Posted by Astounder on October 31, 2007, at 11:48:50
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
> Hi gang,
>
> I take lots of sedating meds: Lexapro, Lithium, Abilify. My pdoc used to have me on Provigil to help w the daytime sleepiness. Unfortunately my new insurance won't cover it. I'm not totally heartbroken b/c it was only so-so. Any suggestions for alternative meds? I was on dexedrine for a while, but new pdoc seems a little hesitant to rx it. That seems like it might be a good option to me, but I'll have to work on pdoc. Ideas?!?! Anyone?!!?
>
> Best,
> EEYou could augment the Lexapro with protriptyline (Vivactil) a noradrenergic tricyclic that is supposed to be truly stimulating. Or you can switch out the Lexapro with an SNRI like Cymbalta or Effexor--you could do a fast cross-taper without having withdrawal issues.
You could also try augmenting with EMSAM, a stimulating MAO-B inhibitor patch that preferentially increases dopamine levels.
You can try switching the Abilify with Geodon; both of these are sometimes known to cause behavioral activation, though through different mechanisms.
Perhaps your best bet would be to switch Lithium with Lamictal which unlike other mood stabilizers can actually be stimulating and causes the least cognitive slowing.
There are also OTC stimulants available: Nicotine patches/gum, ephedrine, and caffeine, all of which have synergistic effects when taken together. They can also help control the weight gain and insulin tolerance some of the drugs you're taking are known for.
poster:Astounder
thread:791249
URL: http://www.dr-bob.org/babble/20071027/msgs/792520.html