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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by leslieg on September 4, 2010, at 13:13:08
I have narcolepsy and adrenal exhaustion and have to take stimulants on a daily basis. (Currently, Vyvanse in the am followed by Dextroamphatamine in the afternoon). I cannot wake up, much less function, without them. I've got a lot of muscle tension and about once a week I need to take valium in the evening to try to address that. I also take either valium or ambien for sleeping. I am *not* happy with this dependence! Today, as sometimes happens, my muscle tension is sky-high and I've stretched for hours and had my husband work on my back and neck and still my arms are numb. I have, basically, 2 choices. 1) Take valium and give up on the day, being a parent, fixing dinner (we are gluten-free so no fast food or take-out is available), and hope that tomorrow is better. or 2) Take valium and also caffiene and dexi and see if I can salvage any part of the day.
(I also have bipolar II so am also on Tegretol).
Thanks,
Leslie
Posted by ed_uk2010 on September 4, 2010, at 13:57:15
In reply to amphetamines and valium at same time?, posted by leslieg on September 4, 2010, at 13:13:08
>have to take stimulants on a daily basis
>got a lot of muscle tension and about once a week I need to take valium in the evening to try to address that.Is the muscle tension caused by the stimulant, or something else? I suppose you could try a different type of stimulant such as Concerta.
Posted by Christ_empowered on September 4, 2010, at 16:49:44
In reply to Re: amphetamines and valium at same time?, posted by ed_uk2010 on September 4, 2010, at 13:57:15
using amphetamines and sedatives (barbiturates, low-dose antipsychotics, or tranquilizers) either in combo-pills like "Dexamyl" (dexedrine plus amytal, a barbiturate) or as separate prescriptions to be taken around the same time/day, used to be a pretty common practice. I'm just giving you a little history lesson so you can see that it's not necessarily a bad thing. I know it seems far from ideal, but I think its important to do what you need to do to keep going and functioning. My concern was that some of your problems might be stimulant-related--do you think that's the case? Have you considered a dosage reduction, or maybe a switch? Its kind of a long-shot, but they do still prescribe Desoxyn (methamphetamine) for narcolepsy. Its more potent that d-amphetamine, so you can get away with lower doses, which often means fewer side effects. The downside is that its expensive and rarely prescribed, and I think its dosed 3x daily, which kind of sucks.
Have you tried any supplements? I'm not a supplement guru or anything, but I have read on a number of orthomolecular psychiatry websites that niacinamide (the non-flushing form of B3) can help with anxiety and tension (acts kind of like a benzo, and makes benzos work better at lower doses) and may help relieve problems associated with amphetamine use. I personally take 6 grams daily, in 3 doses, to help with my bipolar disorder....its done wonders for my anxiety and my skin (oddly enough, high dose niacinamide can help rosacea. They also put it in wrinkle creams).
Anyway, I hope everything works out OK for you. Whatever you do, don't beat yourself up over taking meds you need to function; the last thing you need when you have to take meds is guilt over having to take meds.
Good luck.
Posted by Phillipa on September 4, 2010, at 17:16:15
In reply to used to be a commmon combo..., posted by Christ_empowered on September 4, 2010, at 16:49:44
Seriously did you doc test your adrenal function and diagnose as adrenal fatigue? If that is the case cure is rest, lack of stress and maybe low dose of prednisone for a limited amount of time. Phillipa
Posted by leslieg on September 4, 2010, at 17:42:20
In reply to Re: used to be a commmon combo..., posted by Phillipa on September 4, 2010, at 17:16:15
I have had my cortisol and DHEA-S tested via every-4-hour saliva 3 times in the past year. (Using the company Neurogistics). My DHEA is low at all time points; my cortisol varies but is not curving at all the way it should. My doc (as most western docs seem) doesn't believe there can be anything between a healthy adrenal and a dead one. I've shown my med doc and my p-doc my results. They just set them aside.
I am taking Targeted Amino Acid Therapy as recommended by Neurogistics. The amino acids have helped -- my bipolar is far more under control now, for example. But I fear it isn't working well enough to combat what the dexi is doing to me. I'd love to find a doctor who can monitor me and go beyond the AMA!
The supplements I take have a lot of magnesium, but not much naicin (in any form). I'm going to ask my Neurogistics practitioner about adding some.
I have 4 kids. A 22-yr-old who has bipolar and spends too much time in jail, a 19-year-old who is physically and mentally disabled. (Thankfully, she is living with her caregivers, but I am still her guardian, etc.), a 9-year-old with Aspergers who shows signs of failing after 2 weeks of 4th grade and a 5-year-old who we are testing for Bipolar, etc. as his behavior is bizzare and he is not potty trained yet (and more).
So, yes, you were saying about lack of stress? I hire help whenever / wherever we can afford it. But we have no family within 1000 miles ... lots of people look for ways to help me reduce my stress, and many times a day I have to make a choice between "me" or something else. I choose "me" as often as I possibly can.
I know the stress is what got me so bad off, and on days like today I know it -- combined with the meds I currently can't live without -- is killing me.
> Seriously did you doc test your adrenal function and diagnose as adrenal fatigue? If that is the case cure is rest, lack of stress and maybe low dose of prednisone for a limited amount of time. Phillipa
Posted by leslieg on September 4, 2010, at 18:36:01
In reply to Re: amphetamines and valium at same time?, posted by ed_uk2010 on September 4, 2010, at 13:57:15
I suspect the muscle tension is at least partly from the stimulant. I pooped out on Ritalin. Just last Sunday I tried a Nuvigil, but I felt horrible. Awake enough, but I think it *really* stressed my adrenals 'cause they had the job of keeping me moving.
> >have to take stimulants on a daily basis
> >got a lot of muscle tension and about once a week I need to take valium in the evening to try to address that.
>
> Is the muscle tension caused by the stimulant, or something else? I suppose you could try a different type of stimulant such as Concerta.
>
Posted by leslieg on September 4, 2010, at 19:00:35
In reply to used to be a commmon combo..., posted by Christ_empowered on September 4, 2010, at 16:49:44
Thanks so much for your input! It is very helpful.
I answered your question about supplements in another follow-up post.
I try to take the smallest dose of stimulant I need. I actually have Vyvanse in both 40 mg and 60 mg, but usually have to take the 60 mg. (Every few months 60 is too much and I become very irritable and 40 works for a week or more. Then I'm back to needing 60.) I also break the Dexi to get whatever dose I think I need.
For today, I realized I hadn't tried just taking advil, and that helped just enough to get me through.
Posted by emmanuel98 on September 4, 2010, at 19:19:59
In reply to Re: used to be a commmon combo... » Christ_empowered, posted by leslieg on September 4, 2010, at 19:00:35
I would guess your muscle tension is caused by chronic stress due to your difficult life circumstances. Myabe you need a break from your family now and again, so you can get a message, sit in a whirlpool, exercise. Is that possible, to get a caretaker or have your husband give you some time off?
Posted by leslieg on September 4, 2010, at 21:06:35
In reply to Re: used to be a commmon combo..., posted by emmanuel98 on September 4, 2010, at 19:19:59
I think I'd need at least a month off to have any serious healing. My husband is a good man, but when he is under stress he losses his short-term memory and he can't focus on the task-at-hand (like driving). (He has Aspergers).
But yes, I was re-reading what low DHEA-S does, and muscle degeneration is one of those things. So the muscle tension is probably caused by both the stress and the amphetamines.
I do try to go dancing once a week, but it is hard not to overdo it and end up in worse shape. Every day I start out thinking "I need to exercise today!" and I try to plan out when ... but if I find myself with any "free" time, resting always wins. Because if I don't rest, I won't be safe to drive.
> I would guess your muscle tension is caused by chronic stress due to your difficult life circumstances. Myabe you need a break from your family now and again, so you can get a message, sit in a whirlpool, exercise. Is that possible, to get a caretaker or have your husband give you some time off?
Posted by floatingbridge on September 8, 2010, at 13:41:10
In reply to Re: used to be a commmon combo..., posted by leslieg on September 4, 2010, at 21:06:35
Hi, you've got a full plate. Sorry there isn't time for rest.
Can you get a massage? If your healthcare covers it, try and get a prescription. Or maybe out of pocket once a month. It helps me.
Muscle relaxant? I am prescribed zanaflex at night. Some people take low doses throughout the day. I personally
do not recommend flexeril. Strong, but maybe for you at night alright. However, I felt drugged the next day.Xyrem. Isn't that for narcolepsy? Some
do very well.Don't blame yourself or the meds for muscle tension. Sounds like you're doing what you can.
Posted by Phillipa on September 8, 2010, at 20:23:25
In reply to Re: used to be a commmon combo... » leslieg, posted by floatingbridge on September 8, 2010, at 13:41:10
FB what do you know about soma as have a bottle here. Phillipa
Posted by floatingbridge on September 9, 2010, at 14:16:38
In reply to Re: used to be a commmon combo... » floatingbridge, posted by Phillipa on September 8, 2010, at 20:23:25
Hi Phillip, I'm not familiar with soma. Is it mucsle relaxant + pain reliever? For your back?
Posted by Phillipa on September 9, 2010, at 21:24:02
In reply to Re: used to be a commmon combo... » Phillipa, posted by floatingbridge on September 9, 2010, at 14:16:38
FB muscle relaxer old one for old me and old back. I tried a third first time and horrible nightmares. So no more and been so tired lately. You got energy? I need to borrow some. Love Phillipa
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