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Dr. Bob is Robert Hsiung, MD,
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Posted by delna on July 9, 2001, at 1:15:32
hi
i have just joined the board
I was wondering what experiences people have had with stimulants for depression or sleepiness. Have u developed any tolerance?
I am constantly sleepy and have been taking effexor 300mg for 1 year (for depression). I am much more awake with it. However I am still too sleepy to keep my job or drive. My doctor added modafinil at 200mg or 400mg. For the first few days it worked great. I was fully alert and could concentrated but soon it stopped helping. Could this be tolerance.
My doctor added wellbuttin 150mg X 2 but this has not helped me at all.
He is reluctant to prescribe stimulants as he is worried about tolerance and addiction. But I know that there are people who have to take it for life and manage somehow.
Anyway – it would really help to know your experiences with stimulants and tolerance.
thanks
delna
Posted by Lorraine on July 9, 2001, at 12:17:01
In reply to stimulants and tolerance, posted by delna on July 9, 2001, at 1:15:32
> hi
> i have just joined the board
> I was wondering what experiences people have had with stimulants for depression or sleepiness. Have u developed any tolerance?
> I am constantly sleepy and have been taking effexor 300mg for 1 year (for depression). I am much more awake with it. However I am still too sleepy to keep my job or drive. My doctor added modafinil at 200mg or 400mg. For the first few days it worked great. I was fully alert and could concentrated but soon it stopped helping. Could this be tolerance.
> My doctor added wellbuttin 150mg X 2 but this has not helped me at all.
> He is reluctant to prescribe stimulants as he is worried about tolerance and addiction. But I know that there are people who have to take it for life and manage somehow.
> Anyway – it would really help to know your experiences with stimulants and tolerance.
> thanks
> delnaDelna: I have been on dexidrine and now adderral for about 5 months--no increase in my amount (which is 12 mg of adderral a day). Sometimes I decrease it. I just don't find it remotely addicting. I'm not using it to get high.
Posted by SalArmy4me on July 10, 2001, at 0:56:41
In reply to stimulants and tolerance, posted by delna on July 9, 2001, at 1:15:32
Modafinil is without much abuse potential:
Jasinski, Donald R *. Kovacevic-Ristanovic, Ruzica +. Evaluation of the Abuse Liability of Modafinil and Other Drugs for Excessive Daytime Sleepiness Associated with Narcolepsy. Clinical Neuropharmacology. 23(3):149-156, May/June 2000:
"Summary: Psychostimulants have been used routinely for the treatment of the disabling daytime sleepiness associated with narcolepsy. However, the perceived and real potential for abuse of amphetamine and amphetaminelike stimulants prompted a search for new wake-promoting compounds with lower dependency and abuse liabilities. Modafinil is a novel wake-promoting agent with a mechanism of action that differs markedly from that of amphetamine and amphetamine-like stimulants. In controlled clinical trials, modafinil has been shown to be an effective and well-tolerated treatment for excessive daytime sleepiness (EDS) in patients with narcolepsy. With a benzhydrylsulfinylacetamide structure, modafinil has a low level of solubility in water (< 1 mg/mL) and is unstable at temperatures >=180[degrees]C, physicochemical properties that reduce the potential for its abuse via intravenous injection and smoking, respectively. Available preclinical and clinical data on the abuse liability of modafinil suggest a much lower potential for abuse and dependency than amphetaminelike stimulants commonly used for treating EDS in patients with narcolepsy. Therefore, modafinil represents a valuable therapeutic option for the treatment of EDS associated with narcolepsy."
Posted by BFrederick on July 10, 2001, at 13:20:53
In reply to stimulants and tolerance, posted by delna on July 9, 2001, at 1:15:32
> Hi Delna! I took Ritalin in conjunction with Prozac and later Effexor. I started with 10mg 3x a day and eventually went to 20mg 3x a day, but I think it was just the natural process of finding out what would work. All in all, I probably took it for 3yrs. It definitely helped with the sleepiness and helped improve mood also. I never felt addicted to it, although I could feel myself "coming down" when it started to wear off. Not really any worse than coming down from caffiene.....didn't have any cravings for it or anything like that. In the meantime, I discovered I had a sleep disorder and discontinued it on my own with no problems whatsoever. After a brief period off of meds--ya gotta try every now and then :)-- I started Wellbutrin SR 150mg 2x a day. It has improved the depression, but I never felt wired like some people have. I still suffer from lack of motivation.....although, I don't HAVE to sleep (like I did before solving the sleep disorder), I'm still very tempted to sleep my weekends away. I'm experimenting with the Adrafinil right now with some subtle results. From what I've read, the Adderall appears to be preferable to Ritalin, but I've never tried it.
Good luck! I hope your doctor gives you the chance to explore that option.
Posted by Zo on July 10, 2001, at 14:59:22
In reply to stimulants and tolerance, posted by delna on July 9, 2001, at 1:15:32
> hi
> i have just joined the board
> I was wondering what experiences people have had with stimulants for depression or sleepiness. Have u developed any tolerance?Nope, no tolerance. I assume by that you mean, needing more. . .Have been on Dex four years. ..If anything, I need a little less now. My experience has been that some of these meds are to some extent "curative."
Zo
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