![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by KarenB on July 12, 2000, at 10:59:48
Hi guys!
It is going on week two and I am feeling much better. Adrafinil (300mg 2x a day) seems to boost mood and motivation as well as provide mild, unwired energy. Adderall helps with focus and energy and at the lower dose I am taking (10mg, 2x a day) has yet to trigger migraines. I stopped taking the Inderal last week and no headaches so far. Hope it stays that way.
My doc started me on Zyprexa when Buspar failed to help with irritability, anxiousness and low level depression. It is working. My mind is "quiet. I never knew how much "noise" was going on until it stopped. I do notice, though, that I have a new appreciation for sweets that could be hazardous to my weight. I am so excited about being back in a size 2/3 thanks to the Adderall, that I don't want anything to spoil it. I could stand to lose 5 more lbs. Don't worry - no anorexia going on here- just a very small frame (5'1").
Could it be that the Zyprexa is preventing the migraines and not just the decrease in Adderall dose? Anybody got any comments on that?
The true test will be at the end of the month, when PMDD may arrive. We'll see how effective these medications are when faced with PMS.
Just a sidenote to the women: I have found that when I am more physically active on a regular basis, all PMS symptoms - physical, mental and emotional - are not nearly as intense. Walking fast, at least 1/2 hour a day, really helps. I have more available energy when I do this, too.
Karen
Posted by Ant-Rock on July 12, 2000, at 12:52:09
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
> Hi guys!
>
> It is going on week two and I am feeling much better. Adrafinil (300mg 2x a day) seems to boost mood and motivation as well as provide mild, unwired energy. Adderall helps with focus and energy and at the lower dose I am taking (10mg, 2x a day) has yet to trigger migraines. I stopped taking the Inderal last week and no headaches so far. Hope it stays that way.
>
> My doc started me on Zyprexa when Buspar failed to help with irritability, anxiousness and low level depression. It is working. My mind is "quiet. I never knew how much "noise" was going on until it stopped. I do notice, though, that I have a new appreciation for sweets that could be hazardous to my weight. I am so excited about being back in a size 2/3 thanks to the Adderall, that I don't want anything to spoil it. I could stand to lose 5 more lbs. Don't worry - no anorexia going on here- just a very small frame (5'1").
>
> Could it be that the Zyprexa is preventing the migraines and not just the decrease in Adderall dose? Anybody got any comments on that?
>
> The true test will be at the end of the month, when PMDD may arrive. We'll see how effective these medications are when faced with PMS.
>
> Just a sidenote to the women: I have found that when I am more physically active on a regular basis, all PMS symptoms - physical, mental and emotional - are not nearly as intense. Walking fast, at least 1/2 hour a day, really helps. I have more available energy when I do this, too.
>
> KarenWay to go, Karen!!!
Posted by Noa on July 12, 2000, at 15:31:16
In reply to Re: Cocktail Update:It's Working!! » KarenB, posted by Ant-Rock on July 12, 2000, at 12:52:09
> Way to go, Karen!!!
Yeah!!
I think your theory about being active is a good one. My friend who has epilepsy, with siezures related to monthly hormone changes, says this is the case for her.
Posted by AndrewB on July 12, 2000, at 15:35:47
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
Karen,
With Zyprexa you are taking a low dose antipsychotic as you were with sulpiride. Does the effect Zyprexa has on you compare at all with the effect sulpiride had?
AndrewB
Posted by Angela5 on July 12, 2000, at 15:37:17
In reply to Re: Cocktail Update:It's Working!!, posted by Noa on July 12, 2000, at 15:31:16
This is wonderful news!!! :)
I hope that it helps kick PMS in the butt, too... ;)
Posted by CarolAnn on July 12, 2000, at 18:27:01
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
Zipadeedoodah!
Posted by shellie on July 12, 2000, at 18:40:58
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
Karen, that's really great that you and your pdoc have put together the right meds for you. I think that you are proof that the future of psychiatric drugs is not only combinations of medications, but really very individualized combinations.
I am feeling a bit more optimistic because of your successful experience, and others on the board, and also feel very fortunate that there is so much information available on this board for me to use in my own cocktail quest. shellie
Posted by Renee N on July 12, 2000, at 22:08:54
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
Karen,
I am so happy for you! Your success is encouraging. I am going to try Adrafinil after I get off of Effexor and ADDerall. Wish me luck.
I hope your PMS is soon a just an unpleasant memory...Renee N
Posted by Janice on July 12, 2000, at 22:28:20
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
KarenB,
this is fantastic! The headaches could have been a side effect of Adderall that would have gone away after a week or two by itself.so just how much of your self-esteem is derived from your size? Regardless of what you answer, I won't be able to help you. I think the politically correct answer should be 0.
Now, you must conquer the PMS beast - and she is a tough one Karen!!!!! Keep us informed. Janice
Posted by SLS on July 13, 2000, at 8:03:43
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
> It is going on week two and I am feeling much better. Adrafinil (300mg 2x a day) seems to boost mood and motivation as well as provide mild, unwired energy. Adderall helps with focus and energy and at the lower dose I am taking (10mg, 2x a day) has yet to trigger migraines. I stopped taking the Inderal last week and no headaches so far. Hope it stays that way.I am so excited to hear this. I feel like getting my hands on adrafinil right now and downing a few pills.
I began taking Provigil 200mg/day a few days ago. I experienced an immediate mild improvement that lasted perhaps four hours. For me, this is tremendously significant. Later in the day, I felt pretty dull-witted and kinda zombie-like. This had pretty much worn off by the end of day 2. On day 3, I knew that I still gleaned a small improvement in energy and cognition, but that has begun to dissipate. How does this compare with your experience with Provigil?
That I experienced such a demonstrable improvement over the first two or three days gives me hope that adrafinil might have what it takes. Based on what I have seen here on Psycho-Babble, adrafinil seems to be more effective for depression than Provigil, and produces fewer, if not milder side effects. The only two disadvantages I see for adrafinil is that U.S. citizens must rely upon foreign sources and that it has a liability for stressing the liver. Otherwise, making the decision between Provigil and adrafinil is a no-brainer.
What provisions have you made for monitoring liver function?
What is the nature of the effects on the liver, and what is the rate of their occurrence?
I believe you described experiencing an antidepressant effect with Provigil, even though sedation and fatigue may have been produced by it. I know it will be difficult for you to compare the antidepressant effects of the two drugs given the adverse effects of Provigil, but how would you describe the differences, if any, in the quality and magnitude of improvement? How long did it take for you to see an improvement with both drugs?
Can you make any statements regarding your experiences at 300mg versus 600mg?
To what degree do you think Zyprexa may be acting as an antidepressant? Do you feel that adrafinil is totally responsible for your improvements in depression?
I will try to remain on Provigil for a while longer. I find it very difficult to remain on a drug that has produced a transient antidepressant effect that dissipates. My history has consistently demonstrated that there is no reappearance of a response once it has been lost. I am extremely impatient, especially when I think something better is within arm's reach. I will keep you informed as to how I progress with Provigil, just in case I do well enough to offer you reason enough to try switching at some point in the future.
I would be grateful for any answers you can provide me with.
I am happy for you. I can't help but to smile as I write this. :-)
I wish you continued success.
Sincerely,
Scott* JohnL - Good work. Applause. Thank you.
Posted by shellie on July 13, 2000, at 8:21:19
In reply to Re: Cocktail Update:It's Working!! » KarenB, posted by SLS on July 13, 2000, at 8:03:43
>
> I began taking Provigil 200mg/day a few days ago. I experienced an immediate mild improvement that lasted perhaps four hours. For me, this is tremendously significant. Later in the day, I felt pretty dull-witted and kinda zombie-like. This had pretty much worn off by the end of day 2. On day 3, I knew that I still gleaned a small improvement in energy and cognition, but that has begun to dissipate. How does this compare with your experience with Provigil?
>
> That I experienced such a demonstrable improvement over the first two or three days gives me hope that adrafinil might have what it takes. Based on what I have seen here on Psycho-Babble, adrafinil seems to be more effective for depression than Provigil, and produces fewer, if not milder side effects. The only two disadvantages I see for adrafinil is that U.S. citizens must rely upon foreign sources and that it has a liability for stressing the liver. Otherwise, making the decision between Provigil and adrafinil is a no-brainer.Scott, do you feel secure taking adrafinil with an MAOI?
> I will try to remain on Provigil for a while longer. I find it very difficult to remain on a drug that has produced a transient antidepressant effect that dissipates. My history has consistently demonstrated that there is no reappearance of a response once it has been lost.Scott, are you only taking the provigal once a day?
I was told to take it twice. Also, can your dose be increased? shellie
Posted by Rick on July 13, 2000, at 11:35:12
In reply to Re: Cocktail Update:It's Working!! » KarenB, posted by SLS on July 13, 2000, at 8:03:43
>
> > It is going on week two and I am feeling much better. Adrafinil (300mg 2x a day) seems to boost mood and motivation as well as provide mild, unwired energy. Adderall helps with focus and energy and at the lower dose I am taking (10mg, 2x a day) has yet to trigger migraines. I stopped taking the Inderal last week and no headaches so far. Hope it stays that way.
>
> I am so excited to hear this. I feel like getting my hands on adrafinil right now and downing a few pills.
>
> I began taking Provigil 200mg/day a few days ago. I experienced an immediate mild improvement that lasted perhaps four hours. For me, this is tremendously significant. Later in the day, I felt pretty dull-witted and kinda zombie-like. This had pretty much worn off by the end of day 2. On day 3, I knew that I still gleaned a small improvement in energy and cognition, but that has begun to dissipate. How does this compare with your experience with Provigil?
>
> That I experienced such a demonstrable improvement over the first two or three days gives me hope that adrafinil might have what it takes. Based on what I have seen here on Psycho-Babble, adrafinil seems to be more effective for depression than Provigil, and produces fewer, if not milder side effects. The only two disadvantages I see for adrafinil is that U.S. citizens must rely upon foreign sources and that it has a liability for stressing the liver. Otherwise, making the decision between Provigil and adrafinil is a no-brainer.
>
> What provisions have you made for monitoring liver function?
>
> What is the nature of the effects on the liver, and what is the rate of their occurrence?
>
> I believe you described experiencing an antidepressant effect with Provigil, even though sedation and fatigue may have been produced by it. I know it will be difficult for you to compare the antidepressant effects of the two drugs given the adverse effects of Provigil, but how would you describe the differences, if any, in the quality and magnitude of improvement? How long did it take for you to see an improvement with both drugs?
>
> Can you make any statements regarding your experiences at 300mg versus 600mg?
>
> To what degree do you think Zyprexa may be acting as an antidepressant? Do you feel that adrafinil is totally responsible for your improvements in depression?
>
> I will try to remain on Provigil for a while longer. I find it very difficult to remain on a drug that has produced a transient antidepressant effect that dissipates. My history has consistently demonstrated that there is no reappearance of a response once it has been lost. I am extremely impatient, especially when I think something better is within arm's reach. I will keep you informed as to how I progress with Provigil, just in case I do well enough to offer you reason enough to try switching at some point in the future.
>
> I would be grateful for any answers you can provide me with.
>
> I am happy for you. I can't help but to smile as I write this. :-)
>
> I wish you continued success.
>
>
> Sincerely,
> Scott
>
> * JohnL - Good work. Applause. Thank you.Scott, I've been taking my Provigil 100 mg upon awakening, and 100 mg at noon. For me, this lengthens the alertness/cognition effect, with no effect on nighttime sleep or even daytime napping (by choice). As you've probably seen, doses over 200 mg/day have been shown to enhance effectiveness in some people, but not most. Also, side effects may show up (or increase) over 200 mg. It's all so dependent on what other meds you are taking and when, as well as your own psychological profile and body chemistry.
In one way, my experience with Provigil sounds like yours. I experienced some very pleasant but mild euphoria, but that went away quickly. In my case, however, all the other benefits have "stuck" around for four weeks now: wakefulness, alertness, motivation, enhanced cognition, more-outgoing behavior, and enhanced sexual function (the latter could also be due to my Serzone).
One thing seems clear based on posts here: If you don't see much improvement, and are comfortable with the foreign supply and liver toxicity potential, then you should consier giving adrafinil a try.
Good Luck,
Rick
Posted by kerry B on July 13, 2000, at 18:00:40
In reply to Cocktail Update:It's Working!!, posted by KarenB on July 12, 2000, at 10:59:48
> Hi guys!
>
> It is going on week two and I am feeling much better. Adrafinil (300mg 2x a day) seems to boost mood and motivation as well as provide mild, unwired energy. Adderall helps with focus and energy and at the lower dose I am taking (10mg, 2x a day) has yet to trigger migraines. I stopped taking the Inderal last week and no headaches so far. Hope it stays that way.
>
> My doc started me on Zyprexa when Buspar failed to help with irritability, anxiousness and low level depression. It is working. My mind is "quiet. I never knew how much "noise" was going on until it stopped. I do notice, though, that I have a new appreciation for sweets that could be hazardous to my weight. I am so excited about being back in a size 2/3 thanks to the Adderall, that I don't want anything to spoil it. I could stand to lose 5 more lbs. Don't worry - no anorexia going on here- just a very small frame (5'1").
>
> Could it be that the Zyprexa is preventing the migraines and not just the decrease in Adderall dose? Anybody got any comments on that?
>
> The true test will be at the end of the month, when PMDD may arrive. We'll see how effective these medications are when faced with PMS.
>
> Just a sidenote to the women: I have found that when I am more physically active on a regular basis, all PMS symptoms - physical, mental and emotional - are not nearly as intense. Walking fast, at least 1/2 hour a day, really helps. I have more available energy when I do this, too.
>
> Karen
Hi Karen,
I didn't realize you were on zyprexa. I think it has been the wonder drug for me. As you mentioned about all the noise that was going on in your head, I was the same, but after a week on zyprexa it stopped and I too have some peace and quiet in there.
I have a pretty full on day doing things again that I hadn't been doing and all my creativity has returned. I drive everyone crazy but I just can't seem to sit down. But anything is better than the down side so I am making the most of it while it lasts. I try to prepare myself for tomorrow cause I never know what it will be like.
Glad zyprexa is working for you too, also, I have developed a sweet tooth and I usually don't eat that sort of stuff so I am trying to stop with that but it's hard 'cause it's such a strong craving. Maybe try eating a sweet fruit with natural sugars in it. I never usually eat fruit but I found I like oranges out of the fridge. They seem to satisfy the craving and also help with the dryness of mouth I seem to have now. Just a thought.........Kerry B
Posted by KarenB on July 13, 2000, at 23:21:57
In reply to Re: Cocktail Update:It's Working!!, posted by Janice on July 12, 2000, at 22:28:20
> KarenB,
> this is fantastic! The headaches could have been a side effect of Adderall that would have gone away after a week or two by itself.I gave that headache THREE WEEKS to go away and for the first time in my life, went to the emergency room on a Saturday night and said, "Ok, give me the Demerol." That was why I started the Inderal, which worked great to keep the migraines away, so I could have the benefits of the Adderall sans headache.
> so just how much of your self-esteem is derived from your size? Regardless of what you answer, I won't be able to help you. I think the politically correct answer should be 0.
Politically correct? The term you meant to use is "dishonest," right? As to your question, the answer would be, "some." I don't feel good when I have extra weight on. And, when you are 5'1", extra weight looks like EXTRA WEIGHT, you know what I mean? If I gain five pounds, I'm in a larger size. I am really small boned. My Scottish grandma still wears a size 2, at 93. I SHOULD be a size two, if I am healthy and not carrying around extra baggage. Being lean and mean is good for just about anyone's self esteem:)
>
> Now, you must conquer the PMS beast - and she is a tough one Karen!!!!! Keep us informed. JaniceYou mean like cowering and saying "don't hurt me?" That's what I did this month. It's more like PMDD. I was completely incapacitated for three days. I really cannot take this nonsense anymore. It's bad enough trying to adjust and trial the meds without going insane for a few days each month. My GYN will probably put me on hormone therapy next week, when I have my exam. Today, they took a biopsy to rule out any problems. Please pray for normal results.
Thanks for your encouragement:)
Karen
Posted by KarenB on July 13, 2000, at 23:41:46
In reply to Re: Cocktail Update:It's Working!!, posted by AndrewB on July 12, 2000, at 15:35:47
> Karen,
>
> With Zyprexa you are taking a low dose antipsychotic as you were with sulpiride. Does the effect Zyprexa has on you compare at all with the effect sulpiride had?
>
> AndrewBAndrew,
Yes, mentally, the effects are much the same. The difference I notice between the two is in my physical symptoms of fatigue, apathy and general heaviness. So far, the Sulpiride gives better relief from those symptoms. But...I never took Sulpiride aside from the Amineptine, so that could be responsible for some of the relief. I think those two had a synergistic effect when taken together. As for social anxiety and better mental and emotional stability, they both work. The only thing I don't like about the Zyprexa is that "pull-up-a-chair-to-the-refrigerator" intensity of HUNGER!!
GIVE ME CHOCOLATE OR PAY THE PRICE!!;^P
Karen
Posted by KarenB on July 14, 2000, at 0:37:53
In reply to Re: Cocktail Update:It's Working!! » KarenB, posted by SLS on July 13, 2000, at 8:03:43
>I began taking Provigil 200mg/day a few days ago. I experienced an immediate mild improvement that lasted perhaps four hours. For me, this is tremendously significant. Later in the day, I felt pretty dull-witted and kinda zombie-like. This had pretty much worn off by the end of day 2. On day 3, I knew that I still gleaned a small improvement in energy and cognition, but that has begun to dissipate. How does this compare with your experience with Provigil?
I think it made me more tired but I had the worst case of PMS I have had in years, while I was attempting to give it a fair trial. I may try it again later, after I get this hormonal thing under control.
> What provisions have you made for monitoring liver function?
None yet. If it continues to work, I have a very cooperative primary care D.O. who will no doubt write a script every three months for the labwork.
> What is the nature of the effects on the liver, and what is the rate of their occurrence?
This I don't know. Anybody have an answer to that one? It's not that I don't care, it's just that the effects of my illness are so dark and scary, I am maybe willing to take somewhat of a risk rather than be where my mind goes without effective meds.
> I believe you described experiencing an antidepressant effect with Provigil, even though sedation and fatigue may have been produced by it. I know it will be difficult for you to compare the antidepressant effects of the two drugs given the adverse effects of Provigil, but how would you describe the differences, if any, in the quality and magnitude of improvement? How long did it take for you to see an improvement with both drugs?
First day with Provigil, I felt better. May have been a "placebo effect," I don't know but the effect waned after a few days. In the afternoon I was very, very tired, even though I took the second dose prior to the first dose wearing off. I think there is more of a "mood brightening" effect with Adrafinil, although subtle. Come to think of it, it is probably more like Amineptine than anything I have taken. Very similar. No wired feeling. As the "good drug guide" describes it, "cleanish." No detectable side effects whatsoever, for me. Just that "good normal" we are all looking for, with no feeling of being medicated. Effects are almost immediate with both, however, I have read that Adrafinil can take up to three weeks to have it's full cognitive benefit manifest. So, I am committed to giving it a full trial. My mom split shipping with me and is trialing it, as well. She is 70 and having problems with memory. I'll be interested to see what her response will be. So far so good, she tells me.
> Can you make any statements regarding your experiences at 300mg versus 600mg?As with all stimulants I have tried, I need that second dose in early afternoon. I always go almost a week at the lower dose at first, to see how I really feel.
> To what degree do you think Zyprexa may be acting as an antidepressant?I'm sure it is. Neuroleptics, in my system, definitely work as anti-anxiety, antidepressant agents. But, the energy, focus and motivation is surely coming from the Adrafinil. In a very smooth kind of way, it is helping my ADD symptoms.
Do you feel that adrafinil is totally responsible for your improvements in depression?
No. The Zyprexa is responsible in part. My best experience, as you know, is with a psychostimulant plus a neuroleptic. Nothing beats that, to date.
> I will try to remain on Provigil for a while longer. I find it very difficult to remain on a drug that has produced a transient antidepressant effect that dissipates. My history has consistently demonstrated that there is no reappearance of a response once it has been lost. I am extremely impatient, especially when I think something better is within arm's reach. I will keep you informed as to how I progress with Provigil, just in case I do well enough to offer you reason enough to try switching at some point in the future.
Thank you. The impatience from my ADD does not make this drug trialing an easy venture. I know what you mean. It has been my experience as well that when it doesn't work soon into therapy, it NEVER works. I "hang in there," just to lose another couple of weeks of my life.
>
> I would be grateful for any answers you can provide me with.
>
> I am happy for you. I can't help but to smile as I write this. :-)Thanks, Scott. Hope you find some answers soon, too.
Karen
Posted by KarenB on July 14, 2000, at 0:43:24
In reply to Re: Cocktail Update:It's Working!!, posted by kerry B on July 13, 2000, at 18:00:40
Thanks you guys:)
KGB
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.