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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by brynb on August 31, 2013, at 15:48:42
Hi All-
Has anyone used Amantadine for lethargy/fatigue? If so, what was your experience?
I'm doing well on my current med regimen, but i'm still excessively tired and lethargic. I'm pretty sure my meds are the cause, as well as my inactivity. Stimulants are not an option for me (they make me too moody, anxious, etc.); Nuvigil also makes me anxious and a bit unstable. I've taken Provigil before with some success, but it's quite expensive. With both Nuvigil and Provigil, when I stop taking them, I get that stimulant "crash."
While I know exercise will help, I'd like to take something temporarily to help my excessive sleepiness. I literally have to drag myself out of bed in the (late) morning.
I'd appreciate any feedback.
Thanks!
-b
Posted by phidippus on September 3, 2013, at 11:00:09
In reply to Amantadine, posted by brynb on August 31, 2013, at 15:48:42
You shouldn't be experiencing a 'crash' from Nuvugil or Provigil. They are not stimulants in the traditional sense.
Try Xyrem.
Eric
Posted by brynb on September 3, 2013, at 21:20:40
In reply to Re: Amantadine » brynb, posted by phidippus on September 3, 2013, at 11:00:09
> You shouldn't be experiencing a 'crash' from Nuvugil or Provigil. They are not stimulants in the traditional sense.
>
> Try Xyrem.
>
> EricThanks, Eric. Can you tell me more about Xyrem? Have you tried it? My insurance won't cover Provigil. Is it in the same class as Provigil and Nuvigil?
I don't know why I feel a crash. I think it's because Provigil gives me more energy than I'm used to so maybe I'm more active while on it and just worn out by the end of the day.
Thanks again.
Posted by phidippus on September 4, 2013, at 6:24:04
In reply to Re: Amantadine » phidippus, posted by brynb on September 3, 2013, at 21:20:40
I don't know much about Xyrem, other than it being different than Nuvigil/Provigil.
Eric
Posted by antennastoheaven on September 4, 2013, at 8:24:42
In reply to Re: Amantadine » phidippus, posted by brynb on September 3, 2013, at 21:20:40
> Thanks, Eric. Can you tell me more about Xyrem? Have you tried it? My insurance won't cover Provigil. Is it in the same class as Provigil and Nuvigil?
Xyrem is a drug that metabolizes to GHB. It is indicated for excessive daytime sleepiness and works by causing more restorative sleep. It is extremely expensive (in the US) and looks like it may be a pain to get.
Posted by antennastoheaven on September 4, 2013, at 8:37:15
In reply to Re: Amantadine » brynb, posted by phidippus on September 3, 2013, at 11:00:09
> You shouldn't be experiencing a 'crash' from Nuvugil or Provigil. They are not stimulants in the traditional sense.
They are not stimulants in the traditional sense but all that means is that they don't have all of the characteristics of a traditional stimulant "crash" experienced by users of amphetamines and similar drugs (which for me is a sudden drop in mood usually accompanied with anxiety /in addition to/ a subjective reduction in subjective wakefulness/energy). That drastic drop in alertness can be felt on amphetamines, methylphenidate, caffeine, modafinil, armodafinil, etc. and is probably best described as a "crash".
Posted by antennastoheaven on September 4, 2013, at 8:51:05
In reply to Amantadine, posted by brynb on August 31, 2013, at 15:48:42
> Nuvigil also makes me anxious and a bit unstable. I've taken Provigil before with some success, but it's quite expensive. With both Nuvigil and Provigil, when I stop taking them, I get that stimulant "crash."
Some people do not respond well to modafinil/armodafinil. There is at least one study that links modafinil response to genetics. I have found both drugs to be marginally more effective than caffeine, but not nearly as effective as amphetamines. One time I took modafinil and fell asleep about an hour later! I have noticed changes in behavior when on these drugs. I am usually less talkative than baseline, which usually isn't a big deal. More troubling, I am more likely to act like I am annoyed or aggravated, without actually feeling the change in mood I normally would.
According to SNPedia[1], a SNP has been linked to modafinil response and those with a specific genotype do not have much of a response to the drug: "rs4680(G;G) carriers deprived of sleep respond quite well to 2x 100mg modafinil in terms of improved vigor and well-being, and maintained baseline performance with respect to executive functioning, whereas rs4680(A;A) individuals barely responded to the drug at all." Per 23andMe, I have AG, which according to the study abstract[2] is supposed to be somewhere in between in effectiveness. I don't have access to the study and I probably wouldn't understand it if I did.
[1] http://www.snpedia.com/index.php?title=Rs4680
[2] http://www.ncbi.nlm.nih.gov/pubmed/19037200?dopt=Abstract
Posted by brynb on September 4, 2013, at 10:00:24
In reply to Re: Amantadine, posted by antennastoheaven on September 4, 2013, at 8:51:05
thanks for all your feedback, antennastoheaven.
i was told that insurance won't cover provigil and nuvigil because there are other drugs (namely stims) that produce the same effect. not the case for me. provigil does help me with wakefulness. i get too moody, depressed, unstable etc. on stims, so they're a no-no for me.
i agree you can crash from anything stimulating. i don't know what my solution is, but i do know i would feel better if i were more active and exercised (quite the task when always tired!).
thanks again.
-b
Posted by alchemy on September 8, 2013, at 15:50:01
In reply to Re: Amantadine » antennastoheaven, posted by brynb on September 4, 2013, at 10:00:24
Provigil actually seemed to only give me energy for about 4 hrs! Luckily it wasnt a mood crash like the stimulants. I would stll probably take it except for how crazy expensive it is even now its generic. And of course my insurance won't cover it.
A long time ago I tried amantadine for motivation. Unfortunately it didn't help with anything. But of course we all react differently.
This is the end of the thread.
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