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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by michael on September 26, 2000, at 18:54:26
This is pretty long... first the background...
I've reveiewed my med history, trying to figure out what has been most effective for me... and this is when what I’ve come up with:
I had tried prozac (20mg/day) for a month, but stopped when the prescription ran out due to side effects - essentially memory problems (and sleepiness). I would go into another room, and by the time I got there, had no idea what it was I had intended to do or get. I could be in the middle of a train of thought, and all of a sudden, have no idea where I had been going with that train of thought, or what the goal of that train of thought had been, what I was trying to figure out, etc. [Fortunately (as it turns out) I wasn't working at the time, so I could appreciate the humorous side of it, and laugh at how ridiculous these "side-effects" were.]
After a week of no meds at all, I tried amisulpride for a 7 to 10 days. I slept most of the time - I'd say from 16 to 20 hours a day. So I stopped the amisulpride.
A few days later, I received the adrafinil that I had orderd, and tried that. It seemed to work great - felt like I hadn't felt for years... didn't really 'feel' anything (eg: didn’t feel a ‘buz’), but not feeling run-down, etc., and just feeling 'normal' again, felt so good. Best I’ve felt in years.
After about 2 weeks, I got the 'cold from hell', and felt Miserable for 2 weeks. During that period, I also started wellbutrin (primarily for smoking cessation, for which it had been helpful in the past, but it had been of minimal ,if any, benefit psychologically).
Anway, once the cold had passed, I felt pretty good again, but not to the level I had initially, when I first started the adrafinil.
.....................
My thoughts were that perhaps the wellbutrin was interfering w/the adrafinil. Or that perhaps the first couple of weeks with adrafinil had been some kind of 'euphoric effect', which faded with time...Well, in the months since, I've had the opportunity to try the adrafinil alone (w/o the wellbutrin), as well as trying adrafinil 'again', after some wash-out periods w/no meds. The result being, the adrafinil is still helpful, but not to the extent it first was.
I've also tried adding amisulpride to the adrafinil... w/o much of a difference.
.....................
OK, finally, here's the part about which I'm interested in soliciting feedback... I’m wondering if it’s possible that the prozac may have been working w/the adrafinil – due to prozac’s long half-life – during those first couple of weeks? Or am I grasping at straws here? When I started the adrafinil, it had been 3 weeks since I stopped the prozac, which had only been 20mg/day.What first made me consider this idea, was a second trial of amisulpride this summer, with nothing at all like the sedative effect I encountered the first time I tried it. My thinking was that perhaps my initial response to the amisulpride (extreme sedation) was due to the prozac still in my system when I tried it...? And if so, then maybe my optimum response to the adrafinil was also related to the residual prozac?
So, I’m considering:
Try low (very) dose prozac again w/the adrafinil? Low enough to avoid the memory/sedative effects... How low? (10mg? 5mg?) How long of a trial would I need to try? (I would stop it if I encountered the negative side effects again) I would have to buy the prozac retail at the moment – I have one refill of 60*10mg left, but no insurance coverage at the moment...
Or one other option – I have nearly a month’s worth of 37.5mg/day venlafaxine xr left from a previous trial... trying that at 37.5mg/day w/the adrafinil? I have previously tried 75mg/day, up to 225mg/day. Main effects were slight anxiolytic effect, serious anorgasmia, mild sedation, and (can’t remember for certain, but I think - ironically) some difficulty w/mental focus.
Any thoughts on these two ideas? Or am I chasing ghosts here...? Is my residual prozac idea pushing it a bit...? Hope this long ramble is coherent... Thanks for any feedback.
Posted by Narelle Lehane on September 26, 2000, at 19:25:50
In reply to Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by michael on September 26, 2000, at 18:54:26
HI Michael,
I was on Prozac 20 mgs and had the same side effects, but they passed after a month. Perhaps you didn't give the drug long enough to settle down, I have done that with other ADs in the past, that is, come off them before they could even start to be effective becuase the initial side effects seemd too much. You really should talk to a doctor, perhaps try a different SSRI that has less side effects (I know people who have tried Prozac, got too sleepy, then tried Zoloft, for example, and not had any side effects at all. You could also think about taking your meds at night so the sedation effect is minimised during the day? I'm not an expert, suggest you work this out with a doctor. I think your local fa,mily doctor would have all the info you need - they do in Australia anytway, not sure about your system.
Narelle
Posted by michael on September 26, 2000, at 23:24:45
In reply to Re: Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by Narelle Lehane on September 26, 2000, at 19:25:50
Hi Narelle,
Thanks for the feedback. I know that side effects often pass after a number of weeks, but these were so extreme, and didn't seem to be lessening after 4 weeks, that I said forget it.
Were your side effects really that extreme? I mean I seriously became a complete fool... Like I said, I could laugh at it at the time, because I could afford to (not working), but there is no way I could've worked like that.
As for SSRI's, I may have made a hasty decision, but after my experience w/prozac, and my previous experience with effexor (similar, but less sedative & less thinking impairment-much), I decided to try other, non-serotonin focused meds... don't recall if I tried taking them in the evening, although, the much bigger problem for me was the "stupid-inducing" aspect (huge), rather than the sedative aspect...
Thanks for your thoughts - michael
> HI Michael,
> I was on Prozac 20 mgs and had the same side effects, but they passed after a month. Perhaps you didn't give the drug long enough to settle down, I have done that with other ADs in the past, that is, come off them before they could even start to be effective becuase the initial side effects seemd too much. You really should talk to a doctor, perhaps try a different SSRI that has less side effects (I know people who have tried Prozac, got too sleepy, then tried Zoloft, for example, and not had any side effects at all. You could also think about taking your meds at night so the sedation effect is minimised during the day? I'm not an expert, suggest you work this out with a doctor. I think your local fa,mily doctor would have all the info you need - they do in Australia anytway, not sure about your system.
> Narelle
Posted by AndrewB on September 28, 2000, at 10:06:01
In reply to Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by michael on September 26, 2000, at 18:54:26
Michael,
Is there any other serotonergic agent you can try that won't likely cause those side effects (St. John's Wort???)?
Posted by michael on September 28, 2000, at 13:25:53
In reply to Re: Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by AndrewB on September 28, 2000, at 10:06:01
Andrew -
Thanks for the idea. St. John's was the first 'med' that I tried - I think it was 300mg tid of the standardized type. Tried it for at least six weeks. Didn't notice any effects... Might be worth trying again w/the adrafinil, but given the long trial period required, I think I'm gonna try the low dose effexor xr (at 37.5mg/day) first, since I already have some.
Hoping that maybe I can get the mild anxiolytic effect I had previously, and the dreams were nice... And that the adrafinil will counter the negative sedative/cognitive effects... Overall, hoping it'll be similar to how the adrafinil alone felt, when I took it after the prozac trial... That was definitely the best I've felt in years - wish I knew for certain if the prozac was a factor or not...
Thanks again for the idea, I'll definitely add it to my current list of options. Maybe next, if this doesn't pan out... If you have any other thoughts, please let me know. michael
> Michael,
>
> Is there any other serotonergic agent you can try that won't likely cause those side effects (St. John's Wort???)?
Posted by JohnL on October 2, 2000, at 4:31:35
In reply to Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by michael on September 26, 2000, at 18:54:26
Michael!
I think you hit a bullseye! Way to go! Now THAT's what I call making sense of it all. I can tell you thought this out very carefully like a detective, and I think you've done a marvelous job.I think your reasoning makes perfect sense. Why? Because I experienced the same exact thing. My best response to Adrafinil, Amisulpride, or both together, came about 2 weeks after stopping longterm Prozac. I definitely agree with you there is some kind of good synergy between Adrafinil and/or Amisulpride AND low dose Prozac. I don't think it's your imagination. I think it's real.
That's why I am now taking small dose Prozac again. I empty the contents of a 20mg capsule into juice, stir it well, and drink 1/4 of it per day, saving the rest in the fridge for the next day. I can even skip a day if I want. Prozac, as you know,lingers a long time. I'm sure my 5mg dose of Prozac by itself is not a major factor, but when it is the platform for Adrafinil and/or Amisulpride (mostly Adrafinil) it is a HUGE factor. That's my experience anyway, and seems to be in complete agreement with yours.
Is it the same with Effexor? I don't know. I think it could be. I once tried them both together and it was great, though only for a couple days. Side effects, ya know. Effexor was just way too sedating for me and also caused serious anorgasmia at just 37.5mg. Prozac on the other hand actually boosts my libido and does not have serious anorgasmia (just enough to make lovemaking better, but not enough to make it laborious). Perfect.
Very interesting! Way to go! I just had to respond and let you know that you are not the only one that has noticed this phenomenon with Prozac and Adrafinil. It's my experience exactly.
John
Posted by michael on October 12, 2000, at 22:26:33
In reply to Re: Feedback/thoughts? Andrew/JohnL/Cam et al. (long), posted by JohnL on October 2, 2000, at 4:31:35
John,
Thanks very much for the feedback/insight. Are you saying that you are able to notice a difference w/this new regime, now that you've started w/the low dose prozac again?
I plan to try 5mg/day prozac w adrafinil - hoping to get back to where I was for those two weeks last spring... (20mg/day had horrendous effects on my memory...) Planning on starting next week - when the prozac arrives... Not have as much success w/effexor trial - but then again, I've been sick, so I may give it another shot down the road, but first I'm gonna try the prozac/adrafinil combo. Hoping I won't have any libido/ED issues with this combo... Keeping my fingers crossed, and trying not to get my hopes up to high... Thanks again, and let me know how things are working out (what's your regimine these days?) or if you have any other insights to share. michael
> Michael!
> I think you hit a bullseye! Way to go! Now THAT's what I call making sense of it all. I can tell you thought this out very carefully like a detective, and I think you've done a marvelous job.
>
> I think your reasoning makes perfect sense. Why? Because I experienced the same exact thing. My best response to Adrafinil, Amisulpride, or both together, came about 2 weeks after stopping longterm Prozac. I definitely agree with you there is some kind of good synergy between Adrafinil and/or Amisulpride AND low dose Prozac. I don't think it's your imagination. I think it's real.
>
> That's why I am now taking small dose Prozac again. I empty the contents of a 20mg capsule into juice, stir it well, and drink 1/4 of it per day, saving the rest in the fridge for the next day. I can even skip a day if I want. Prozac, as you know,lingers a long time. I'm sure my 5mg dose of Prozac by itself is not a major factor, but when it is the platform for Adrafinil and/or Amisulpride (mostly Adrafinil) it is a HUGE factor. That's my experience anyway, and seems to be in complete agreement with yours.
>
> Is it the same with Effexor? I don't know. I think it could be. I once tried them both together and it was great, though only for a couple days. Side effects, ya know. Effexor was just way too sedating for me and also caused serious anorgasmia at just 37.5mg. Prozac on the other hand actually boosts my libido and does not have serious anorgasmia (just enough to make lovemaking better, but not enough to make it laborious). Perfect.
>
> Very interesting! Way to go! I just had to respond and let you know that you are not the only one that has noticed this phenomenon with Prozac and Adrafinil. It's my experience exactly.
> John
Posted by JohnL on October 13, 2000, at 3:27:49
In reply to Re: Feedback/thoughts? » JohnL, posted by michael on October 12, 2000, at 22:26:33
Michael,
I've been taking 5mg Prozac along with my Adrafinil for about 2 weeks now. So far it's doing what I had hoped it would.
John
This is the end of the thread.
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