![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Racer on February 27, 2006, at 14:04:16
Last week, my pdoc -- Dr MaybeGoodEnough -- prescribed Ritalin. I'd started Provigil again, just until I could see her, but Provigil isn't going to help long term, so we decided to see if a real stimulant would help.
Yes, so far, I think it has.
BUT, again, now I need a nap. It hits somewhere around four or five hours after taking it. And I mean I NEED a nap. My eyes start to close, whether I want them to or not, no matter what I'm doing. In fact, I literally fell asleep in my chair the first day, with a cat on my lap and a book open. This is part of the reason Provigil isn't the answer for me -- needing a nap. So far, no real crash on the Ritalin, which is a benefit over Provigil.
Now, Dr MaybeGoodEnough did start me at 2.5 mg, twice a day, so maybe it's just that the dose isn't nearly high enough yet. (Oh, nearly forgot, it's also making me want to eat everything in sight. I think I'm weird.) I'm supposed to raise it after the first week, but I think I may have to either raise it sooner, or give it up before then.
Other than a slight headache, which may have nothing to do with it, no bad effects so far. That's a good thing.
So, my question is, for anyone with experience with stimulants: is it likely that an increased dose will help with the closing eyes? Or maybe a longer acting version? (She said some people who do well on regular Ritalin don't do well on the long acting, so she starts everyone on the regular short acting.) Or a different stimulant? Any ideas?
Also, she lowered Wellbutrin, because she said that there was too high a risk of seizure taking both, and I wonder if she's being too cautious? Or is it that much of a risk? She plans to try me up to 5mg, twice a day, on the Ritalin, and has reduced Wellbutrin to 300mg from 450mg. So far, not bad, but I wonder if the 450 might be OK in case things start to go south?
Thanks!
Oh, yeah -- I know I'm weird. I usually can't drink coffee, because it upsets my stomach, but it will often put me to sleep if I do have some...
Posted by Phillipa on February 27, 2006, at 20:10:15
In reply to OK, so it Ritalin making me need a nap?, posted by Racer on February 27, 2006, at 14:04:16
Paracoxical reaction? I dunno. But I would like to know. Fondly, Phillipa
Posted by Maxime on February 27, 2006, at 20:26:19
In reply to OK, so it Ritalin making me need a nap?, posted by Racer on February 27, 2006, at 14:04:16
Hi Racer
Regular Ritalin only lasts about 4 hours. So maybe you need an extra dosage in there. You could also try the SR version.I'm glad you don't crash on it ... I sure did.
Maxime
> Last week, my pdoc -- Dr MaybeGoodEnough -- prescribed Ritalin. I'd started Provigil again, just until I could see her, but Provigil isn't going to help long term, so we decided to see if a real stimulant would help.
>
> Yes, so far, I think it has.
>
> BUT, again, now I need a nap. It hits somewhere around four or five hours after taking it. And I mean I NEED a nap. My eyes start to close, whether I want them to or not, no matter what I'm doing. In fact, I literally fell asleep in my chair the first day, with a cat on my lap and a book open. This is part of the reason Provigil isn't the answer for me -- needing a nap. So far, no real crash on the Ritalin, which is a benefit over Provigil.
>
> Now, Dr MaybeGoodEnough did start me at 2.5 mg, twice a day, so maybe it's just that the dose isn't nearly high enough yet. (Oh, nearly forgot, it's also making me want to eat everything in sight. I think I'm weird.) I'm supposed to raise it after the first week, but I think I may have to either raise it sooner, or give it up before then.
>
> Other than a slight headache, which may have nothing to do with it, no bad effects so far. That's a good thing.
>
> So, my question is, for anyone with experience with stimulants: is it likely that an increased dose will help with the closing eyes? Or maybe a longer acting version? (She said some people who do well on regular Ritalin don't do well on the long acting, so she starts everyone on the regular short acting.) Or a different stimulant? Any ideas?
>
> Also, she lowered Wellbutrin, because she said that there was too high a risk of seizure taking both, and I wonder if she's being too cautious? Or is it that much of a risk? She plans to try me up to 5mg, twice a day, on the Ritalin, and has reduced Wellbutrin to 300mg from 450mg. So far, not bad, but I wonder if the 450 might be OK in case things start to go south?
>
> Thanks!
>
> Oh, yeah -- I know I'm weird. I usually can't drink coffee, because it upsets my stomach, but it will often put me to sleep if I do have some...
Posted by mattw84 on February 27, 2006, at 21:29:14
In reply to Re: OK, so it Ritalin making me need a nap?, posted by Maxime on February 27, 2006, at 20:26:19
Yes, the "rebound" is likely what is causing the excessive drowsiness. I would try to get to a TID schedule if not QID.
It is wise to reduce the wellbutrin, the interaction could be very unpleasant. Keep the Ritalin dose low, if not I would not recommend taking the wellbutrin at the same time. Good luck.
Matt
Posted by alohashirt on February 27, 2006, at 22:26:20
In reply to OK, so it Ritalin making me need a nap?, posted by Racer on February 27, 2006, at 14:04:16
I get that too with ritalin, concerta, focalin, dexedrien ro adderall. There are a bunch of nutty side-effects that never seem to be clearly documented. I notice that for stimulants to work I need to eat regularly, have exercise and and get enough sleep. If I miss any I get sleepy. Stimulants + provigil can work
well together. Some people seem to find they need much higher doses of Provigil than the usual dose.> Last week, my pdoc -- Dr MaybeGoodEnough -- prescribed Ritalin. I'd started Provigil again, just until I could see her, but Provigil isn't going to help long term, so we decided to see if a real stimulant would help.
>
> Yes, so far, I think it has.
>
> BUT, again, now I need a nap. It hits somewhere around four or five hours after taking it. And I mean I NEED a nap. My eyes start to close, whether I want them to or not, no matter what I'm doing. In fact, I literally fell asleep in my chair the first day, with a cat on my lap and a book open. This is part of the reason Provigil isn't the answer for me -- needing a nap. So far, no real crash on the Ritalin, which is a benefit over Provigil.
>
> Now, Dr MaybeGoodEnough did start me at 2.5 mg, twice a day, so maybe it's just that the dose isn't nearly high enough yet. (Oh, nearly forgot, it's also making me want to eat everything in sight. I think I'm weird.) I'm supposed to raise it after the first week, but I think I may have to either raise it sooner, or give it up before then.
>
> Other than a slight headache, which may have nothing to do with it, no bad effects so far. That's a good thing.
>
> So, my question is, for anyone with experience with stimulants: is it likely that an increased dose will help with the closing eyes? Or maybe a longer acting version? (She said some people who do well on regular Ritalin don't do well on the long acting, so she starts everyone on the regular short acting.) Or a different stimulant? Any ideas?
>
> Also, she lowered Wellbutrin, because she said that there was too high a risk of seizure taking both, and I wonder if she's being too cautious? Or is it that much of a risk? She plans to try me up to 5mg, twice a day, on the Ritalin, and has reduced Wellbutrin to 300mg from 450mg. So far, not bad, but I wonder if the 450 might be OK in case things start to go south?
>
> Thanks!
>
> Oh, yeah -- I know I'm weird. I usually can't drink coffee, because it upsets my stomach, but it will often put me to sleep if I do have some...
Posted by blueberry on March 1, 2006, at 5:49:20
In reply to OK, so it Ritalin making me need a nap?, posted by Racer on February 27, 2006, at 14:04:16
I wonder if your adrenal glands are shot, or maybe thyroid sluggish? If the adrenal glands are near exhaustion, they can pump out some norepinephrine for a few hours being artificially stimulated, but then become completely depleted resulting in profound exhaustion. I think looking at more frequent dosing would be the first trick. But if the problems stayed the same or got worse, then I would be more tempted to think there is an actual physical thing going on rather than a brain thing. On the other hand, some people do actually get tired on stimulants. Maybe it's just never been looked at, since adrenal gland exhaustion is not a commonly looked at problem outside of naturopathy, but that would actually explain the paradoxical effect to stimulants.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.