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With Xyrem, you need to titrate up to a high dosage. I started off with 2.25g twice a night. All of the dosing is done in grams, so I'm not sure how you could even measure out mg. The plunger is marked off in grams and 2.25 g twice a night is a general starting dose. I went from 2.25 g to 3 g and then up to 3.75 g, all twice a night. I had side effects each time I bumped up a dose, but they went away in a few days. That was until I got up to the 3.75 g dose. I started having chest pains and then my cobra got screwed up and I ran out of drugs and can't get more until my insurance company straightens it out. I will start all over on the small dose to avoid side effects, but I've never heard of small doses working for narcolepsy or cataplexy.

I talk to a great group of folks who are on the drug on another web site. Our narcolepsy group has a fairly large number on Xyrem too. From what I've read, small doses are generally used to get high and those doses are the types used by "clubbers". From talking to others, most need at least 3.75 or the 4.5 g doses to control EDS or catalplexy.

If you used 4.5 g twice a night, then that is NOT a small dose at all. That's the maximum dosage and most docs don't start patients on it, they work patients up to it over time. Talk to your doctor. Headaches and "hangover" are side effects that generally go away as your body adjusts. Good luck.

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