Posted by AndrewB on May 5, 2000, at 2:26:06
In reply to Re: Wellbutrin/Parnate/Ritalin, posted by Jon Barnes on May 4, 2000, at 14:16:17
Jon,
Fatigue can have a lot of causes. Finding the cause and appropriate treatment may be time consuming. You have already run through the common first option medicines for dealing with fatigue. Now you may have to scratch a little deeper. After quite a bit of searching around, I found ways to remove my fatigue. I’ve read that nearly all fatigue conditions can be effectively dealt with, but it will require on your part the patient, persistent, and wise pursuit of clues and solutions related to your condition. Here are some suggestions to get you on your way:
1) The fact that your norepinephrine (NE) active meds (Parnate, Ritalin and Wellbutrin) worked at first but then made you feel more fatigued than ever may indicate an underlying ‘metabolic fatigue’.
One strategy that can work in these cases is to pulse dose the NE med. In other words take frequent drug holidays from the medicine. For example, take the medicine one day on followed by one day off, or take the medicine five days on and two days off. The on/off schedule will have to be tailored to your individual metabolism. Also you may do better using a relatively low dose of your NE med.
So what is a good medicine to use. Provigil may work well. The active ingredient in Provigil is modafinil. Modafinil will generally increase one’s physical and mental arousal without interfering with night time sleep. It has relatively few side effects. It is available in the US. It seems to work exclusively on the alpha 1 adrenergic receptor. It builds up into the body into steady state concentrations fairly quickly (2-4 days) and leaves the body fairly quickly too.
2) Dopamine D2 postsynaptic receptor stimulator medicines have been shown also to be effective for some in taking away fatigue, especially mental fatigue. These medicines have been used to treat fatigue where stimulants like ritalin have failed. Bromocriptine and amisulpride are two such medicines. Bromocriptine is available in the US. It is also available from overseas without a prescription. It is inexpensive. Amisulpride is only available from overseas. I use it myself and it helps immensely with my mental fatigue. It is also an AD that is generally side effect free in men and can be mixed with other antidepressants. For ordering information on amisulpride as well general information pertaining to its safety and efficacy, please email me.
3) Finally I would suggest you learn all you can about your condition. A place to start would be to learn about Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and Chronic Fatigue Syndrome (CFS). Regardless of whether or not you have either of these syndromes, you may be able to take away your fatigue by applying the strategies used to treat these conditions. I’m not sure, but I may have read that mono is sometimes seen at the onset of CFIDs. For more information on CFIDs go to www.cfids.com. For more information on CFS go to the excellent website www.beatcfsandfms.org. I suggest that you look at the section on increasing metabolic energy.
Best of luck,
AndrewB
poster:AndrewB
thread:32115
URL: http://www.dr-bob.org/babble/20000429/msgs/32364.html