Posted by Sad Panda on August 11, 2004, at 0:33:33
In reply to perversely caught between insomnia and fatigue, posted by zeugma on August 10, 2004, at 22:58:20
> I am currently trying Provigil in the hope of findng a way to keep my energy from getting depleted too easily without causing insomnia. I find that 100 mg causes me to crash in the mid-afternoon. My pdoc is reluctant to prescribe any more, because I reported a lot of insomnia when i started the med. The situation is perverse: I am ALWAYS fatigued, no matter how much sleep I get (the week I went off Strattera and was taking 100 mg nortriptyline I had the best sleep of my life, but still felt severely anergic) but also have great difficulty falling asleep. I seem to have narcolepsy in which the auxiliary symptoms (sleep paralysis, hypnagogic hallucinations) interrupt my sleep UNLESS I have something (nortriptyline, buspirone) that potently blocks REM in my system. By 4 pm it seems the REM suppressant effect of nortriptyline has worn off and when I try to take a nap I immediately go into REM and wake up in discomfort. Actually it's probably cataplexy because I still feel awake at the time I start dreaming, and have the REM atonia.
>
> Anyway, just babbling, i'm frustrated with how tired I always am but hate the insomnia too. Insomnia does not make me more tired, but does induce a nasty dysphoria. Tomorrow i'll try a little Ritalin and see if that helps my sleepiness without keeping me up all night.
>
>Hi Z,
In the list of AD's that I can get on the Australian PBS, Clomipramine is reserved for Cataplexy associated with narcolepsy, Obsessive-compulsive disorder & Phobic disorders in adults.
Might be the excuse you need to try Clomipramine. It would be fairly easy to switch between Clomip. & Nort.
Cheers,
Panda.
poster:Sad Panda
thread:376220
URL: http://www.dr-bob.org/babble/20040805/msgs/376259.html