) I'll sleep better and wake up more refreshed.
>
> We'll see...Peace. :-)What kind of decongestant do you take? If it has ephedrine or pseudoephedrine in it, it could keep you awake. Those drugs both make me hyper and jittery.
Breathe-rite strips really help me a lot. I have to wear one to bed in order to sleep at night or else I can't breathe.
Marsha
Posted by vbAgent on January 8, 2006, at 22:29:07
In reply to Re: Treatment-resistant insomnia and I'm sick of i » vbAgent, posted by 4WD on January 8, 2006, at 22:13:07
Hi 4WD,
Sorry for the confusion, but I don't take a decongestant...but I used to in the form of Zyrtec-D. If I ever use one again it will be early in the day, and on an as-needed basis, so it doesn't interfere with sleep or disturb my blood pressure. I steer clear of decongestants now because I have high blood pressure (which is under control).
If I'm always stuffed up and congested then I want to think that breathing easier will help with sleep. Thanks for mentioning Breathe-rite. It sounds like a good idea. I hope they're cheap $$. ;-]
Posted by 4WD on January 8, 2006, at 22:34:17
In reply to Re: Treatment-resistant insomnia and I'm sick of i, posted by vbAgent on January 8, 2006, at 22:29:07
> Hi 4WD,
>
> Sorry for the confusion, but I don't take a decongestant...but I used to in the form of Zyrtec-D. If I ever use one again it will be early in the day, and on an as-needed basis, so it doesn't interfere with sleep or disturb my blood pressure. I steer clear of decongestants now because I have high blood pressure (which is under control).
>
> If I'm always stuffed up and congested then I want to think that breathing easier will help with sleep. Thanks for mentioning Breathe-rite. It sounds like a good idea. I hope they're cheap $$. ;-]A month's worth is about $12 where I live.
And you can actually use the same one twice though they tell you not to.Marsha
Posted by vbAgent on January 8, 2006, at 22:55:34
In reply to Re: Treatment-resistant insomnia and I'm sick of i, posted by 4WD on January 8, 2006, at 22:34:17
> > Hi 4WD,
> >
> > Sorry for the confusion, but I don't take a decongestant...but I used to in the form of Zyrtec-D. If I ever use one again it will be early in the day, and on an as-needed basis, so it doesn't interfere with sleep or disturb my blood pressure. I steer clear of decongestants now because I have high blood pressure (which is under control).
> >
> > If I'm always stuffed up and congested then I want to think that breathing easier will help with sleep. Thanks for mentioning Breathe-rite. It sounds like a good idea. I hope they're cheap $$. ;-]
>
> A month's worth is about $12 where I live.
> And you can actually use the same one twice though they tell you not to.
>
> MarshaThat is cheap. Thanks so much for sharing!
----------
p.s. You're not crazy. Just keep the faith. If you're like me and others, you just need someone to talk to. I wonder if babble-mail would be another good place for support? I'll have to look into it...Take care.
Posted by yxibow on January 8, 2006, at 23:36:00
In reply to Treatment-resistant insomnia and I'm sick of it!, posted by vbAgent on January 8, 2006, at 1:37:03
> Well, it's safe to say that Lunesta 2mg has completely lost it's sleep-promoting effect. I'm totally sick of it. Insomnia sucks. I just don't know what to do...I've gone from Lunesta to Ambien CR back to Lunesta, and now I'm immune to thier hypnotic effect.
Just a question, how much of Ambien CR (did you try regular Ambien ?) did you take. Some people are stubborn to its effects -- I take 20mg, well I used to take 20mg of Ambien, I currently take 15mg. Its well tolerated at 20mg (I would not go above, I've never heard of usage above).
There's also Rozerem, although it is melatonin related so hormonally could interfere with depression though that isn't your DX. Lunesta did not have a lot of effect on me until I got to 3mg.
And then there's the weaker Sonata, which I dont know if you've tried, you could also dose that to whatever stratosphere psychiatrists are comfortable with these days. As mentioned before, there is chloral hydrate, though it is somewhat dangerous and is basically the component of a "mickey finn."
If you can tolerate the weight gain possibility, there is Remeron though with the amount of amphetamine in your system I would think would partially counteract that.
>
> Any good psychiatrist would probably correctly suspect that insomnia isn't my primary disorder; I also have adult ADD for which I now take 15mg/day of Adderall.Its a pretty powerful drug, its legal methamphetamines basically and is triplicate so its no wonder that you're kept awake. I assume you've been through trials with Strattera, Provigil and Wellbutrin instead.
>Seroquel was very helpful but I'm extremely uncomfortable taking such a powerful drug solely for treating insomnia.
I agree that antipsychotics shouldn't be the first resort to insomnia, but sometimes a small dose does help. 25 to 50mg is way below the "clinical" dose for Seroquel.
>I just want a regular sleep schedule!!!
me too! And that's also part of good sleep hygiene, whether you're capable of actually going to sleep at that point or not, consistently going to bed at the same time each day helps. Resisting the urge to take daytime naps also helps -- I'm not always successful with that I must admit. Finally, some excercise somewhat before bedtime also helps to improve sleep.
-- tidings
Posted by vbAgent on January 9, 2006, at 0:21:55
In reply to Re: Treatment-resistant insomnia and I'm sick of i » vbAgent, posted by yxibow on January 8, 2006, at 23:36:00
> Just a question, how much of Ambien CR (did you try regular Ambien ?) did you take. Some people are stubborn to its effects -- I take 20mg, well I used to take 20mg of Ambien, I currently take 15mg. Its well tolerated at 20mg (I would not go above, I've never heard of usage above).
Well, I took 6.25mg to 12.5mg of Ambien CR at bedtime when the pdoc switched me back to Lunesta 2mg (I don't know why she did).
> There's also Rozerem, although it is melatonin related so hormonally could interfere with depression though that isn't your DX. Lunesta did not have a lot of effect on me until I got to 3mg.
We tried Rozerem but it didn't have an effect.
> Its a pretty powerful drug, its legal methamphetamines basically and is triplicate so its no wonder that you're kept awake.
Right, it is a potent drug! It blows my mind that some people can take such high dosages, like 60mg to up to 120mg, and also take an antidepressant. To avoid interfering with sleep I don't take Adderall any later than 5-6pm. Sometimes I'll take just 10mg/day instead of the regular 15mg/day. The pdoc has prescribed 10mg to be taken 3x/day (30mg/day), but this amount gives too much CNS stimulation. My pdoc knows I take less than the prescribed amount.
> I assume you've been through trials with Strattera, Provigil and Wellbutrin instead.
Strattera didn't work well and I experienced some dizziness and nausea from it. This could be due to the affect it had on my liver.
Wellbutrin just made me feel weird, but I think that was because we didn't start out on a low dose; this was many years ago and not with my current pdoc.
Never tried Provigil.
> me too! And that's also part of good sleep hygiene, whether you're capable of actually going to sleep at that point or not, consistently going to bed at the same time each day helps. Resisting the urge to take daytime naps also helps -- I'm not always successful with that I must admit. Finally, some excercise somewhat before bedtime also helps to improve sleep.
I never take daytime naps. Waking up early, like at 8am, is very hard if I don't have morning obligations. So I guess the answer is to give myself more morning obligations. In addition to what I've already decided to do, proper sleep hygiene is something I need to work on. I live in a very small, single bedroom apartment. So, objects associated with wakefullness and stimulation (like TV or the computer) are literally an arm's length away.
I'm a Gold's Gym member, but sadly I've been so busy and preoccupied that I have missed too many workouts for my liking. I am going to work very hard at working out in the morning since my work schedule doesn't allow me to hit the gym after work.
Thanks for giving me something to think about & work on. Great reply. Take care...
Posted by vbAgent on January 9, 2006, at 2:32:17
In reply to Re: Treatment-resistant insomnia and I'm sick of i » vbAgent, posted by yxibow on January 8, 2006, at 23:36:00
Some of the posts in this thread, including my own, have caused me to rethink some things. For example, Provigil. I know that Provigil is a Schedule IV drug and Adderall is Schedule II.
Hmm...I do have extreme difficulty getting up early. Never been a morning person. When I do awaken early I'm dazed and confused; somewhat delirious and very out of it; a type of depression that improves over the course of the day. I have a mild case of idiopathic hypertension, which is fortunately under control. A nose that's always stuffy and often completely blocked if I slack on taking my allergy meds. I work the late shift.
So, if obstructive sleep apnea/hypopnea syndrome &/or shift work sleep disorder is a contributing factor more than other possible (and known) explanations, then the answer is clear: drop Adderall and try Provigil; and increase the Lunesta from 2mg to 3mg; also give Breathe-rite a trial run along w/ measures to improve sleep hygiene.
I'll talk to the substitute pdoc about this on Tuesday.
---------
p.s. Does anyone think I'm moving too fast? Or, am I on the right track?
Posted by vbAgent on January 9, 2006, at 11:02:03
>> Some of the posts in this thread, including my own, have caused me to rethink some things. For example, Provigil. I know that Provigil is a Schedule IV drug and Adderall is Schedule II.
>> Hmm...I do have extreme difficulty getting up early. Never been a morning person. When I do awaken early I'm dazed and confused; somewhat delirious and very out of it; a type of depression that improves over the course of the day. I have a mild case of idiopathic hypertension, which is fortunately under control. A nose that's always stuffy and often completely blocked if I slack on taking my allergy meds. I work the late shift.
>> So, if obstructive sleep apnea/hypopnea syndrome &/or shift work sleep disorder is a contributing factor more than other possible (and known) explanations, then the answer is clear: drop Adderall and try Provigil; and increase the Lunesta from 2mg to 3mg; also give Breathe-rite a trial run along w/ measures to improve sleep hygiene.
>> I'll talk to the substitute pdoc about this on Tuesday.
>> ---------
>> p.s. Does anyone think I'm moving too fast? Or, am I on the right track?
See my earlier post concerning "Treatment-resistant insomnia and I'm sick of it!"
If I can switch to a softer drug like Provigil by dropping Adderall then I'm game, especially if it's a more appropriate medication for what might be just sleep-related problems. At this point I'd like to get peoples' experiences with Provigil vs Adderall. I now take 10-15mg/day of regular Adderall for adult ADHD.
What could I expect from Provigil? Thanks.
Posted by vbAgent on January 9, 2006, at 16:34:32
In reply to Experiences regarding Provigil vs Adderall, posted by vbAgent on January 9, 2006, at 11:02:03
I'm going to heed my own advice as of late. Although this is a great forum for the exchange of information, it's risky business. I'll let the doctor do their job; I'm in no position to self-diagnose. Arrogance is dangerous. Good luck to everyone trying to find peace of mind.
So, ignore or delete this thread. :-)
Posted by gardenergirl on January 9, 2006, at 17:14:52
In reply to Re: Treatment-resistant insomnia and I'm sick of i » yxibow, posted by vbAgent on January 9, 2006, at 2:32:17
> Hmm...I do have extreme difficulty getting up early. Never been a morning person. When I do awaken early I'm dazed and confused; somewhat delirious and very out of it; a type of depression that improves over the course of the day.Same with me. I'm also quite grumpy in the a.m. Just ask my husband.
I've been using light therapy for depression. This is my second year doing so, although I admit, I'm not consistent with it like I was last year. Last time, though, using it at the same time every morning (approximately 7:00 a.m.) really really helped me with my ability to wake up in the a.m. I also found that I was sleeping better at night, as far as being able to initiate sleep, since I was getting up at the same time everyday. Of course I HATE doing this on the weekends. But it really does help me when I do it "right".
I may try the Breathe right strips, too. Apparently, I snore lately. It's probably related to weight gain, but it's worse when I take 10 mg Ambien.
And btw, my pdoc has suggested Provigil since I have mild ADHD, mostly inattentive. She didn't think my insurance would cover it, but I think it might, so next time I see her I'm going to ask again.
Good luck.
gg
Posted by vbAgent on January 9, 2006, at 17:30:46
In reply to Re: Treatment-resistant insomnia and I'm sick of i » vbAgent, posted by gardenergirl on January 9, 2006, at 17:14:52
Aren't these light boxes expensive? I might consider it if it doesn't break the bank - I'm on a very tight budget. Where would I buy one? The internet?
Good luck with Provigil if it's prescribed. I don't see why your pdoc wouldn't give it a trial run, since it's a Schedule IV drug. Take care... :-)
Posted by gardenergirl on January 9, 2006, at 17:45:14
In reply to Re: Treatment-resistant insomnia and I'm sick of i » gardenergirl, posted by vbAgent on January 9, 2006, at 17:30:46
I have two light boxes (hubby supports us very well...I'm lucky). One is a free standing floor lamp. It was about $130ish from Full Spectrum Solutions on the internet.
I also have an Apollo Go-lite, which I use for travel. I got this at Sam's Club for maybe about $160? I forget.
These are expensive, but not as bad as the traditional "light boxes", which can go for $400 or more.
Thanks,
gg
Posted by willyee on January 9, 2006, at 17:51:15
In reply to Re: STOP, posted by vbAgent on January 9, 2006, at 16:34:32
It`s not that i do not choose to have a porfessional help me,but lets look at what we have.......
You have to wait for youre med check,usualy 2 weeks is typical,you sit in an office and watch as your doctoer frantcly handles patient by patient.
Now you get called,and u have a 20 min session,your docter now how to remeber where you and her are,find out how you are doingmand discuss a new plan,thats quite a lot for a 20 mintute session.
Not only that but it was important to refer to your docter when all we had were books,youre average libary had no comparison with a PDR.In this day and age,you have very reliable web sites such as remedyfind,.com crazymeds.com and usualy companies themselves offer online data sheets.
You have access to people who are in the same boat as you,you can get and idea of a medication simply by asking.Now you can take all this with u and go to your docter with something,prepared for your visit.
My only disappoint is my docter doesent seem to value any thing i bring in,especialy when i normaly tell her medication doses ranges while before she even finds it in the pdr pages.
I dont wanna play docter,but with all the resources we have now that we did not have less than a decade ago,its hard to sit around and let a 20 min session be the only viable option to your mental health.
I will agree its essential people understand a group like this,and stand back and relaise its a MASS foroum and to do everything in their power to control how they use it,i personaly try to stay involved only in what relates to me,not cause im selfish,but because i dont wanna get caught up being more obsessed with medicatio than i already am.But last example,in a case of someone going on a maoi,its very unlikly that doc in that 20 min sesssion will provide you with the ENORMOUS amount of info you can obtain here,the doc will give u general info which is great,
but here you will hear from people actualy on the medication,and get a more clear idea of what it holds in store for you.I believe the phrase keep ur doc invovled was much more important in the days when we dident have many resources.
Posted by vbAgent on January 9, 2006, at 18:09:40
In reply to Re: STOP, posted by willyee on January 9, 2006, at 17:51:15
willyee, good points & well said!!
Just like we use medication as a tool, use a forum like this one offered by Dr. Bob as a tool. It's what we do with the information that matters. We live in an age of information overload and saturation. Yes, knowledge is power, but at the same time it's potentially harmful to people who are impressionable, easily influenced, or simply suffer from lack of judgment.
Peace...
Posted by JohnKeats on January 9, 2006, at 23:55:43
In reply to Treatment-resistant insomnia and I'm sick of it!, posted by vbAgent on January 8, 2006, at 1:37:03
> Well, it's safe to say that Lunesta 2mg has completely lost it's sleep-promoting effect. I'm totally sick of it. Insomnia sucks. I just don't know what to do...I've gone from Lunesta to Ambien CR back to Lunesta, and now I'm immune to thier hypnotic effect.
>
> Any good psychiatrist would probably correctly suspect that insomnia isn't my primary disorder; I also have adult ADD for which I now take 15mg/day of Adderall. He/she will want to prescribe either an antidepressant or antipsychotic to augment the sleep-aid to treat some underlying anxiety and/or depression. I do NOT want that to happen. I have never experienced relief or benefit from an AD. Seroquel was very helpful but I'm extremely uncomfortable taking such a powerful drug solely for treating insomnia. Maybe I should just suck it up and do what has to be done. Sometimes I think I need a mood stabilizer. I just don't know...I'm plagued with indecision and irritation. I just want to cry...I want to punch a hole in my computer monitor. So frustrated...so very frustrated. I just want a regular sleep schedule!!!Hey vbAgent,
I feel you, insomnia is something that has a huge negative impact on your life. It (literally) screws up your whole day and makes whatever underlying condition you have much worse. With my insomnia I used to lie in bed and stare at the ceiling until 6 A.M. Then when it was time to go to work I would have to: 1. Go in to work without sleep (dozing in my chair, stealing 30min naps in the washroom.) 2. Go in to work at 2PM (everybody looking at me like I'm crazy.) 3. Not go in to work at all (manager calling me in for "talks" evey week.) This went on for almost a year and my sleep/wake cycle became totally out of whack. Like you, I felt like crying every time I just could not bloody fall asleep. None of the conventional insomnia meds did anything. So my depression and anxiety kept me from sleeping, and because of insomnia my job performance was really bad so I felt even more depressed and anxious. This is a good example of the ubiquitous "vicious cycle" in psych diseases.I know you don't want to take an psych drug just to fall asleep but I've come to believe that quality of life is more important than playing by the rules. I used to be pretty anti-psych med but personally I've never had a drug exert a "powerful" effect that made me somehow lose control or be somebody I'm not.
Right now I take amitriptyline (Elavil) at night - it's an older TCA antidepressant that's not as fashionable as the SSRIs and has a lot more potential side-effects (make SURE you get the complete side-effect profile for TCAs if you decide to try it.) But it's been a life saver for me. I still have a long way to go but being able to sleep whenever I want is a blessing. So if you can find a psych drug that can give you a regular night sleep I'd say go for it. Getting a good night's sleep is a big part of getting better. Once your sleep cycle is regulated and you no longer have the "pressure" to fall asleep, you can look at more mainstream therapy for getting the sleep you need. Take care and good luck.
Posted by robot on January 10, 2006, at 0:01:57
In reply to Treatment-resistant insomnia and I'm sick of it!, posted by vbAgent on January 8, 2006, at 1:37:03
dont know if anyone else sugested this, but if you do try another AD, Remeron knocks me out.
Also, in the long term, you might try learning simple meditation. Ive found that its helped me sleep just paying more attention to my breath. And doing this sitting in a chair helps me get sleepy because Im not as stressed feeling like Im trying to go to sleep. Learning to sit still doing nothing for a little while is good for general mental health.
You might try a restricted diet (I wouldnt recommend fasting while on meds) of uncooked foods and natural water for a week every so often to begin cleansing out toxins from your body.
Meletonin is good for sleep, though youve probably already tried this.
If youre not getting much sleep anyway, maybe you could just stay up 2 nights on purpose; that might help you sleep on the third night, but only give yourself 8 hours. Then 8 the next night. I have no idea if thats a good idea or not for you, it just occurred to me.
Others on this board would know more about it than I.
> Well, it's safe to say that Lunesta 2mg has completely lost it's sleep-promoting effect. I'm totally sick of it. Insomnia sucks. I just don't know what to do...I've gone from Lunesta to Ambien CR back to Lunesta, and now I'm immune to thier hypnotic effect.
>
> Any good psychiatrist would probably correctly suspect that insomnia isn't my primary disorder; I also have adult ADD for which I now take 15mg/day of Adderall. He/she will want to prescribe either an antidepressant or antipsychotic to augment the sleep-aid to treat some underlying anxiety and/or depression. I do NOT want that to happen. I have never experienced relief or benefit from an AD. Seroquel was very helpful but I'm extremely uncomfortable taking such a powerful drug solely for treating insomnia. Maybe I should just suck it up and do what has to be done. Sometimes I think I need a mood stabilizer. I just don't know...I'm plagued with indecision and irritation. I just want to cry...I want to punch a hole in my computer monitor. So frustrated...so very frustrated. I just want a regular sleep schedule!!!
Posted by vbAgent on January 10, 2006, at 14:38:12
In reply to Re: Treatment-resistant insomnia and I'm sick of it!, posted by robot on January 10, 2006, at 0:01:57
JohnKeats and Robot, thanks so much for your responses.
I had a meeting with the substitute pdoc today; my regular doctor is out of the office until later this month. It went well. He made no changes, thankfully, meaning we didn't add or replace any medication. He suggested, however fishy it sounds, that I experiment with the timing and dosages of Adderall. Bearing in mind I take the last dose (5mg) no later than 5-7pm, he said that I may NOT be getting complete coverage throughout the day and into the night. The main reason I cannot fall asleep is a very restless mind. I keep myself up pacing, worrying, reading two or more books, messing around on the computer, smoking, thinking about yesterday and tomorrow, etc; basically moving from activity to activity like a juggler handling a lot of tennis balls or constantly changing channels on the TV. I don't know of any other way to phrase it...
I told the doctor that I always thought you had to follow the prescribing directions (for Schedule II stimulants) to the letter - no more, no less and *definitely* don't take it late in the day. The doctor corrected me saying, "No, your needs will constantly change. None of my patients take the same dose all the time. In the morning you may need more and in the evening less. Try taking 2.5-5mg at 9pm to calm your mind." There's also the issue that I'm afraid it will raise my blood pressure or that I'll become addicted. The impression I got after the meeting was he worked toward debunking some of the myths, fears and mistaken beliefs that I have collectively formed about medication over the years. He wasn't giving me permission to misuse or abuse Adderall, but to exercise flexibility with experimentation, all within reason.
So, I will put his words into action. Wish me luck. Peace...
Posted by vbAgent on January 10, 2006, at 14:58:14
In reply to RE: Result of doctor's appt. - robot, JohnK, et al, posted by vbAgent on January 10, 2006, at 14:38:12
I'm going to buy an at-home blood pressure monitoring device to keep an eye on my progress. I owned one for a while, but my brother borrowed it some time ago and simply hasn't given it back. Since he's also ADHD it's probably lost. Later... ;-]
Posted by vbAgent on January 12, 2006, at 2:49:42
In reply to RE: Result of doctor's appt. - robot, JohnK, et al, posted by vbAgent on January 10, 2006, at 14:38:12
> JohnKeats and Robot, thanks so much for your responses.
>
> I had a meeting with the substitute pdoc today; my regular doctor is out of the office until later this month. It went well. He made no changes, thankfully, meaning we didn't add or replace any medication. He suggested, however fishy it sounds, that I experiment with the timing and dosages of Adderall. Bearing in mind I take the last dose (5mg) no later than 5-7pm, he said that I may NOT be getting complete coverage throughout the day and into the night. The main reason I cannot fall asleep is a very restless mind. I keep myself up pacing, worrying, reading two or more books, messing around on the computer, smoking, thinking about yesterday and tomorrow, etc; basically moving from activity to activity like a juggler handling a lot of tennis balls or constantly changing channels on the TV. I don't know of any other way to phrase it...
>
> I told the doctor that I always thought you had to follow the prescribing directions (for Schedule II stimulants) to the letter - no more, no less and *definitely* don't take it late in the day. The doctor corrected me saying, "No, your needs will constantly change. None of my patients take the same dose all the time. In the morning you may need more and in the evening less. Try taking 2.5-5mg at 9pm to calm your mind." There's also the issue that I'm afraid it will raise my blood pressure or that I'll become addicted. The impression I got after the meeting was he worked toward debunking some of the myths, fears and mistaken beliefs that I have collectively formed about medication over the years. He wasn't giving me permission to misuse or abuse Adderall, but to exercise flexibility with experimentation, all within reason.
>
> So, I will put his words into action. Wish me luck. Peace...
Unfortunately, his suggestion isn't working to help me fall asleep. I took Adderall 2.5mg at bedtime along with Lunesta 2mg, but all without the anticipated benefit. Don't tell your local pharmacist, but out of desperation the other night I took 8mg of Lunesta, 4x the prescribed dose, but even THAT had no effect. Wow, do I have problems! Don't worry, I won't be doing that again; it's pointless. Now, it's past 3:30am and I'm at the computer. I'm not wide-awake, wired or agitated. Just a laying-in-bed-staring-into-space kinda deal. I've accepted my disposition. God grant me the serenity to accept the things I cannot change. Although this is the wrong attitude, I'd prefer to laugh at my situation than get more frustrated. At least I made the effort!Anyhow, I meet with my regular doctor for a standard med check on Wed Feb 15th. Let's hope I'm still sane and gainfully employed by then. Of course, I'll keep ya'll posted. Later... :-)
Posted by robot on January 13, 2006, at 19:22:01
In reply to RE: Result of doctor's appt. - robot, JohnK, et al, posted by vbAgent on January 10, 2006, at 14:38:12
You might try this to relax, it helps me: I lie down on my back and count my breaths down from 50. I take relaxed but FULL breaths. When I get down to zero I just lay there and watch myself. Its very calming.
> JohnKeats and Robot, thanks so much for your responses.
>
> I had a meeting with the substitute pdoc today; my regular doctor is out of the office until later this month. It went well. He made no changes, thankfully, meaning we didn't add or replace any medication. He suggested, however fishy it sounds, that I experiment with the timing and dosages of Adderall. Bearing in mind I take the last dose (5mg) no later than 5-7pm, he said that I may NOT be getting complete coverage throughout the day and into the night. The main reason I cannot fall asleep is a very restless mind. I keep myself up pacing, worrying, reading two or more books, messing around on the computer, smoking, thinking about yesterday and tomorrow, etc; basically moving from activity to activity like a juggler handling a lot of tennis balls or constantly changing channels on the TV. I don't know of any other way to phrase it...
>
> I told the doctor that I always thought you had to follow the prescribing directions (for Schedule II stimulants) to the letter - no more, no less and *definitely* don't take it late in the day. The doctor corrected me saying, "No, your needs will constantly change. None of my patients take the same dose all the time. In the morning you may need more and in the evening less. Try taking 2.5-5mg at 9pm to calm your mind." There's also the issue that I'm afraid it will raise my blood pressure or that I'll become addicted. The impression I got after the meeting was he worked toward debunking some of the myths, fears and mistaken beliefs that I have collectively formed about medication over the years. He wasn't giving me permission to misuse or abuse Adderall, but to exercise flexibility with experimentation, all within reason.
>
> So, I will put his words into action. Wish me luck. Peace...
Posted by vbAgent on January 17, 2006, at 1:49:36
In reply to RE: Serenity now, serenity now...LOL, posted by vbAgent on January 12, 2006, at 2:49:42
It's almost 2:15am and I did it again. Yep, cumulatively I wound up ingesting 8mg of Lunesta tonight. Surprisingly, I'm not inebriated or oversedated. I must have quite the immune system...Anyway, dude, I just want to fall asleep!
OKay, I took 5mg or Adderall at 11am and then another 5mg at 4pm. That's it. Also, I had one cup of coffee in the morning. Caffeine can potentiate the effects of Adderall, which is the reason I'm careful to not drink more than one cup in the AM.
So, how will the doctor react after learning that I haven't followed the presribing directions? Will she be upset or disappointed? Will she terminate treatment due to alleged misuse or abuse of a controlled medication? I will be completely forthcoming and honest with my pdoc. Taking more than the presribed amount doesn't make me "high" or "euphoric". Higher doses helps me sleep (when it actually works) than Lunesta 2mg (which has no effect whatsoever). Do ya'll think that after informing the pdoc and therapist of my situation it would generate some cause for concern? There has been no response or recourse of action suggested by either health care professionals.
Are they uncaring? Do they think I'm a drug-seeking junkie who doesn't deserve any further help? Screw 'em. Screw the whole damn system. I will stop the negative self-talk. Here I am again like bad breath. No one wants to deal with it. So, I've returned to square-one apparently, and continue to be sick of treatment-resistant insomnia. Oh well...Like some say: Life is a bitch, and then you go mad.
Have a nice day ya'll! :-)
Posted by 4WD on January 17, 2006, at 22:17:30
In reply to RE: Serenity now OR Serenity never: Am I doomed?, posted by vbAgent on January 17, 2006, at 1:49:36
> It's almost 2:15am and I did it again. Yep, cumulatively I wound up ingesting 8mg of Lunesta tonight. Surprisingly, I'm not inebriated or oversedated. I must have quite the immune system...Anyway, dude, I just want to fall asleep!
>
> OKay, I took 5mg or Adderall at 11am and then another 5mg at 4pm. That's it. Also, I had one cup of coffee in the morning. Caffeine can potentiate the effects of Adderall, which is the reason I'm careful to not drink more than one cup in the AM.
>
> So, how will the doctor react after learning that I haven't followed the presribing directions? Will she be upset or disappointed? Will she terminate treatment due to alleged misuse or abuse of a controlled medication? I will be completely forthcoming and honest with my pdoc. Taking more than the presribed amount doesn't make me "high" or "euphoric". Higher doses helps me sleep (when it actually works) than Lunesta 2mg (which has no effect whatsoever). Do ya'll think that after informing the pdoc and therapist of my situation it would generate some cause for concern? There has been no response or recourse of action suggested by either health care professionals.
>
> Are they uncaring? Do they think I'm a drug-seeking junkie who doesn't deserve any further help? Screw 'em. Screw the whole damn system. I will stop the negative self-talk. Here I am again like bad breath. No one wants to deal with it. So, I've returned to square-one apparently, and continue to be sick of treatment-resistant insomnia. Oh well...Like some say: Life is a bitch, and then you go mad.
>
> Have a nice day ya'll! :-)I don't think I'd tell the pdoc I took 8mg (unless you have a history of abuse. In that case she needs to know). But I would tell her that 2mg had no effect, so I'd tried 3mg. And that didn't work, so I'd tried 4mg and that that didn't work either.
I just think telling her you took 8 mg might flag you as a potential abuser. Even if it doesn't make you high, she may not believe you and she may not be willing to trust you with other meds if she thinks you will quadruple your dose without telling her first.
Just my opinion.
Marsha
Posted by vbAgent on January 18, 2006, at 13:52:23
In reply to RE: Serenity now OR Serenity never: Am I doomed? » vbAgent, posted by 4WD on January 17, 2006, at 22:17:30
>> I don't think I'd tell the pdoc I took 8mg (unless you have a history of abuse. In that case she needs to know). But I would tell her that 2mg had no effect, so I'd tried 3mg. And that didn't work, so I'd tried 4mg and that that didn't work either.
>> I just think telling her you took 8 mg might flag you as a potential abuser. Even if it doesn't make you high, she may not believe you and she may not be willing to trust you with other meds if she thinks you will quadruple your dose without telling her first.
Sleep deprivation coupled with desparation makes ppl do silly things, including being too honest with your physician. I was very forthcoming with everyone about Lunesta not working at any dose. When I talked to the therapist yesterday, I brought the empty bottle of Lunesta and a 3/4 full bottle of Adderall. I have no issues with Adderall (I have ADHD); I only take half of what I'm supposed to take. Isn't that weird considering Adderall has a higher abuse potential being Schedule II? Anyway, another doc switched me to Seroquel for sleep & maybe hypomania issues.
I think it's important to be as forthcoming and honest as possible w/o flogging yourself. That way maybe they'll trust me more and not think I'm so much as a junkie but someone who just really wants to sleep. Hiding & concealing your problems (like silence) can sometimes make things worse. I guess it's a judgment call depending on individual circumstances...Later.
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