Posted by zeugma on January 29, 2005, at 19:42:24
In reply to Re: Treating side effects » zeugma, posted by ed_uk on January 29, 2005, at 17:26:59
> Good luck with the Strattera :-)
> Have you ever taken more than 100mg of nortriptyline? I wondered whether you'd find it helpful for anxiety or ADD symptoms.
It might be helpful for anxiety and even ADD, I don't know. 100 mg nortrip seems to be more stimulating than 75 mg, but nothing like the effects of Provigil or ritalin.
> Also, have you tried any other benzos apart from clonazepam? Do they all worsen your cataplexy?
No, I haven't, it was hard enough to get the clonazepam! Doctors may be less leery of prescribing benzos in the US than UK, but only slightly. Alprazolam is seen as having a much higher abuse potential than clonazepam, so it's much harder to get prescribed. What is interesting about clonazepam is the fact that it's a powerful antiepileptic, and the fact that it triggers cataplexy made me realize that my sleep disorder was probably REM rather than NREM related. >
> How long did you take Strattera for before it made you fatigued and depressed? The kappa agonists used as analgesics generally cause dysphoria and sedation with the first dose. Mmmm, I wonder what else Strattera is doing apart from acting as an NRI? I've often wondered the same thing RE reboxetine.
it was quite a while. I was on strattera for nearly a year before the fatigue and depression became severe. strattera distinctly does NOT have a sedating or dysphoric effect on first dose, in fact it strikes me as a powerful antidepressant that is neutral as regards sedation. The depression and fatigue that later hit is another story, and my pdoc attributed it to the fact that I needed a stimulant, and my physical energy simply gave out. that's plausible, but leaves me where I started: the fatigue has been constant for years, and I have not been able to tolerate ANY stimulating medication (Wellbutrin, Ritalin, cylert, Provigil). I think this strongly negative history with stims caused him to skip the amphetamines. Part of the problem, as I see it, is that stims produce positive effects only when plasma levels are highest, and on the up- or down-slope I would experience severe irritability, anxiety, and marginal cognitive benefit. I don't see any way around this conundrum.
I wonder what your view of the effectiveness of reboxetine is. have you ever tried it? Like i said before, I really don't know the justification for adding strattera as opposed to simply increasing nortrip beyond 100 mg, except for the lack of cardiotoxicity. I even wonder if some of my response to strattera was placebo. I know people sometimes combine SSRI's, but that there is no evident justification for this, and psychopharmacological orthodoxy counsels against this kind of redundancy.
Are you still trying to get on some kind of stimulant? I know you highly favor d-amphetamine over methylphenidate. Is this because d-amph is less anxiogenic?