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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by JohnL on August 31, 2001, at 18:29:54
I wanted to mention a few things about Adrafinil in other threads, but they would have detracted from the original topics, so I thought I would start a new thread here.
There are problems with all drugs, even aspirin, and Adrafinil is no exception. It shares common problems of other psychiatric drugs, such as possible anxiety, possible hypomania, possible worsening of depression, etc etc, things all the drugs share. But in addition, here are some other problems:
1. Because it is generically priced, there will never be good research to support it. Most of the research I have found was done on elderly dogs, rats, and senior citizens. Most of the research was aimed at memory enhancement and motivational stimulation. I can attest that it is excellent for both of those, but like I said, research is sorely lacking. That is a problem because a majority of people in the psychiatric world, whether they be patients or doctors, tend to rely too heavily on research and not enough on intuitive logic. People who need proof will undoubtedly sidestep a very good drug, simply because they prefer to go on someone else's research (usually flawed anyway). My own pdoc was personally involved in the pre-clinical trials of Serzone. Serzone looked great. Why in the world it didn't work out very well in his real world office setting is a mystery. Research proved almost useless. Nevertheless, a majority of people are deadset on having research, and in this aspect Adrafinil runs into problems.
2. Potential liver problems exist. In a year and a half of taking Adrafinil myself, and three blood/liver tests to monitor it, my tests have always come back perfectly normal. But the potential is there, so anyone taking Adrafinil should volunteer for a blood/liver test twice a year.
3. Just based on anecdotal observations of people here at this board who have tried Adrafinil, there is one big problem. That is, in most cases (not all), the people end up feeling so much better that they stop coming around! So we never hear from them again. I guess in a way that is good, but in a way it is bad because we don't get to continually see the great improvements Adrafinil has brought many people who otherwise suffered on so many other drugs.
Hope this is helpful.
John
Posted by Cindylou on September 1, 2001, at 7:24:07
In reply to Problems With Adrafinil, posted by JohnL on August 31, 2001, at 18:29:54
Hi John,
I have tried Adrafinil on three separate occasions, all for about two days each. The first time, I just took 300 mg. in the morning. The second time, I took half a pill twice during the day. And the third time, I just took half a pill in the morning.All three times, I felt really bad. The opposite of what Adrafinil is supposed to do -- I felt spacy, tired, out-of-it, heavy-headed, discombobulated (is that even a word?), etc. The time I took 300 mg. in the morning, I ran a red light with my 2 year old daughter in the back seat -- I've never done that before!
I kept thinking it couldn't be the Adrafinil causing this because I had heard so many good things about it. But three times with the same experience -- it has to be the Adraf.
I am taking Prozac -- 10 mg. I am taking Wellbutrin also (75 mg 2x a day) but tried the Adrafinil with and without the Wellbutrin.
I am very sensitive to medications, and have even thought of trying the Adrafinil again, with a quarter of a tablet twice a day! But for the most part, I have come to the conclusion that it does not sit well with me.
Any thoughts on this are greatly appreciated.
Thanks,
cindy
> I wanted to mention a few things about Adrafinil in other threads, but they would have detracted from the original topics, so I thought I would start a new thread here.
>
> There are problems with all drugs, even aspirin, and Adrafinil is no exception. It shares common problems of other psychiatric drugs, such as possible anxiety, possible hypomania, possible worsening of depression, etc etc, things all the drugs share. But in addition, here are some other problems:
>
> 1. Because it is generically priced, there will never be good research to support it. Most of the research I have found was done on elderly dogs, rats, and senior citizens. Most of the research was aimed at memory enhancement and motivational stimulation. I can attest that it is excellent for both of those, but like I said, research is sorely lacking. That is a problem because a majority of people in the psychiatric world, whether they be patients or doctors, tend to rely too heavily on research and not enough on intuitive logic. People who need proof will undoubtedly sidestep a very good drug, simply because they prefer to go on someone else's research (usually flawed anyway). My own pdoc was personally involved in the pre-clinical trials of Serzone. Serzone looked great. Why in the world it didn't work out very well in his real world office setting is a mystery. Research proved almost useless. Nevertheless, a majority of people are deadset on having research, and in this aspect Adrafinil runs into problems.
>
> 2. Potential liver problems exist. In a year and a half of taking Adrafinil myself, and three blood/liver tests to monitor it, my tests have always come back perfectly normal. But the potential is there, so anyone taking Adrafinil should volunteer for a blood/liver test twice a year.
>
> 3. Just based on anecdotal observations of people here at this board who have tried Adrafinil, there is one big problem. That is, in most cases (not all), the people end up feeling so much better that they stop coming around! So we never hear from them again. I guess in a way that is good, but in a way it is bad because we don't get to continually see the great improvements Adrafinil has brought many people who otherwise suffered on so many other drugs.
>
> Hope this is helpful.
> John
Posted by JohnL on September 1, 2001, at 9:15:14
In reply to Re: Problems With Adrafinil » JohnL, posted by Cindylou on September 1, 2001, at 7:24:07
Hi Cindy,
It always distresses me to hear when one of my favorite drugs doesn't work as well for someone else. You know the saying "mileage varies"? I hate that saying because it is so true.Your reaction to Adrafinil tells me that whatever your symptoms are, they probably do not have much to do with the noradrenergic chemistry. Or possibly your body just rejects the Adrafinil molecule for some genetic reason. Or perhaps as you said your body is extra sensitive.
I think giving it one more try at a tiny dose is probably worth a shot, but if it again goes bad I would forget it. Try cutting the pill into quarters. They don't have to be exact sizes. Maybe go with the smallest chunk. I would also do just one quarter a day, and not two.
It is my guess that other drugs could increase the amount of Adrafinil in your system. I think that is why I do fine with just one pill per day. I think the Prozac and Zyprexa in my system are increasing the concentration of Adrafinil. The typical Adrafinil dose is supposedly 2 to 4 pills a day, but just one is perfect for me.
It is hard to argue with results. In other words, if you try 1/4 pill per day and it makes you feel weird, then your body is trying to tell you it does not like this foreign substance Adrafinil for whatever reason. Adrafinil has helped a lot of people, but we do see a small population of people that do not tolerate it well.
John
Posted by adamie on September 1, 2001, at 15:06:43
In reply to Problems With Adrafinil, posted by JohnL on August 31, 2001, at 18:29:54
hi john. my adrafinil will be arriving soon. I was only able to get a 40 pill supply of 300mg. even if say 600mg day would be the effective dose for most people would I be able to see a very noticable positive effect with just 300mg a day? I want to try and be as long on it as possible. with 600mg a day I could only be on it 2 weeks. so I hope 300mg a day for 1 month will be enough for me to see a big effect.Right now I am not taking anything except 5htp 250mg a day. I dunno how the 5-htp is effecting me. would taking adrafinil with 5-htp cause any problems? but my main question is generally, chances are will I be able to see a noticable positive effect with just 300mg not being on any other meds? or should I try 600mg for the 2 weeks instead? if adrafinil has a positive effect my mom will buy more for me. so i'm hoping it will work well. it certainly looks to be a great med.
Posted by JohnL on September 1, 2001, at 16:22:59
In reply to Re: Problems With Adrafinil » JohnL, posted by adamie on September 1, 2001, at 15:06:43
Hi there Adamie,
When your Adrafinil arrives, I would and have approached it this way:With a knife, cut one pill in half. They don't have to be exact. If one half is a little smaller than the other, start with the small half. Take just that one half pill for the first day.
The second day do the other half. Then by day 3 you should be able to tell if you can go higher or not. If you are comfortable doing it, then go up to one whole pill a day. Stay there for about a week.
You can then decide to higher or stay there. For me, at that point, I decided to go higher. I went up to 2 a day, then 3, then 4. But I intuitively could tell those doses were too high for me, so I backed off. I eventually settled at just one pill a day, because that's where it felt the best for me. Of course, I am also taking other meds, so that kind of confuses it a bit.
You might feel some effect during day 1 through day 3. You might not. I did. Keep in mind that Adrafinil's benefits continue to improve over several weeks. Things to look for:
You are taking interest and motivation in something.
You are being more outgoing and more talkative.
You are feeling more creative.
You might feel like your memory is improving.
You notice the depression is fading.You should see at least a hint of these things happening by two weeks. But what dose you take will depend on how comfortable you are with any side effects that might occur. There is a rare chance you might actually feel worse instead of better. That can and does happen with any psychiatric drug. But hopefully this will go well for you.
If you are having bad experiences with Adrafinil during the first week or so, then you might just finish out the supply and see how it goes.
If on the other hand you feel a hint of something good during the first week, make sure to do all you can to convince your buyer that you want and need more for a full trial. If you feel neutral or somewhat better, get some more. If you feel worse, don't get more. A lousy situation would be if you are feeling improved but then your supply runs out. You want to be sure to have more onhand.
Each time I start a new medicine it is kind of like a journey into the unknown. You can read all about it, study it, think about, etc, but you never really know for sure what's going to happen until you actually swallow the pill and begin the journey. Then, let your intuition and your senses guide you. Your body will speak in many different ways to let you know whether it likes your medicine or it doesn't.
Hope this is helpful.
John>
> hi john. my adrafinil will be arriving soon. I was only able to get a 40 pill supply of 300mg. even if say 600mg day would be the effective dose for most people would I be able to see a very noticable positive effect with just 300mg a day? I want to try and be as long on it as possible. with 600mg a day I could only be on it 2 weeks. so I hope 300mg a day for 1 month will be enough for me to see a big effect.
>
> Right now I am not taking anything except 5htp 250mg a day. I dunno how the 5-htp is effecting me. would taking adrafinil with 5-htp cause any problems? but my main question is generally, chances are will I be able to see a noticable positive effect with just 300mg not being on any other meds? or should I try 600mg for the 2 weeks instead? if adrafinil has a positive effect my mom will buy more for me. so i'm hoping it will work well. it certainly looks to be a great med.
Posted by pellmell on September 2, 2001, at 0:20:14
In reply to Re: Adrafinil Adamie, posted by JohnL on September 1, 2001, at 16:22:59
Damn it, John, you are seriously tempting me to order some of this stuff. Two of my major problems are mild social phobia and lack of motivation. Effexor (XR, of course...I'm on my second week at 225mg) seems to have alleviated the anxiety and helped somewhat with the social phobia, but not as much as I'd like. Also, serotonergic meds in the past have, while making me feel better, sapped me of motivation. Effexor doesn't seem to be doing this so much, but still...a drug that would help me get through a 12+ credit semester without fatally neglecting 3/4 of my classes would be wonderful. Right now, after two years of failing at college and one year on a leave of absence, in spite of excellent grades and standardized test scores coming out of high school and an extremely successful semester right before my depression hit, I'm feeling quite demoralized. I feel like I still haven't recovered from that first seriously debilitating major depressive episode three years ago...not so much in terms of mood (medication helps that) but in terms of direction and motivation. Those nine months of undiagnosed major depression and especially the subsequent treatment were extremely disorienting. I've been reconstructing myself ever since. I have no clue what my "baseline" personality is anymore, with all of the antidepressants I've been on (and off). Peter Kramer's right: these drugs really *are* thymoleptics. I'm doing fine now, though, coasting along working 40 mindless hrs/week in the university computer labs and taking one class.
Anyway. I've gone on more than I expected to, but I suppose I'll leave my story there.
Heh...so...would you expect any problems taking Adrafinil with Effexor? I'm not sure I'll be doing this anytime soon, though; I'd prefer to run through what my pdoc here chooses to offer me before I reach across the ocean for treatment.
Well...thanks for reading.
-pm
Posted by Collette1 on November 23, 2001, at 10:50:11
In reply to Problems With Adrafinil, posted by JohnL on August 31, 2001, at 18:29:54
I am on my 3rd day of Adrafinil and I have a question that I haven't been able to find the answer to in all my searches......do you take this drug on an empty or full stomach? Since my pdoc is unaware of this medicine, I am relying on Psycho-babble for all my information. Thank you, Collette
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