I don't want to be tired! When to take a stimulant PRN?

[Wonderful.Cheese]

Aaaaaand we are back to not being able to stay awake all day again!

I nap at least once a day for at least an hour. I just can't stay awake! And I've been getting enough sleep at night these last few days.

 

I feel like I did all of those damn sleep studies for nothing. I can't handle stimulants. I should have been able to try them before spending thousands on sleep studies. Not cool.

I drink some caffeine in the morning and afternoon. Not overboard but a moderate or small amount.

 

NOTHING HELPS.

 

I know you are thinking, "It's not that bad" "Lots of people nap" "Naps are good for you!"

 

Easy to say when you have not wasted years of your life being asleep or so damn sleepy you may as well have been completely asleep. I feel like I'm chained to the bed. I really am.

 

I've tried provigil and ritalin. Both make me manic. I'm taking provigil prn for now. If I take it for more than a week I get insanely irritable. Ritalin caused a major manic episode and we can't afford the cardiologist appointments along with the sleep dr appointments along with the EKG tests.

 

So it's provigil prn for now. How do I know when to take it? I need it every day if I want to stay awake and alert. However, mood wise the side effects are too risky. Mania causes more damage than hypersomnia/narcolepsy to my life. I can drive short distances, but nothing over 15 minutes. 

 

I just don't want to be tired anymore!!!!!!!!!!!!!!!!!!!!!!!!!!!

[LikeMinded]

Provigil seems to work for you until you take it regularly... so maybe it's building up in your bloodstream?  You could try smaller doses of that stuff (basically cutting the smallest 100mg pill into pieces).  This doesn't guarantee lack of buildup but could be worth a shot.

 

Granted, I'm not even an expert by experience here, as I'm very dopamine deprived and need to be on 54mg/d of methylphenidate (active ingredient in Ritalin) and used to take 200mg/d of Provigil.

 

On the other hand, you could try more caffeine (ask your doctor first about this, since nobody wants it to make you go manic).  I'll admit that my own father takes about 3-5 cups a day to prevent fatigue.

 

Again, sorry I couldn't offer you a qualified opinion here, but maybe what I said helps.  Wishing you the best!

[Wonderful.Cheese]

Provigil seems to work for you until you take it regularly... so maybe it's building up in your bloodstream?  You could try smaller doses of that stuff (basically cutting the smallest 100mg pill into pieces).  This doesn't guarantee lack of buildup but could be worth a shot.

 

Granted, I'm not even an expert by experience here, as I'm very dopamine deprived and need to be on 54mg/d of methylphenidate (active ingredient in Ritalin) and used to take 200mg/d of Provigil.

 

On the other hand, you could try more caffeine (ask your doctor first about this, since nobody wants it to make you go manic).  I'll admit that my own father takes about 3-5 cups a day to prevent fatigue.

 

Again, sorry I couldn't offer you a qualified opinion here, but maybe what I said helps.  Wishing you the best!

 

Thank you so much! I really appreciate your reply.

 

I started off originally taking half of a 100 mg tablet of provigil and it worked. But sleep dr wanted to go higher because I still scored high on that sleepiness test/quiz (not sure of the name of the test/quiz, sorry). So I went up to 200 mg provigil quite fast. And I think you are spot on about that it had built up in my system and that was an issue because the effect on my mood wasn't pretty.

 

I could try splitting 100 mg again and staying on that dose. Maybe that would be just enough. I will ask my sleep dr about this for sure! Thank you for the good idea! That helps for sure! I and I am positive she will be fine with me doing this because I take 200 mg prn now. She's all about reducing doses to the least possible amount as long as it is still effective.

 

I wish I could have handled the ritalin prn. But oh well. I worked up from 5 mg to 30 mg prn. But yeah, like I said full blown batshit mania ensued. And the episode still lingers a bit. I even had to switch out an AAP for another (latuda to risperdal).

 

Sorry for rambling!

[Phoenix_Rising]

That's quite a dilemma, Cheese. I've taken provigil and stims (not at the same time) and been lucky enough not to get hypo. I wonder if nuvigil would be the same story for you.

[melissaw72]

I agree with splitting the dose if ok with your DR, even if only as needed.  It sounds to me like you had too much of the med at 200 mg.

[jt07]

I'd lay off the stims for a couple of weeks to give your brain a chance to recover from this latest episode even if it means sleeping a lot. Then I think you can work with your doctors to carefully introduce them provided you have a strong anti-manic (like Risperdal) on board.

[Gearhead]

I agree with jt. Your brain needs rest after a bad manic episode. Imagine it like this: you just went to a really raucous slumber party and stayed up all night. Now you're home again, and you're really tired. The obvious thing to do s go to bed early and sleep late the next morning.

 

Only you didn't go to a one-night sleep-deprivation event. Your mind and body ran on redline for weeks. You have a much greater debt to repay. For now, the best thing you can do is go to bed and stay there. Worry about normal sleep and wake cycles when you've had a chance to recover.

[Wonderful.Cheese]

Just got our bill for the sleep studies. It was a lot more than we had expected. We already only have $5 until Tuesday. Great. I'm so glad I did those and got absolutely no answers and no benefit from them.

Sure I use CPAP daily but it doesn't help. And the supplies are super expensive too.

But I can't handle or afford stimulants. So why the fuck couldn't I try the provigil or Ritalin b4 the sleep studies? She even acknowledged that they prob couldn't DX me with narcolepsy because of my meds anyway. So....what was the point of th studies? Did she need a new sport car I guess?

[melissaw72]

 

So....what was the point of th studies? Did she need a new sport car I guess?

 

Exactly.  I know what you mean.  Sometimes I wonder the same thing about other DRs.

[Wonderful.Cheese]

 

So....what was the point of th studies? Did she need a new sport car I guess?

 

Exactly.  I know what you mean.  Sometimes I wonder the same thing about other DRs.

I'm glad I'm. It the only one melissa! Ugh!

And I'm back to being chained to the bed as is my usual routine still. I am not even going to email the sleep dr. It is pointless.

[LikeMinded]

At least you can e-contact your SDoc; I can't even get in touch with my PDoc via email (although US health IT regulations are probably going to change that extremely soon).

 

Granted, if I were in the shoes of a Doc (in the US, they're pretty much bound to 80 hour workweeks), I would personally want a sports car.  Heck, I almost became an MD myself due to that kind of greed (thankfully I absconded and am going the PhD route at this time).  Well uh, I still want a sports car, but doesn't any man in his early 30s...?

 

I'm thinking you should really push the half/half idea if it seems comfortable to you.  Maybe you can email the doctor about the idea.  But this is just a popular opinion...

[Wonderful.Cheese]

I can't contact my pdoc via email. I have to call his nurse who relays a message to pdoc. And this rarely happens.

 

I can email sleep dr's nurse. And she relays some of it to my sleep dr.

I tried the 50 mg of provigil for about a week. Same bad results. I guess I just can't handle that med.

 

Sleep dr wants to try adderall or concerta. I don't know what the hell to do. I will probably try adderall but if I get manic again even a bit I will need to stop it. I guess I will have to pay for EKG tests and cardiologist appointments. Even though I don't know if we can really afford that. We have $5 in our bank account right now. I don't know what to do. But I can't do anything if I'm chained to the bed. IDK!!!!!!!!!!!!!

[Flash]

I hope adderall allows you to stay awake without making you manic. You shouldn't have to choose between sleeping your life away and brain cooties.

[Wonderful.Cheese]

I hope adderall allows you to stay awake without making you manic. You shouldn't have to choose between sleeping your life away and brain cooties.

I think you are spot on flash.

Unfortunately the choice has been made for me. I'm so freaking upset. Pdoc has told sleep dr no stimulants until whenever he deems it appropriate. I was told to talk to shitty pdoc if I wanted more answers or to discuss things further. Well I don't even see pdoc til end of July.

So I guess I have to sleep my life away.

I just may as well kill myself. I mean it. That's it. It's all over.

[water]

I'm sorry Cheese. :-{

 

How are you? I am worried.

[LikeMinded]

I can't contact my pdoc via email. I have to call his nurse who relays a message to pdoc. And this rarely happens.

 

I can email sleep dr's nurse. And she relays some of it to my sleep dr.

I tried the 50 mg of provigil for about a week. Same bad results. I guess I just can't handle that med.

 

Sleep dr wants to try adderall or concerta. I don't know what the hell to do. I will probably try adderall but if I get manic again even a bit I will need to stop it. I guess I will have to pay for EKG tests and cardiologist appointments. Even though I don't know if we can really afford that. We have $5 in our bank account right now. I don't know what to do. But I can't do anything if I'm chained to the bed. IDK!!!!!!!!!!!!!

 

*sigh* This reminds me of my repeated attempts to contact my ophthalmologist for purposes of performing surgery on my affected bum right eye, which suffers severe keratoconus to the point of legal blindness.  Total phone tag.  All the pre-op visits have been scheduled; all that needs to be done is a date for a minor operation.  fml.

 

That all said, I'd avoid anything EKG-cardio related (unless you have a known cardio disorder; arrhythmias can be fatal!) I, for one, have a known cardiac nerve obstruction due to previous surgery when I was an infant 30 years ago, and am concerned for myself as well as others who are also prone to potentially fatal arrhythmias.   If you know you are *NOT* an arrhythmia risk, though, I would personally push your pdoc into a balanced load of stims and tell your pdoc that you are *NOT* at risk for fatal issues and take your stims as desired!

 

Furthermore, please do not kill yourself, WonderfulCheese.  I have had at least 3 close members of my family or best friends do the act over the past 15 years.  It is traumatic for those who survive on past the suicide's decision.  My very best friend of 10 years killed himself over tinnitus (a neuro-sensory disorder that is totally evil; I have it myself as well!) because he refused to see a doctor regarding his condition.  I know you're better than his naivete, and that you're capable of reaching a solution regarding this issue.

 

If you have any seriously psychologically life-threatening concerns, please don't hesitate to PM me; that's what we CBers are here for.