Psycho-Babble Medication | about biological treatments | Framed
This thread | Show all | Post follow-up | Start new thread | List of forums | Search | FAQ

Re: ed- your opinion please » ed_uk

Posted by zeugma on February 16, 2005, at 16:22:44

In reply to Re: ed- your opinion please » zeugma, posted by ed_uk on February 16, 2005, at 7:06:14

> Hi Zeugma!

Hi Ed!
>
> >i needed to be simultaneously calmed and stimulated
>
> Me too!!! I don't like caffeine either, it does nothing for me, I still feel tired.
>
> >there's clonazepam 1 mg, which keeps a lid on the anxiety but which adds to the asthenia, so i keep the dose as low as possible.
>
> Do you think it's worth trying a different benzo? I think I've asked you that before but I don't remember what you said. You could try a low dose of chlordiazepoxide or something like that? For whatever reason, some people find certain benzos more fatiguing than others. I have a friend who found chlordiazepoxide made him more tired than clonazepam but other people seem to find the opposite.
>

Don't you think ALL benzos have, as a consequence of GABA potentiation, a degree of sedative activity? In my case, atomoxetine had more fatiguing/depressogenic activity than clonazepam, although clonazepam is a natural suspect. I also differentiate between the sedative activity of nortriptyline, which is antihistaminic in nature, and the unusual fatigue that atomoxetine induced. I find myself fairly tolerant of antihistamines, and they do help me sleep (another paradox: I am sleepy all day, but sometimes feel too agitated to sleep at night. My circadian rhythms have been totally off since childhood!)
> >he wants me to retry Provigil at 50 mg tomorrow am.
>
> Perhaps it could be worth one last try. I'm a bit concerned that what you experienced before was some kind of unusual allergic/hypersensitivity reaction. The swollen lymph nodes (lymphadenopathy) reminded me of 'serum sickness'. It's probably way off but here's a link, may drugs can cause serum sickness but I've never heard of a case with modafinil......
> http://www.emedicine.com/EMERG/topic526.htm
>

Thanks for the link. It is obviously a major concern. It was frustrating because I did not discontinue Provigil because of lack of efficacy, and I stayed on it as long as I could because I was clearly getting a lot of benefit from it. So far no swollen lymph nodes or other weird reactions :) But of course, I am going to be careful, and I'm glad my pdoc app't is next week. At the time, I didn't know that the lymph node problem could have been serum sickness or allergic reaction. I do have a multitude of allergies, and certain drugs have caused potentially life-threatening reactions, and I am hugely concerned that this will happen with provigil again too. At the same time I have been falling asleep at work, so you can see my dilemma. And the caffeine pills I was taking every three hours were more effective at causing anxiety than having any kind of therapeutic effect.

I'm terrified of the amphetamines ,too. It seems like I run into big problems when I go below 75 mg nortriptyline, so I can't really take any drug that has substantial sympathomimetic activity without seeing a cardiologist.

As far as I recall, the adverse reactions to Provigil began with the first dose, and were not dose-dependent. So maybe the fact that so far I've gotten through unscathed is a good sign. On the other hand, I am going to have my pdoc look at my lymph nodes regardless of how I feel just to be sure.
> >I know it's a long shot, but I suppose it's just possible that the weird s/e I experienced on provigil were specific to nortriptyline, and that switching to desipramine might alleviate them.
>
> It's possible, that's all I can say really. Your Provigil side effects were quite unique, I really don't know what caused them.
>
> >And provigil, unlike d-amphetamine, would not send me to the cardiologist
>
> I wonder whether a cardiologist might suggest bisoprolol, it's more beta1 selective than atenolol- I think it penetrates the blood brain barrier to a greater extent though.
>
> >if it's something like akathisia, an SSRI or an AP would be a very bad idea
>
> What makes you think it was akathisia?
>

I have terrible difficulty initiating movements. I constantly feel this 'resistance'to actual physical movement though I am simulataneously tense within. It has been improved by nortriptyline, which is mildly antimuscarinic, and is specifically mitigated by provigil, which appears to act on circuits intimately tied to movement:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9774168

you can see that provigil is under investigation for Parkinsonian disorders. There is a very close connection between Parkinson's disease, depression, and sleep disorders. I am afraid that if I don't treat my various sleep/attentional./affective disorders properly, I'll wind up with Parkinson's soon (this also is what terrifies me about the atypical AP's).

Best,

z
> Best Regards,
> Ed.


Share
Tweet  

Thread

 

Post a new follow-up

Your message only Include above post


Notify the administrators

They will then review this post with the posting guidelines in mind.

To contact them about something other than this post, please use this form instead.

 

Start a new thread

 
Google
dr-bob.org www
Search options and examples
[amazon] for
in

This thread | Show all | Post follow-up | Start new thread | FAQ
Psycho-Babble Medication | Framed

poster:zeugma thread:446337
URL: http://www.dr-bob.org/babble/20050212/msgs/458894.html