Posted by JohnL on July 15, 2000, at 7:26:55
In reply to Re: adrafinil, posted by shellie on July 14, 2000, at 9:54:36
> John. I was totally ready to go the adrafinil route but my pdoc is worried about combining it with an MAOI, since it causes release of serotonin and dopamine. Would you worry about that?
>
> btw, I think you're right--the extreme afternoon tiredness is probably related to the nardil, but I've don't do well on ssris, and nardil seems to have the least side effects for me. I would be very scared that I'd bottom out if I try to get off the nardil and try just adrafinil. Last time off the nardil, I ended up in the hospital, waiting to start and have it kick in again. Because of my business, I can't afford to bottom out again, so that's why I'm doing the augmentation route. Thanks, for your advise, ShellieShellie,
I personally wouldn't be afraid of Nardil+Adrafinil. But that's just me. I could be all wrong. But the reasons I feel safe about it are because:
1) Release of serotonin and dopamine occur at the highest doses, according to the medication label information.
2) I always approach anything that's new to me--whether it be prescrips, herbs, whatever--with a real sense of caution. I like to dip my toes in the water, so to speak, before diving in. Actually, I'm that way with anything.Even if a doctor tells me XYZ med is 100% safe and has no side effects, I will go home and cut his recommended starting dose into half or even a quarter. I've been burned and learned. Some doctors just have no idea. They can err too much on the side of caution, preventing the patient from ever having a real chance of being completely well; or they can err too much on the side of naiveness (is that a word?) and scare the patient with too much too fast, or wrong choices altogether.
On the other hand, if the doctor tells me XYZ drug has some dangers and side effects, it's nice to be aware of that, but it doesn't change anything. I still cut his recommended starting dose in halves or quarters. The dangers and risks are planted in my mind, and I'm aware of what to be on the lookout for so I can catch anything bad real early before it gets out of hand.
Could Nardil and Adrafinil be dangerous? I'm sure they could. Anything could. But at lower or midish doses? Don't quote me, but I don't think so. I really don't. At my 600mg dose I don't feel any serotonin enhancement at all. I know what serotonin feels like. That's not what's happening. In your shoes I would feel comfortable splitting a 300mg pill of Adrafinil in half. It really does seem like a tame medication to me. Very effective, but very tame at the same time. If after 4 days or so all was well, I would go up to a whole pill a day. Four days later, if all was still well, I would go to 1 1/2 a day. I would probably stay at 2 pills a day for several weeks before making any more decisions. I don't see any danger in the combination as long as it is approached in a 'dip your toes' first manner.
I'm not suggesting you try it or warning you not to try it. I'm just saying that if I were in your shoes, this is how I would feel about it and this is how I would go about doing it. I understand up front--with myself anyway--that getting a doctor to go along with a medication from another country is not realistic. And I therefore have to take all responsibility for safety onto my own shoulders. The last thing I want to do is end up looking like a total fool in the emergency room. That's why I go real low at first. With anything and everything.
Hope this helps in some way.
John
poster:JohnL
thread:40375
URL: http://www.dr-bob.org/babble/20000708/msgs/40501.html