Psycho-Babble Medication Thread 382548

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Re: I'll definitely try cutting down on the diet Coke alesta

Posted by Dinah on August 29, 2004, at 14:28:28

In reply to Re: I'll definitely try cutting down on the diet Coke Dinah, posted by alesta on August 29, 2004, at 13:44:26

My neurologist thinks it's likely I have narcolepsy although the sleep test wasn't conclusive. I'm not nearly as sure as he is, although a good number of my mother's large family has been diagnosed with narcolepsy or idiopathic hypersomnia.

I don't think my daytime sleepiness has increased since starting Klonopin, although some of the sleep problems noted in the study (central apnea and reduced stage 3-4 sleep) can be caused by Klonopin. But since I started the Klonopin because I'd wake up at 3 in the morning with anxiety attacks, I'm not sure doing away with it would help my sleep any. :)

Still, I do wonder if I'd need the Provigil without the Klonopin and Depakote (for mood stabilization and migraine prophylaxis). How much is the medication merry-go-round?

Oh well. First things first, I suppose. See if reducing caffeine stops the Provigil from interfering with my sleep. If it does, it might feel more natural (like the Klonopin and Depakote do) and it won't feel as much like I'm popping pills to meet some external standard of productivity.

 

Re: I'll definitely try cutting down on the diet Coke Dinah

Posted by alesta on August 29, 2004, at 14:56:23

In reply to Re: I'll definitely try cutting down on the diet Coke alesta, posted by Dinah on August 29, 2004, at 14:28:28

dinah :),
no, i don't think you should go off the klonopin...i just wondered b/c some people say they take provigil due to klonopin-induced drowsiness...i was going to suggest if that was the case for you (which it isn't, so never mind) that you reduce your klonopin dose a bit. it seems like you have good reasons for taking everything you're taking right now. please stop thinking about taking meds in such a negative light.:) there is a crucial difference between you and a drug abuser off the street. Youre taking these drugs to become normal. These street addicts are taking them to get high. they are abusing drugs, you are using them properly. and in some cases Im sure these street addicts are attempting to merely self-medicate, but they are going about it the wrong way. They need to go to a good psychiatrist who can help them restore a more natural balance, rather than throw it off even further..

amy :)

 

Re: zeugma...sorry!!:) alesta

Posted by zeugma on August 29, 2004, at 17:30:05

In reply to zeugma...sorry!!:), posted by alesta on August 29, 2004, at 13:34:38

> > Btw, I realize that my screen name is ambiguous as to gender, but I am male.
>
> OMG, zeugma, i am so sorry! i don't know why i assumed you were female! i was wondering for the longest time and then i guess my subconscious just went ahead and picked a gender to think of you as. :) i don't think it's natural to think of a person in a genderless way, you know what i mean? anyways..thanks for telling me!!!
>

no forgiveness needed. it's impossible to think of anyone in a genderless way, and in particular the English language forces gendered pronouns on us, so when confronted by an ambiguous name, one must pick. I find gender one of those difficult things to understand, myself. but I'm working on it! :)
> forgive me, dear sir...(being dramatic :))
> amy :)
again no forgiveness necessary...

-z

 

Re: um.....interesting dialog on PROVIGIL... Rick? SLS

Posted by Rick on August 30, 2004, at 18:48:43

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? Dinah, posted by SLS on August 29, 2004, at 10:44:47

> Has Rick posted recently regarding his experience with long-term use of Provigil?

Interesting to check out Psycho-Babble for the first time in many moons and see that someone had just asked about me the day before.

So we've discovered an exciting new benefit of long-tern Provigil use, namely development of telepathic powers :)

Eveything's still going fine after four years of a combo of 100 mg Provigil + 1 mg Klonopin for non-depressive Social Phobia. (At various times I've had some other stuff in the mix, but not for quite awhile.)

Provigil has a lot fewer side effects than the great majority of psychotropics I've taken. The main adverse effects over the past year are sometimes-awful dry mouth (my pdoc thinks it's the Klonopin, but I don't) and occasional increased heart rate. Provigil still works great as part of my anxiety treatment (e.g., makes me more outgoing) and doesn't interfere with sleep. Maybe a few times a month I experience some insomnia which might be exacerbated by Provigil (I really can't tell), and also a few times a month I experience the kind of daytime sleepiness that I had frequently pre-Provigil.

I do have some episodes of memory problems and what that gaggle of INTENSE conspiracy-obsessed sleep board folks called the "stoopids", as well as low motivation at times, but who knows what the drivers are? My guess is that the main suspects are Klonopin, increasing age (most recently at a rate of 1 year every 365 days) and/or...well...ME.

Rick

 

Re: um.....interesting dialog on PROVIGIL --Rick

Posted by alesta on August 30, 2004, at 20:17:23

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? SLS, posted by Rick on August 30, 2004, at 18:48:43

hi, rick :),

i just wanted to say hi and welcome you back for however long you intend to stick around. i feel like i know you, as i've read so many of your klonopin posts while doing research...i guess that kinda makes you a psychobabble "celebrity.":)

take care,
amy

 

Re: um.....interesting dialog on PROVIGIL --Rick alesta

Posted by Rick on August 30, 2004, at 23:06:44

In reply to Re: um.....interesting dialog on PROVIGIL --Rick, posted by alesta on August 30, 2004, at 20:17:23

Thanks, Amy! I've been called many things through the years, but I don't think "celebrity" was one of them. You've made my day...unless, of course, you meant INFAMOUS celebrity ;)

Rick

 

Provigil -- Scott Dinah

Posted by Rick on August 31, 2004, at 1:38:19

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? SLS, posted by Rick on August 30, 2004, at 18:48:43

Oops...Just realized I neglected to say that my long-term personal experience with Provigil supports Scott's reply to Dinah top-to-bottom.

Rick

 

Re: um.....interesting dialog on PROVIGIL... Rick? Rick

Posted by SLS on August 31, 2004, at 8:04:06

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? SLS, posted by Rick on August 30, 2004, at 18:48:43

Hi Rick!

> > Has Rick posted recently regarding his experience with long-term use of Provigil?
>
> Interesting to check out Psycho-Babble for the first time in many moons and see that someone had just asked about me the day before.

Synchronicity is scary sometimes, but always fun to think about!

It's good to see you.

I am so glad to hear that things are still good with you. I wish you had been around a few weeks ago to render your comments on the utility of benzodiazepines. Unfortunately, benzo-phobia among practicing psychiatrists still runs rampant. At times, it seems absolutely brainless.

A dear friend of mine who has schizoaffective disorder remained symptom-free for several years taking a combination of Xanax + Risperdal. That's all she needed. Then, she changed doctors. The new guy decided that Xanax was a demon, and mandated that she discontinue it in favor of Neurontin. Despite 8 hospitalizations for psychosis in 1 1/2 years, this doctor stubbornly refused to restart Xanax, despite her pleadings. She has since seen two more doctors with the same results. The longest she has been symptom free was three months ago when she managed to get a hold of some Xanax through a GP. Unfortunately, she is in the state system, and is given little choice as to who she must see for treatment. She is in the hospital right now.


- Scott

 

Thanks, Rick. :) (nm)

Posted by Dinah on August 31, 2004, at 9:35:14

In reply to Provigil -- Scott Dinah, posted by Rick on August 31, 2004, at 1:38:19

 

Yikes re your poor friend's mistreatment - Jeez! (nm) SLS

Posted by Rick on August 31, 2004, at 15:11:53

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? Rick, posted by SLS on August 31, 2004, at 8:04:06

 

Re: Yikes re your poor friend's mistreatment - Jeez!

Posted by alesta on August 31, 2004, at 15:28:07

In reply to Yikes re your poor friend's mistreatment - Jeez! (nm) SLS, posted by Rick on August 31, 2004, at 15:11:53

hi, again, rick :),
yeah, you sort of came back at a *weird* time.:) things are definitely heating up around here!

amy :)

 

shocking development about benzos at Web World alesta

Posted by zeugma on August 31, 2004, at 18:17:38

In reply to Re: Yikes re your poor friend's mistreatment - Jeez!, posted by alesta on August 31, 2004, at 15:28:07

check out what's been added at Depression Web World, and note what a change of line this appears to be about the merits of benzos for anxiety...

http://www.depression-webworld.com/brainstormsndx.htm

scroll down to the bottom, and contrast particularly with entry 17 in the series.

-z

 

Re: shocking development about benzos zeugma

Posted by alesta on August 31, 2004, at 19:57:55

In reply to shocking development about benzos at Web World alesta, posted by zeugma on August 31, 2004, at 18:17:38

hi, zeug!
i'm having problems with my computer...it says the plugin won't initialize or something...i do have adobe acrobat reader, i think, unless i uninstalled it...darn. i'll have to get back to you on that...i'm looking forward to reading this information..!

thanks, zeugy!

 

Re: um.....interesting dialog on PROVIGIL... Rick?

Posted by zana on September 1, 2004, at 16:23:09

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? Rick, posted by SLS on August 31, 2004, at 8:04:06

i have taken provigil for 2 years and LOVED it at first. did all the good things people mentioned and SE, slight headache, stomach, tight muscles were more than worth it. i take klono and neurontin at night so getting to sleep was not a big deal. BUT after a while I found that i started majorly crashing in early evening 3 or 4 hrs after second dose and would get sweats and thrash when i lay down. Pdoc said last 2 were serotonin effects. i felt as if provigil were exhausting a neurotransmitter and then i just had to wait for there to be more the next day.
eventually stopped. now use for a few days at a time, once a day and only 1/4dose (ie 50ish mg hard to tell since pill is only scored for half break.) this gives me same ole benefits w/o crashes.

 

Re: um.....interesting dialog on PROVIGIL... Rick? zana

Posted by Rick on September 1, 2004, at 17:36:38

In reply to Re: um.....interesting dialog on PROVIGIL... Rick?, posted by zana on September 1, 2004, at 16:23:09

> i have taken provigil for 2 years and LOVED it at first. did all the good things people mentioned and SE, slight headache, stomach, tight muscles were more than worth it. i take klono and neurontin at night so getting to sleep was not a big deal. BUT after a while I found that i started majorly crashing in early evening 3 or 4 hrs after second dose and would get sweats and thrash when i lay down. Pdoc said last 2 were serotonin effects. i felt as if provigil were exhausting a neurotransmitter and then i just had to wait for there to be more the next day.
> eventually stopped. now use for a few days at a time, once a day and only 1/4dose (ie 50ish mg hard to tell since pill is only scored for half break.) this gives me same ole benefits w/o crashes.

That's great that 50mg taken intermittently seems effective for you while reducing the side effects you were experiencing. This is especially nice with a med that's so pricey! I've tried cutting my daily 100mg to 50mg a few times in an effort to reduce the dry mouth, but 50 really didn't seem to provide much theraputic benefit.

Rick

 

Re: shocking development about benzos--zeug...

Posted by alesta on September 1, 2004, at 18:16:03

In reply to shocking development about benzos at Web World alesta, posted by zeugma on August 31, 2004, at 18:17:38

hi, zeugma :),
my computer won't let me read the document for some reason...i don't want to be a pain in the neck here, but could you possibly copy and paste the "shocking development" onto this site when you get a chance? i would be eternally grateful....:)

thank you!
amy :)

 

Re: shocking development about benzos--zeug... alesta

Posted by zeugma on September 1, 2004, at 18:59:37

In reply to Re: shocking development about benzos--zeug..., posted by alesta on September 1, 2004, at 18:16:03

> hi, zeugma :),
> my computer won't let me read the document for some reason...i don't want to be a pain in the neck here, but could you possibly copy and paste the "shocking development" onto this site when you get a chance? i would be eternally grateful....:)
>
> thank you!
> amy :)

Amy, the site is down.It's not your computer. Maybe the development was really too "shocking" after all.

Let's hope they recover soon

:)

z

 

Re: um.....interesting dialog on PROVIGIL... Rick? zana

Posted by zeugma on September 1, 2004, at 19:06:09

In reply to Re: um.....interesting dialog on PROVIGIL... Rick?, posted by zana on September 1, 2004, at 16:23:09

BUT after a while I found that i started majorly crashing in early evening 3 or 4 hrs after second dose and would get sweats and thrash when i lay down. Pdoc said last 2 were serotonin effects. i felt as if provigil were exhausting a neurotransmitter and then i just had to wait for there to be more the next day.>>

yes, i felt certain this drug had serotonin effects, although of course this drug is shrouded in mystery. Is the effect like being on too high of a dose of SSRI, assuming you've taken one?

And yes, yes, the crash is awful. It's a little better when I take it with 10 mg Ritalin, but still steep and draining (I hate it). Btw I take it for ADHD and possible narcolepsy, am at 100 mg all in the am to fend off insomnia. Have you also taken Ritalin? Would you recommend it over Provigil?

-z

 

Re: um.....interesting dialog on PROVIGIL... Rick?

Posted by zeugma on September 1, 2004, at 19:07:18

In reply to Re: um.....interesting dialog on PROVIGIL... Rick? zana, posted by zeugma on September 1, 2004, at 19:06:09

i forgot to mention, at about 4 pm i also get drenched in sweat.

 

Re: shocking development about benzos--zeug...

Posted by zeugma on September 2, 2004, at 4:53:01

In reply to Re: shocking development about benzos--zeug... alesta, posted by zeugma on September 1, 2004, at 18:59:37

the site is back up. unfortunately i can't cut and paste an article in pdf format from my computer. I'll paraphrase then: Dr. Stahl says that despite recommendations to use SSRI's as first-line treatments for anxiety disorders, he says that in fact benzodiazepines are more widely prescribed, and that since each treatment has an independent mechanism for treating anxiety, it is pharrmacologically rational to combine the two classes of drugs and that remission is more likely when both are used together.
What he doesn't say, but is implied by the fact that he doesn't appear critical of the fact that benzos are prescribed more widely, is that benzodiazepines are probably more effective than SSRI's for anxiety.

Another interesting thing is that Paxil is the most prescribed SSRI for anxiety. I think Paxil would have been the SSRI that I would have had the best chance of tolerating, because of this; although of course it also has the worst s/e profile of the SSRI's (probably related to why it works better). I wasn't able to try it because of possible serious interactions with TCA's.

 

Re: shocking development about benzos at Web World zeugma

Posted by olysi79 on September 2, 2004, at 13:01:48

In reply to shocking development about benzos at Web World alesta, posted by zeugma on August 31, 2004, at 18:17:38

Not to sound sarcastic, but I don't think it's anything shocking to learn that benzos are the best treatment for anxiety... they soothe and calm whereas SSRIs take forever to work (if the chosen SSRI even does work) and are loaded with side effects. The problem however is that SOME people become chemically and psychologically addicted to them and also develop a tolerance, hence they are great to use as needed for those really tough days but for SOME people they become unreliable with the addiction and tolerance issues. I'd rather carry my ativan with me for tough days but depend on an SSRI and mood stabilizer for true stabilization.
Just my two cents

> check out what's been added at Depression Web World, and note what a change of line this appears to be about the merits of benzos for anxiety...
>
> http://www.depression-webworld.com/brainstormsndx.htm
>
> scroll down to the bottom, and contrast particularly with entry 17 in the series.
>
> -z

 

Re: shocking development about benzos at Web World olysi79

Posted by zeugma on September 2, 2004, at 13:48:07

In reply to Re: shocking development about benzos at Web World zeugma, posted by olysi79 on September 2, 2004, at 13:01:48

> Not to sound sarcastic, but I don't think it's anything shocking to learn that benzos are the best treatment for anxiety... they soothe and calm whereas SSRIs take forever to work (if the chosen SSRI even does work) and are loaded with side effects. The problem however is that SOME people become chemically and psychologically addicted to them and also develop a tolerance, hence they are great to use as needed for those really tough days but for SOME people they become unreliable with the addiction and tolerance issues. I'd rather carry my ativan with me for tough days but depend on an SSRI and mood stabilizer for true stabilization.
> Just my two cents

I won't take your post as sarcastic, as long as you don't think it was me who was shocked :) however, given the widespread benzophobia even among the medical community (as illustrated by the title of the article, "Don't Ask, Don't Tell, but Benzodiazepines are Still the Leading Treatments for Anxiety Disorder") and given that in an earlier installment of Brainstorms Dr. Stahl speculates that soon the concept of 'anxiolytic' will be replaced by that of 'antidepressant', it did give me a little surprise. It seemed to signal a change in policy of the psychiatric establishment, and how often do we get to see that?

-z


> > check out what's been added at Depression Web World, and note what a change of line this appears to be about the merits of benzos for anxiety...
> >
> > http://www.depression-webworld.com/brainstormsndx.htm
> >
> > scroll down to the bottom, and contrast particularly with entry 17 in the series.
> >
> > -z
>
>

 

Re: shocking development about benzos at Web World

Posted by Rick on September 2, 2004, at 14:50:11

In reply to Re: shocking development about benzos at Web World olysi79, posted by zeugma on September 2, 2004, at 13:48:07

It's important to remember that under-appreciation of theraputically-used benzos -- as well as outright benzophobia -- is largely tied to the economics and related promotion practices of the drug industry. Most benzos have long ago gone off-patent, so generics rule the benzo roost and the big drug companies that originally developed them can no longer make money from them. So they instead promote their on-patent and far more expensive antidepressants, while claiming these are much safer and more effective than benzos -- especially for long-term treatment.

A few months ago the respected Journal of Clinical Psychiatry devoted an entire supplement to "rediscovering" the great benefits of benzos. Interestingly, the supplement was funded by an "unrestricted grant" from Solvay, maker of one of the first new patented benzo products in years, Klonopin Wafers. There was also a second new on-patent benzo product, Xanax XR, approved recently in the U.S. So between these two, it is not so surprising to see that *some* of the heat is being taken off benzos within the medical community and they are being "rediscovered" and de-stigmatized to some degree (not enough, unfortunately, though the articles posted earlier in this thread were heartening). Good pdocs have kept them in the arsenal of treatments all along for use when, and for whom, appropriate.

Last time I posted about a similar issue my post was shunted off to Social Psycho-Babble, and I imagine it will happen again. But patients are essentially doctor-advised consumers of medicines, and should be aware of the factors that can figure -- directly or indirectly -- into a doctors' drug selection. It's ridiculous to take a key, if sometimes subtle, part of the medication-selection process and act as if it is a completely separate or unimportant issue by exiling mention of it to a low-profile area of the site.

Rick

 

my thoughts exactly (nm) Rick

Posted by zeugma on September 2, 2004, at 15:50:50

In reply to Re: shocking development about benzos at Web World, posted by Rick on September 2, 2004, at 14:50:11

 

Re: shocking development about benzos--zeugma

Posted by alesta on September 2, 2004, at 17:58:54

In reply to Re: shocking development about benzos--zeug..., posted by zeugma on September 2, 2004, at 4:53:01

Zeugma, thanks a lot for summarizing that! I dont know what they're so afraid of with the benzos...oh no! they might actually help people to resume normal lives without fear! This is a travesty!

Sorry for that outburst, let me compose myself...

amy:)
sorry if this was a duplicate response to anyone else's, as i haven't read them yet...:)


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