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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by AndrewB on June 10, 2000, at 15:53:19
Reboxetine and Adrafinil take approximately 2 weeks, sometimes longer to take effect. These drugs have been wonderful for many people, providing mental and physical arousal sometimes along with an antidepressant effect. However many people either don’t respond to the medicines or experience intolerable side effects.
Naphazoline is alpha agonist like adrafinil that comes in the form of eye drops. I believe Naph. offers a way to predict whether one will respond to reboxetine, adrafinil, and possibly other drugs that act mainly on the alpha 1 andrenergic receptor.
It acts in seconds to minutes. When it works, one’s tiredness, lack of mental clarity or mood should improve. Simply put a drop in each eye, as instructed below. Wait 10 minutes. If no effect is felt, add two more drops. To maintain the effect, you will have to apply more drops (when you begin to ‘drag’ again) as needed. This may be once a day for others it may be six times or more a day. For some the drops may be too strong. In this case simply dilute with normal sterile saline solution.
Naphazoline is an alpha agonist with a short onset of action and a short half life. Basically, its action is through the same receptors as reboxetine and adrafinil but the onset of the arousal effect is much more rapid. I take reboxetine and the arousal effect I experience from it is about the same as I feel when I take Naphazoline.
You can take Naphazoline on an ongoing basis though the label instructions advise against it. But in fact, some Chronic Fatigue Immune Disorder Syndrome (CFIDS) doctors have some of their patients taking these eye drops for years. I’m not recommending this. I’ve only been taking Naph. for 3 days and I can’t say yet if it is better or worse than the reboxetine I take. (My reboxetine, btw, has partially pooped out.) Naphazoline, certainly, gives a person more control over their degree of arousal; take a little more if you didn’t get much sleep, take less on evenings you want to cut down on sexual side effects.
Naphazoline can be purchased at the local drug store under a variety of tradenames such as Vasocon and Naphcon. A prescription is not required. They cost about $14 for 15mL in the US and about half that in Canada. Read the box before you buy. It should list as active ingredients Naphazoline Hydrochloride at an approximate strength of 0.01%. Naph. should contain no other active ingredients. Brands that have ‘A’s at the end of their trade names, such as VasoconA and NaphconA, contain an antihistamine also as an active ingredient. Do not buy these.
It is my guess that people will experience some (but not all) of the same side effects on Naph. as they would with adrafinil or reboxetine. For example, if Naph. gives one agitation, anxiety, or sexual side effects, there is a good chance reboxetine or adrafinil will do the same. I think reboxetine though can give a person side effects that you wouldn’t get with either Naph. or adrafinil.
Too much Naph. may cause headaches, anxiety, agitation, insomnia, sweating, rapid heart beat. Do not take it if you have high blood pressure or cardiac disease as the medicine will raise blood pressure and can induce arrythmias.
MORE NAPHAZOLINE INFORMATION: (source: Mayo Clinic Health Oasis at www.mayohealth.org/usp/html/202389.htm)
Medical Problems:
The presence of other medical problems may affect the use of ophthalmic naphazoline. Make sure you tell your doctor if you have any other medical problems, especially:Diabetes mellitus (sugar diabetes) or
Heart disease or
High blood pressure or
Overactive thyroid-Use of ophthalmic naphazoline may make the condition worseEye disease, infection, or injury-The symptoms of the condition may be confused with possible side effects of ophthalmic naphazoline
To use:
First, wash your hands. With the middle finger, apply pressure to the inside corner of the eye (and continue to apply pressure for 1 or 2 minutes after the medicine has been placed in the eye). Tilt the head back and with the index finger of the same hand, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close the eyes. Do not blink. Keep the eyes closed for 1 or 2 minutes to allow the medicine to be absorbed. To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.Side Effects of This Medicine:
With overuse or long-term use: Increase in eye irritationSymptoms of too much medicine being absorbed into the body: Dizziness; headache; increased sweating; nausea; nervousness; weakness
Symptoms of overdose: Decrease in body temperature; drowsiness; slow heartbeat; weakness (severe)
Posted by JohnL on June 10, 2000, at 19:37:12
In reply to For those interested in Reboxtine or Adrafinil, posted by AndrewB on June 10, 2000, at 15:53:19
Andrew,
That is so cool. How do you come up with this stuff anyway??? You never cease to amaze me.
Imagine that, curing depression with eyedrops. Too funny. What's even funnier is that it could actually work. I mean, everything makes sense. For $15? OTC? Eyedrops? Depression?
Too funny. Pretty cool. I think I'll call it a day while I've got this big grin on my face. :-)
JohnL
Posted by Dr. Dao on June 13, 2000, at 13:03:42
In reply to For those interested in Reboxtine or Adrafinil, posted by AndrewB on June 10, 2000, at 15:53:19
I've been interested in trying adrafanil since
reading about it here about 2 mos. ago. But
getting a scrip and ordering from abroad has
prevented it so far.These eye drops sound ideal!!
Is is OK to use this with an SSRI (Zoloft)??
Thanks.
Posted by JohnL on June 13, 2000, at 15:51:29
In reply to Re: For those interested in Reboxtine or Adrafinil, posted by Dr. Dao on June 13, 2000, at 13:03:42
> I've been interested in trying adrafanil since
> reading about it here about 2 mos. ago. But
> getting a scrip and ordering from abroad has
> prevented it so far.
>If you ever do decide to try Adrafinil, don't let the prescription get in the way. That's because one isn't required. All ya need is about $30. No prescrip.
Posted by Dr. Dao on June 13, 2000, at 16:59:53
In reply to Re: For those interested in Reb....Dr Dao, posted by JohnL on June 13, 2000, at 15:51:29
I looked at drugstore.com and costco.com and found 0.1% naph. as a Rx only product and in the the local chain drugstore found mostly the combination products (w/antihisamines)at 0.012%
and 0.03% some with methylcellulose lubricant, etc.Which product have you been using Andrew?
Posted by Zannah on June 13, 2000, at 19:51:28
In reply to Re: For those interested in Reb....Dr Dao, posted by JohnL on June 13, 2000, at 15:51:29
>
> If you ever do decide to try Adrafinil, don't let the prescription get in the way. That's because one isn't required. All ya need is about $30. No prescrip.John,
How is that possible? E-mail me or post please. Many thanks~
Zannah
Posted by AndrewB on June 14, 2000, at 0:32:55
In reply to Naph. Eye Drops, posted by Dr. Dao on June 13, 2000, at 16:59:53
> I looked at drugstore.com and costco.com and found 0.1% naph. as a Rx only product and in the the local chain drugstore found mostly the combination products (w/antihisamines)at 0.012%
> and 0.03% some with methylcellulose lubricant, etc.
>
> Which product have you been using Andrew?I've been using Vasocon (0.01% naph.) and Naphcon (0.012%). I'm surprised you didn't find anything on your local shelves. You might ask the pharmacist at the drugstore if they have anything with 0.01% naph as eye drops on the shelves. Or order it from global drugs (www.globaldrugs.com) of Canada.
Sometimes tolerance can develop to the drops. But if that happens , you will know already that adrafinil or a like drug can help you.
Give me feedback on how they work for you. Watch your heart rate, that is, take your pulse and don't let it exceed the low 90s at rest.
Posted by JohnL on June 14, 2000, at 4:56:00
In reply to Re: For those interested in Reb....Dr Dao, posted by Zannah on June 13, 2000, at 19:51:28
> >
> > If you ever do decide to try Adrafinil, don't let the prescription get in the way. That's because one isn't required. All ya need is about $30. No prescrip.
>
> John,
> How is that possible? E-mail me or post please. Many thanks~
> ZannahZannah,
I don't have the website address handy. But if you do a search on International Antiaging Systems, that's the place to order. If you do a search on Adrafinil, you might discover other sources too. But IAS is probably the most popular. They are a reputable source. Delivery time is usually about 4 weeks, but sometimes as soon as 2.
JohnL
Posted by CarolAnn on June 14, 2000, at 9:21:19
In reply to Re: Naph. Eye Drops, posted by AndrewB on June 14, 2000, at 0:32:55
Hey Andrew, I got the Naphcon (0.012%), and I can't really tell if it works or not. What exactly should I feel if it is working? I keep thinking I'm doing it wrong or something. Should it be a dramatically, noticeable effect? I would say that I might feel a little calmer when I use it, but that could just be from lying on the bed relaxed, while I apply the drops. Would you mind explaing exactly what you feel as the drops take effect? Thank you! CarolAnn
Posted by harry b. on June 14, 2000, at 11:02:59
In reply to Naph. Eye Drops, posted by Dr. Dao on June 13, 2000, at 16:59:53
> I looked at drugstore.com and costco.com and found 0.1% naph. as a Rx only product and in the the local chain drugstore found mostly the combination products (w/antihisamines)at 0.012%
> and 0.03% some with methylcellulose lubricant, etc.
>
> Which product have you been using Andrew?Doc-
I went on a search this morning, 4 pharmacies and
found only .025% with 'A'. I went back to the
pharmacy I usually use and asked the pharmacist
about it. He checked on it, said it is available
without a script and ordered it for me.
hb
Posted by AndrewB on June 14, 2000, at 12:14:23
In reply to Re: Naph. Eye Drops » AndrewB, posted by CarolAnn on June 14, 2000, at 9:21:19
>
> Hey Andrew, I got the Naphcon (0.012%), and I can't really tell if it works or not. What exactly should I feel if it is working? I keep thinking I'm doing it wrong or something. Should it be a dramatically, noticeable effect? I would say that I might feel a little calmer when I use it, but that could just be from lying on the bed relaxed, while I apply the drops. Would you mind explaing exactly what you feel as the drops take effect? Thank you! CarolAnnCarol Ann,
Make sure to follow the instruction in the opening post for applying the eye drops.
Not everyone who takes the eye drops will see much of an effect with them. I believe only those with alpha andrenergic system hypofunction will experience improvement when taking naphazoline. Those who don’t see an improvement are unlikely to benefit from taking drugs like reboxetine, Provigil, and adrafinil. But those who do improve after taking the eye drops will, if I am right, also improve (side effects aside) on Provigil, reboxetine or adrafinil. Here is the real value of naphazoline; it predicts whether you would benefit from a class of drugs. If it is able to do this, it will save a nonresponding person the ordeal of a failed drug trial and, on the other hand, point the responder in the direction of an effective medicine for them (or they may decide to continue using the naphazoline).
Those with a PROPERLY functioning alpha andrenergic system will experience:
+less redness in eyes
+increased BP
+possibly increased heart rate
+At higher doses possibly headache or restlessnessThose with a IMPROPERLY functioning alpha andrenergic system will experience:
+improved mental clarity
+less tiredness
+possibly less anxiety
+possibly improved mood
Posted by michael on June 14, 2000, at 13:43:08
In reply to Re: Naph. Eye Drops, Carol Ann, posted by AndrewB on June 14, 2000, at 12:14:23
Naphazoline - OTC 'Clear Eyes' brand has .012%
> Those with a IMPROPERLY functioning alpha andrenergic system will experience:
>
> +improved mental clarity
> +less tiredness
> +possibly less anxiety
> +possibly improved mood
Posted by S.D. on June 15, 2000, at 2:39:15
In reply to For those interested in Reboxtine or Adrafinil, posted by AndrewB on June 10, 2000, at 15:53:19
Only about four bucks for 15mL (0.5 fl. oz). What a deal, eh?
Has two other ingredients but these are only a lubricant and a preservative.S.D.
------------
> Naphazoline can be purchased at the local drug store under a variety of tradenames such as Vasocon and Naphcon. A prescription is not required. They cost about $14 for 15mL in the US and about half that in Canada. Read the box before you buy. It should list as active ingredients Naphazoline Hydrochloride at an approximate strength of 0.01%. Naph. should contain no other active ingredients. Brands that have ‘A’s at the end of their trade names, such as VasoconA and NaphconA, contain an antihistamine also as an active ingredient. Do not buy these.
>
Posted by Johnturner77 on June 20, 2000, at 11:12:25
In reply to Naphazoline - OTC 'Clear Eyes' brand has .012%, posted by michael on June 14, 2000, at 13:43:08
>
>
> I bought some at walmart for less that $3 US. It was .01 % I tried the eyes route and had it running all over my face, so I tried it in my nose. It is much less messy and works as a nasal decongestant too. It didn't have much mental effect on me. Just a little like having my upper eyelids impaled on toothpicks.There is nothing poisonous so why not just put a drop or two under your tongue?
Posted by Scott on June 24, 2000, at 3:34:58
In reply to For those interested in Reboxtine or Adrafinil, posted by AndrewB on June 10, 2000, at 15:53:19
It is my obligation as a curious individual to ask you, basically, How are you so sure that Naphazoline is such an accurate "predictor" of response to Adrafinil (and I must assume Modafinil as well) and Reboxetine? It sounds like purely theoretical speculation. Though you do qualify your statements with an occasional "I think that..." or "I believe...," it seems to have been posted as advice to be consumed at face value.
Apparently, more than a few of those intrigued by your "findings" have hit the shelves of local drugstores in search of the correct dosage of Naphazoline to conduct their own home tests, presumably allowing their results to influence decisions to try painstakingly and extensively researched drugs such as Reboxetine, Adrafinil, and Modafinil.
Paxil is no perfectly reliable predictor for the success of Prozac or Zoloft in a given individual. Nor is Ativan such a tool for determining a person's response to Xanax.
So it certainly seems farfetched and simplistic to use eyedrops designed to clear redness in the eye to predict success of high-tech meds in treating those suffering from idiopathic hypersomnia, narcolepsy, or (!) depression.
I don't intend to sound harsh. The notion is intriguing and could indeed be an idea heading in the right direction. I just feel that you should have posted your opinion as just that rather than reporting it, if you will, as a new finding.
Posted by margret on June 24, 2000, at 8:05:34
In reply to Question for Andrew B, posted by Scott on June 24, 2000, at 3:34:58
Although I have not read the whole thread about the use of these eyedrops I would like to sound some caution with them. I use them sometimes because of several allergies and have been warned by my ophtalmologist to do that only when I really feel it's necessary. When used regularly, they increase the inner pressure in the eyes and this can lead to glaucoma. I just looked at the info for the ones I am using. There is also a warning that there could be negative interactions with MAOIs, tricyclics, alpha and beta receptor blockers. The drops I am using (Austrian product) are containing
diphenhydramine hydrochloride 10.0 mg
naphazoline hydrochloride 5.0 mg
p-hydroxy benzoe acid methylester 6.7 mg
(tried to write these ingredients in English but am not sure if it's correct. Hope you can sort it out.)
Posted by AndrewB on June 24, 2000, at 10:00:22
In reply to Re: Question for Andrew B » Scott, posted by margret on June 24, 2000, at 8:05:34
Scott,
I think my post is quite clear that the use of Naphazoline, an alpha andrenergic agonist, as a diagnostic tool to determine if adrafinil or reboxetine will be effective is something that I have concluded rather than a standard accepted and proven practice. However, if you read literature concerning the treatment of CFIDS patients, it is clear that a variety of alpha 1 agonists/stimulators with short and longer onsets of action may be used with similar results to create arousal. This class of meds works for some but not for other with CFIDs patients. The same can be said for depressed patient with hypoarousal; some but not all will respond positively to alpha 1 agonists/stimulators. The problem with (at least some of) the short onset of action agonists like Naphazoline is that some, an probably most, people quickly develop a tolerance to its effects. The tolerance problem does not negate Naphazoline’s importance as a diagnostic tool. It is the first drug applied by Dr. Goldberg to his CFIDs patients as he tries to profile receptor dysfunction. So again I say, I believe that if you go down to the corner drugstore and get a bottle of Naphazoline eye drops (for getting the red out) and apply them as directed in my first post, you will get a pretty good idea whether you will respond positively to adrafinil or reboxetine.
Magret, the information insert in the box of Vasocon eyedrops, which has Naphazoline as the active ingrediant, include the warnigs that it shouldn't be used if you have glaucoma, high blood pressure or heart irregularites. If you could , Margret, could you let us know which of the warnings you listed apply specifically to Naphazoline.
AndrewB
Posted by margret on June 24, 2000, at 15:05:33
In reply to Re: Naphazoline Eyedrop as a diagnostic, posted by AndrewB on June 24, 2000, at 10:00:22
If you could , Margret, could you let us know which of the warnings you listed apply specifically to Naphazoline.
>
> AndrewBI'm sorry, Andrew, but this is nowhere mentioned in the info. But as I just read the complete information insert again now maybe I should mention that there is also an explicit warning of oral application of the eyedrops since there might be "serious side effects on the central nervous system as well as heart and blood circulation system". I am far from being an expert with these things, just someone trying to understand the effects all these things might have.
(BTW, just noticed the English translation of the ingredients on the outside of the package -- the last one I mentioned in my previous post is 6.7 mg Methyl p-hydroxybenzoate.)
Sorry I cannot be of more help.
Posted by SLS on June 29, 2000, at 8:21:03
In reply to Question for Andrew B, posted by Scott on June 24, 2000, at 3:34:58
Hi Scott, Andrew, and All Others
> > It is my obligation as a curious individual to ask you, basically, How are you so sure that Naphazoline is such an accurate "predictor" of response to Adrafinil (and I must assume Modafinil as well) and Reboxetine?
> I think my post is quite clear that the use of Naphazoline, an alpha andrenergic agonist, as a diagnostic tool to determine if adrafinil or reboxetine will be effective is something that I have concluded rather than a standard accepted and proven practice.
The idea of using naphazoline as a probe to help choose drugs for treating depression is intriguing. I have been looking at modafinil (Provigil) and some of its properties. I think it has been well established that Provigil is not a NE alpha-1 or alpha-2 agonist. I haven't been able to find any detailed information about adrafinil, as there aren't any applicable studies of its pharmacology appearing on Medline. If the same mistakes were made studying adrafinil as were made with modafinil, then it is probably not an alpha adrenergic agonist either. If response to naphazoline is a predictor of response to adrafinil or modafinil, it would not be because they share similar mechanisms of action with regard to NE alpha receptor stimulation.I think Scott's caveats are well taken. I can't wait to see if naphazoline challenges are valuable for treatment selection. However, it must be verified empirically. In the meantime, if one does not respond to naphazoline, I would recommend that they not exclude trying any drug based upon their non-response.
Has anyone responded well to an antidepressant that they chose based upon a positive response to naphazoline?If so...
1. What is your diagnosis?
2. What naphazoline preparation did you use?
3. How did you use it?
4. Can you descibe in detail how you responded to it?
5. What drugs were you taking at the time of the naphazoline test?
5. Which drugs did you choose based on your response to naphazoline, and how well did you respond to them.
6. What other drugs were you taking when you responded to the chosen drugs?
7. What drugs had you tried in the past, and how did you respond to them, positively and negatively?Thanks for any replies.
- Scott
This is the end of the thread.
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