Posted by bleauberry on June 6, 2008, at 18:22:31
In reply to Ritalin (methylphenidate) vs Dextroamphetamine, posted by Molybdenum on June 5, 2008, at 19:53:49
You might want to explore the various brain stimulants at "smart drug" mailorder websites, some of them you mentioned in your post. While they are usually taken for improving cognitive function and creativity, it is often noted they have stimulative properties that are synergistic with other ones like modafinil.
Treating fatigue with stimulants is usually a road to worsening of the underlying problem. Recently someone here was cured of a longtime illness with a combo that included prozac, modafinil, ritalin, and...the key to keep it all working...memantine. But those stories are very rare. More often than not you will hear stories of good effects at first, tolerance developing to where the drug doesn't do much anymore besides worsened side effects, and worsened psychiatric symptoms of depression, anxiety, or psychosis. Not always, but often enough to respectful of that path.
It might make some good sense to find an alternative or integrative MD who can test you for these specific things:
24 hour 4 sample saliva cortisol (to test for hypoadrenalism)
Thyroid free T3, free T4, total T4, and TSH.Low cortisol can be treated with licorice root and/or physciological replacement doses of hydrocortisone and/or adrenal cortex extract, or sometimes whole adrenal extract.
Thyroid is tricky. Someone can have hypothyroid symptoms and yet the doc says the lab numbers are within normal. Normal isn't good enough. Too broad. Too generalized. What is needed is what is optimal for you, and you only, and only a trial will identify what that is. Even top psychiatrists know that patients can respond to T3 or T4 even when there is no lab number justifying it, as seen in Dr Bob's Tips discussions between various doctors. Visit thyroid madness to learn more.
Basically I feel identifying the underlying cause and slowly treating it is a better longterm solution than using a short-term bandaid that is going to likely make the whole thing worse at some point.
Other things to look at:
Gluten intolerance. Easy to test for. Symptoms include profound fatigue.
If you have silver amalgam fillings in your teeth, you gotta get them out ASAP.
Diet: Heavy on proteins, light on carbs, heavy on raw veggies and fruits, very low on sugars, low caffeine. Takes a couple months to start seeing benefits, but they are longlasting.
Get a prescription for an antibiotic such as Doxycycline or Minocycline, start with 25mg a week, 50mg for a week, then 100mg for a couple weeks. If you have any number of mysterious hidden bacterial or micro-organism causes at the root of your problems, you should feel a lot worse as soon as you start treatment (means lot of hidden things are being killed), and you should feel a lot better in a few weeks.A lot of stuff I know. Focus on the big ones...thyroid, adrenal, antibiotics. A typical MD or psychiatrist probably won't be the one to help you get where you want to go. There are others MDs in the minority, usually integrative, who treat these things routinely.
If you want to stay within the confined world of psychiatry, then look to things such as prozac, duloxetine, desipramine, all of which can synergistically be stimulating in combo with modafinil.
poster:bleauberry
thread:833197
URL: http://www.dr-bob.org/babble/20080606/msgs/833344.html