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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 10 to 34 of 34. Go back in thread:
Posted by Janelle on March 17, 2002, at 22:45:39
In reply to Re: ISO: regarding the TSH level, more: » Janelle, posted by IsoM on March 17, 2002, at 17:04:36
Posted by IsoM on March 18, 2002, at 1:03:26
In reply to ISO: where R U getting the Adafranil from? (nm) » IsoM, posted by Janelle on March 17, 2002, at 22:45:39
Sorry, but there are strict policies about posting URLs or any other means of telling you where to get these meds from.
http://www.dr-bob.org/babble/faq.html#illegalBut I'll explain this much & hope it's okay with Dr. Bob. Doing a search on a good search engine like http://www.google.com for sources to buy on-line will give you a number of sites to order from. simply order from the one that you can get the cheapest meds from in the quickest time.
Posted by Charlotte on March 18, 2002, at 5:29:13
In reply to ISO: where R U getting the Adafranil from? (nm) » IsoM, posted by Janelle on March 17, 2002, at 22:45:39
Janelle if you live in the US, let us know if you decide to order adrafinil or modafinil and receive it successfully.
Customs can seize drugs coming into the country which haven't been approved by the FDA (adrafinil hasn't). And I understand that if you order modafinil which is approved here (but is much, much cheaper out of country), they'll seize that too unless you can show them a written prescription from a US doctor.
Charlotte
Posted by fachad on March 18, 2002, at 8:25:26
In reply to FACHAD: Doses and What is being treated » fachad, posted by Janelle on March 17, 2002, at 22:40:45
Short Answer:
It's probably some of both, but it's mostly the meds.
Practical Suggestion:
Could you take more Klonapin and eliminate Zyprexa or vice versa? The fewer meds in the mix, the less likely there will be problems both short and long term.
Long Answer:
I am not an expert - and even the experts don't really KNOW for sure, but I think it's probably mostly the meds.
I get the same thing - like driving away from the house and forgetting if I put the garage door down because I have *no memory* whatsoever of reaching for the control or pushing the button.
I think psych meds cause these types of problems in several ways. First, they somehow subtly interfere with short-term memory and recall.
They also cause apathy and a real tendency to "let things slide" (SSRIs are especially bad here).
They also reduce or quench the natural internal "alarms" of anxiety or depression that a non-medicated person would feel when they are letting things slide (anxiety) and when things have gone south (depression).
Those feelings that the drugs are reducing (anxiety, panic, depression) are all signals from our nervous systems that something in our life is wrong. We are taking meds because these signals are "too loud" and are causing problems in and of themselves. But it's very easy to overshoot and totally quench the signals.
So lets see, reduced memory, apathy, natural alarms disabled...at that point, you are operating at reduced functionality. A hazy, detached, fog is how you described it.
At some point, and it's different for everyone, the cure becomes worse than the disease it was meant to treat. The decison you have to make is whether or not it's worth it.
That's not a dilemma that has an easy solution, but it's the conclusion I've come to from being on various meds for about a decade. The way I've dealt with it is to try to find meds that casue as few problems as possible, and try for as few meds as possible at the lowest possible doses.
And I always try to weigh the cost vs. the benefit of being on any particular med.
> I take:
>
> EffexorXR 150 mg/day for depression
>
> Lamictal - just started so I'm titrating low and slow (due to the rash problem when you start at too high a dose) and this is for Cycling/BiPolar2
>
> Zyprexa - either 2.5mg or 5 mg/night for anxiety, racing thoughts, obsessiveness
>
> Klonopin - 1 mg/day for anxiety
>
> Now that I've answered your questions, what are your comments regarding my thread here. Thanks!
Posted by jay on March 18, 2002, at 14:05:53
In reply to Re: ISO: where R U getting the Adafranil from? » Janelle, posted by IsoM on March 18, 2002, at 1:03:26
> Sorry, but there are strict policies about posting URLs or any other means of telling you where to get these meds from.
> http://www.dr-bob.org/babble/faq.html#illegal
>
> But I'll explain this much & hope it's okay with Dr. Bob. Doing a search on a good search engine like http://www.google.com for sources to buy on-line will give you a number of sites to order from. simply order from the one that you can get the cheapest meds from in the quickest time.If you are, could you possibly chat with me via email, as I will post my email addy if possible.
Thanx!Jay
Posted by IsoM on March 18, 2002, at 14:24:13
In reply to IsoM: R U In Canada...Help!! » IsoM, posted by jay on March 18, 2002, at 14:05:53
Jay, I honestly would like to but this is Dr. Bob's web-site & we must remember to play by his rules. That even covers posting our e-mail addresses for the purpose of finding on-line meds. I didn't realise before that even that wasn't allowed, but it isn't & I have no wish to be blocked. I'm really a stickler for rules, especially if it's not my game.
If you live in Canada, let me tell you this much -
You're allowed to import medications into Canada through the mail for your own personal use. It's not stopped at customs or seized. It's easy to find on-line British companies selling various smart-brain meds & supplements & have them ship the order directly to your mail. Just use http://www.google.com to look for what you want.If, on the other hand, you live in the States & wish to order meds, I have no idea what the laws are. From what I've read, they're much, much tougher.
Posted by Janelle on March 18, 2002, at 14:56:47
In reply to Hazy and Detached from Meds or Depression? » Janelle, posted by fachad on March 18, 2002, at 8:25:26
Posted by JNefyn on March 19, 2002, at 21:52:10
In reply to Hazy and Detached from Meds or Depression? » Janelle, posted by fachad on March 18, 2002, at 8:25:26
I know exactly what you're talking about. I've been on Zoloft and Zyprexa for about a year.
Good news is that I don't feel depressed or anxious.Bad news is that I can barely pull myself out of bed in the morning, and will sleep for 12 hrs on the weekend, and then go back to bed for another couple of hours. I also feel fuzzy and have some problems with short term memory -- altho age may also be a factor ;-) I was beginning to wonder if I should go on a meds "vacation" and try to figure out what's me and what's the meds.
When I complained about this to the dr. last week, she prescribed Provigil. So far, it seems to be helping. Has anyone else had experience with Provigil??
Julie
Posted by IsoM on March 19, 2002, at 22:05:33
In reply to Re: Hazy and Detached from Meds or Depression? » fachad, posted by JNefyn on March 19, 2002, at 21:52:10
I take Olmifon (adrafinil) which is very similar to Provigil (modafinil). Any questions, or what?
Posted by JNefyn on March 19, 2002, at 22:13:12
In reply to Re: Experience with Provigil » JNefyn, posted by IsoM on March 19, 2002, at 22:05:33
> I take Olmifon (adrafinil) which is very similar to Provigil (modafinil). Any questions, or what?
I guess my main question is whether it works? (I know, everyone is different...)Are there are any problems? Also, does the effect last, or does it tend to fade out over time?
Thanks.
Julie
Posted by IsoM on March 19, 2002, at 22:41:36
In reply to Re: Experience with Provigil, posted by JNefyn on March 19, 2002, at 22:13:12
Adrafinil is supposed to be a milder stimulant than modafinil (Provigil) & I'd rather have Provigil but it's more expensive.
Yes, it does work for me, but I have narcolepsy & ADD too. It took a couple of weeks before it started working for me - I read that's how it normally does, but many other people have said it worked immediately for them.
You will probably find as many people think it useless or bothersome, as though that do like it. I think a lot depends on your particular problem, brain chemistry, & perhaps other medications being taken. I have encountered no problems whatsoever on it. It has benefited my mood, alertness, focus, & daytime sleepiness. It also makes me feel gentler & more sociable. I have noticed effects wore off after a couple of months but I think it wasn't the reaction of the drug as much as a body reaction of mine. Please read the following message link to understand what I'm referring to, which is why I'm increasing the dose. I did think my initial dose was small.
http://www.dr-bob.org/babble/20020313/msgs/97812.htmlIf you want to know more, I'll explain.
Posted by Zo on March 20, 2002, at 0:17:55
In reply to Re: Hazy and Detached from Meds or Depression? » fachad, posted by JNefyn on March 19, 2002, at 21:52:10
My god, I'm in awe that you ever get up, that combo would put me into a coma. I slept almost frighteningly well on Zyprexa. . .and Zoloft was like being permanently stoned. You wanna look at haze and detachment, look to the Zoloft. . . .
Posted by 3 Beer Effect on March 20, 2002, at 1:13:34
In reply to Re: Experience with Provigil, posted by JNefyn on March 19, 2002, at 22:13:12
Provigil works great in so called "naive" stimulant patients- those who have never taken Adderall, Ritalin, or Dexedrine.
200 mg is the standard starting dose. To me it feels like extended release caffeine with slight euphoria & much less anxiety. If it "poops out" you can move to 300 or 400 mg which is supposed to be much more effective but causes a greater increase in blood pressure & heartbeat & perhaps anxiety.
For me, I noticed 200 mg Provigil pooped out after 2 months, but I also take Lamictal & Klonopin, both of which could have contributed to the pooping out or may have counteracted its effects (I suspect the Lamictal did it).
If your insurance pays for Provigil (i know Cigna does) you might give it a shot for a few months (refills are allowed), but if they don't it is to expensive (about $5 US per pill) to justify buying it.
The ADD brand name stimulants are more effective but cause more anxiety- similar to the level of anxiety from Caffeine 200 mg. Dexedrine, Dextrostat, Adderall, Ritalin, Focalin range from about 34 cents per pill to $2.50 for Adderall XR, & some of these are available in generics which are even cheaper. But, these are all Schedule II meds & cannot be order through the mail/internet (that would land you in federal prison ala Johnny Cash), & a triplicate DEA prescription from your doctor with no refills allowed is required.
Posted by IsoM on March 20, 2002, at 1:51:56
In reply to Provigil works good if u never taken ADD stims, posted by 3 Beer Effect on March 20, 2002, at 1:13:34
Ah, dear 3 Beer Effect. I do disagree. It's a different affect, yes, & doesn't give one the 'kick in the pants' effect that the other pstims do but people do react differently.
Mind you, my trial on Ritalin was only one week - the doctor at that time figured if I made it through this many years without it, I didn't need it now. So why did he give me a week's worth to try? The ass.
I've also taken Dexedrine long-term. It gives an immediate boost, but I still like my adrafinil (or Provigil, if I could get it cheap). Maybe if I didn't have narcolepsy, it might be different. But with Dexedrine (& the short trial of Ritalin), each time the dose wore off & I'd need another dose for the day, the sleepiness would come over me in a rush. I hated the half-asleep, then awake, then half-asleep, then awake feeling I'd get through the day. I felt like a yo-yo. Now I can stay awake all day knowing that it won't wear off in a couple of hours.
So I'm at least one person who doesn't fit your profile of previous pstim users not liking Provigil.
Posted by JNefyn on March 20, 2002, at 18:26:49
In reply to Re: Hazy and Detached from Meds or Depression? » JNefyn, posted by Zo on March 20, 2002, at 0:17:55
LOL! I have a pretty high tolerance for anything sedative.Thanks, everyone, for your comments. I thought there was something seriously wrong with me.....
> My god, I'm in awe that you ever get up, that combo would put me into a coma. I slept almost frighteningly well on Zyprexa. . .and Zoloft was like being permanently stoned. You wanna look at haze and detachment, look to the Zoloft. . . .
Posted by GB on March 20, 2002, at 21:12:20
In reply to Re: Hazy and Detached from Meds or Depression? » Zo, posted by JNefyn on March 20, 2002, at 18:26:49
I tried provigil. It gave me a strong boost for a week, then a big crash. It was like taking amphetamine/speed.
Is that what provigil is ..... legal speed?
GB
Posted by 3 Beer Effect on March 20, 2002, at 22:03:31
In reply to Provigil-legal speed?, posted by GB on March 20, 2002, at 21:12:20
Provigil (modafinil) requires a prescription & is a schedule IV controlled substance in the US, so no its not legal speed.
Dexedrine & Adderall are pharmaceutical forms of "speed" but are tightly controlled schedule II prescription medications.
Desoxyn is the pharmaceutical form of methamphetmaine or "crank" and is also a schedule II- good luck getting a prescription for that one!
The only real form of "legal" otc "speed" is Caffeine
or the Ephedrine hcl found in Primatene Tablets.
Posted by Janelle on March 20, 2002, at 23:47:23
In reply to Provigil's not legal- is a schedule IV prescrip me, posted by 3 Beer Effect on March 20, 2002, at 22:03:31
Where do you find out this info on which meds belong in which schedules? I'm continually fascinated and impressed by the wealth of knowledge people who post here have!
Thanks.
Posted by Charlotte on March 21, 2002, at 6:39:49
In reply to How do you know what meds are what schedules? » 3 Beer Effect, posted by Janelle on March 20, 2002, at 23:47:23
here is the link for the FDA regulations "Authority to Control: Standards and Schedules" -- Title 21 Part B 13.812 (c):
http://www.fda.gov/opacom/laws/cntrlsub/cntlsbb.htmGo to section 812(c), there is a list in the regulations of what drugs fall under which schedule.
Charlotte
> Where do you find out this info on which meds belong in which schedules? I'm continually fascinated and impressed by the wealth of knowledge people who post here have!
>
> Thanks.
Posted by fachad on March 21, 2002, at 7:57:40
In reply to How do you know what meds are what schedules? » 3 Beer Effect, posted by Janelle on March 20, 2002, at 23:47:23
The easiest way is to look in a PDR. In the picture section, each drug is in a black square. In the upper left hand corner is a symbol.
OTC=over the counter
RX=prescription required
CIV=schedule 4
CIII=schedule 3
CII=schedule 2There is an appendix in the PDR that explains the definitions of each of the schedules, and the special regulations for each.
For example, regular RX can be phoned in and can be refilled for up to a year and you can put 11 refills on it.
Schedule 4 is can be phoned in but only good for six months and you can only put 5 refills on it.
Schedule 2 is only good for a month, it must be handwritten in ink, no phone in allowed, with the DR's DEA number, and no refills are allowed. You must hand carry the paper prescription to the pharmacy.
Schedule 1 is illegal drugs like heroin, LSD, pot, and cocaine.
My pdoc warned me against using the schedules as a measure of how dangerous or addictive a drug is. He said the DEA controlled schedule is a LEGAL NOT A MEDICAL classification, and that frequently drugs with higher numbers (less controlled) are more dangerous and addictive than drugs with lower (more controlled) status.
> Where do you find out this info on which meds belong in which schedules? I'm continually fascinated and impressed by the wealth of knowledge people who post here have!
>
> Thanks.
Posted by Zo on March 21, 2002, at 15:31:16
In reply to Provigil's not legal- is a schedule IV prescrip me, posted by 3 Beer Effect on March 20, 2002, at 22:03:31
3 Beer, your enthusiasm is great, but I often feel you overstate the case, I mean, making generalizations about a med based on your own experience.
Zo
Posted by 3 Beer Effect on March 22, 2002, at 0:50:53
In reply to How do you know what meds are what schedules? » 3 Beer Effect, posted by Janelle on March 20, 2002, at 23:47:23
I recommend the Prentice Hall Nurse's Drug Guide 2002 since it is only about $25-$30 I think at Barnes & Noble bookstores or Amazon.com & seems to be the best of the array of Drug guides for Nurses or even Doctors. It includes the DEA schedule, onset of action, duration of action, 1/2 life, side effects (both frequent & infrequent), contraindications, & everything else you'd probably ever want to know in one small handy book. It has all the medications the PDR has in it listed in easy to find alphabetical order by the drug's generic name.
The PDR (Physicians Drug Reference) is a big huge book that is like $80-$90 & is really a pain to look things up in, & can be somewhat confusing/hard to read, but lists every US FDA approved prescription drug out there. Probably not worth your time unless you are fascinated by psychopharmacology or are a doctor.
Posted by Dr. Bob on March 25, 2002, at 2:13:35
In reply to Re: IsoM: R U In Canada...Help!! » jay, posted by IsoM on March 18, 2002, at 14:24:13
> Jay, I honestly would like to but this is Dr. Bob's web-site & we must remember to play by his rules. That even covers posting our e-mail addresses for the purpose of finding on-line meds.
Thanks! :-)
Bob
Posted by IsoM on March 25, 2002, at 22:47:01
In reply to Re: medication without a prescription, posted by Dr. Bob on March 25, 2002, at 2:13:35
So Dr. Bob, since I played fair & behaved myself, do you think I could get a "Get Out of Blocked" free card like in Monopoly? Just once, it would be fun to let loose & surprise someone with this new, suddenly uncivil IsoM.
Posted by freon on October 23, 2003, at 15:49:51
In reply to Look in (PH) Nurse's Drug Guide or PDR, posted by 3 Beer Effect on March 22, 2002, at 0:50:53
How are medications assigned to DEA schedules? Are there public hearings or similar opportunities for comment? Or is the DEA allowed to make such decisions unilaterally? I am concerned about a useful drug like Provigil (modafinil) being assigned to a DEA schedule without any evidence that it has significant abuse potential. I have a prescription for Provigil, and the conspiracy theorist in me suspects that the government did this simply to prevent us from obtaining the medication at a much lower price from Canada (DEA scheduled drugs cannot be imported by consumers.)
This is the end of the thread.
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Dr. Bob is Robert Hsiung, MD,
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