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Idiopathic Hypersomnia & Cognitive Performance Regimen


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#1 EastofEden

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Posted 11 July 2011 - 05:33 PM


Diagnosed with idiopathic hypersomnia with long sleep time by a sleep specialist on the basis of history and polysomnography.

Issues trying to address:
- Daytime drowsiness; propensity to nap
- Sleep drunkeness on waking
- Sluggish thinking
- Poor memory (formerly, quite exceptional)
- Distractability, poor focus, low motivation
- Headaches
- Fatigue; muscle weakness


Regimen:

Morning:
- Dextroamphetamine (Dexedrine) (5-10 mg)
- Swanson's EFAs (300 mg EPA/200 mg DHA; from fish)
- Piracetam (800 mg - 1600 mg)
- Choline Bitartrate (500 mg)
- L-Tyrosine (500 mg)
- Huperzine A (50 mcg - cycled)
- Creatine Monohydrate (3 g for a month, then 1.5 g)
- Vit. B12 (1200 mcg;cyanocobalamin; low lab values)
- Inositol (650 mg)
- Vit. C with Rose Hips (1500 mg)
- Biotin (5 mg)
- Alpha Lipoic Acid (300 mg)
- Gingko Biloba (120 mg)
- Vit. B Complex (Doses all less than RDA)
- Green Tea Extract (400 mg)
- Vit. D3 (2000 IU)
- Taurine (500 mg)
- Milk Thistle (1000 mg)
- Calcium & Magnesium (333 mg; 167 mg)

At lunch:
- Dextroamphetamine (5-10 mg)
- Turmeric (700 mg)

Occasionally, as needed, during the day:
- Phosphatidyl Serine (500 mg)
- Modafinil (100 mg)

At night:
- Rhodiola Rosea (400 mg)
- Ashwaghanda (450 mg)
- Bacopa Monnieri (500 mg)
- Melatonin (3 mg; if needed due to taking Dexedrine/Moda late in day)
- Magnesium Malate (425 mg)






I would appreciate any comments on my regimen/stack. Specifically, I am looking to "cut the fat" and eliminate supplements
(i) that are contraindicated for fatigue/drowsiness
(ii)that have long-term negative side effects
(iii)that don't do anything.

I have talked to a pharmacist about the supplements I am on since I am taking amphetamines. According to her system, there are no conflicts or problems, but she warned me that not much research has been done on drug/supplement interactions, that there may be contaminations in my products and that the supplement industry is laxly regulated.

For myself I am risk-averse for supplements generally, but I have a moderate-high risk tolerance for supplements that may help with my drowsiness/excessive sleeping/cognitive impairment. I have only been on the Dextroamphetamine for two days now, but already it is working 100x better than the Modafinil. I was surprised that a CNS stimulant seems also to have improved the quality of my sleep - today I woke fairly refreshed, without assistance, at 8:00 AM, and was "with it" within a few minutes. For the past 6 months, I have been dealing with 12+ hours/night sleeping plus naps during the day, extreme sleep drunkeness and confusion upon awakening, wake time (assisted)- 12:00 PM - 2:00 PM, wake time (unassisted) - 2:00 PM - 3:30 PM.

My cognitive performance had also tanked recently. Graduated high school with >95% average while working 35 hours/week and doing very little studying. In courses for my Bachelor of Science, lowest mark has been an 88, most courses mid nineties, several 97s and 98s in a rigorous program (GPA = 3.99). Read War and Peace in 4 days. Excellent memory, especially for trivia, dates, names, etc. Picked up languages and new subjects easily. This sundry list is not to brag (I cringe to read what I have written), but merely to illustrate the profound changes I have experienced.

But oh how the mighty have fallen. This summer was *supposed* to be spent in dedicated, focused study for the MCAT. Instead, I sleep all the time and when I am not asleep I do not have the energy, willpower, motivation, or cognitive wherewithall to study. Things I used to love doing - reading, learning Spanish, playing trivial pursuit, having interesting debates with friends - are now too mentally taxing.

Sorry for the long spiel! Thanks so much to everyone who responds.

Edited by EastofEden, 11 July 2011 - 05:39 PM.


#2 niner

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Posted 11 July 2011 - 06:19 PM

I have only been on the Dextroamphetamine for two days now, but already it is working 100x better than the Modafinil. I was surprised that a CNS stimulant seems also to have improved the quality of my sleep - today I woke fairly refreshed, without assistance, at 8:00 AM, and was "with it" within a few minutes.

But oh how the mighty have fallen. This summer was *supposed* to be spent in dedicated, focused study for the MCAT. Instead, I sleep all the time and when I am not asleep I do not have the energy, willpower, motivation, or cognitive wherewithall to study. Things I used to love doing - reading, learning Spanish, playing trivial pursuit, having interesting debates with friends - are now too mentally taxing.

I've heard that stimulants improving sleep is indicative of an ADD condition. That's also consistent with things being mentally taxing. I don't know if late-onset ADD is an observed thing or not. These symptoms also sound like depression; does that seem like a possibility? I don't see any obvious red flags in your stack. Some people find that smaller doses of melatonin (500-1000 mcg) work better than larger doses.

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#3 EastofEden

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Posted 12 July 2011 - 03:33 AM

I've heard that stimulants improving sleep is indicative of an ADD condition. That's also consistent with things being mentally taxing. I don't know if late-onset ADD is an observed thing or not. These symptoms also sound like depression; does that seem like a possibility? I don't see any obvious red flags in your stack. Some people find that smaller doses of melatonin (500-1000 mcg) work better than larger doses.


I have some of the symptoms of ADD (distractability, daydreaming, continuous task-switching, not following though on projects), and have had them since childhood. But I always did well in school and teachers liked me and indulged some of my less admirable behaviours (handing assignments in late, skipping class, etc.)

I really don't think I am depressed. I must have filled out the screening questionnaire five times - each time I see a new doctor. The only depression-related symptoms are fatigue/sleepiness. Other than the sleep and related issues my life is going extremely well - I have supportive family and friends, good grades, am on track to get into medical school, engage in hobbies which I enjoy, have no money problems, and am reasonably good looking. Any thing that bothers me about my life I am doing things about, but I will still be okay if these things stay the same.

#4 niner

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Posted 12 July 2011 - 10:01 PM

I really don't think I am depressed. I must have filled out the screening questionnaire five times - each time I see a new doctor. The only depression-related symptoms are fatigue/sleepiness. Other than the sleep and related issues my life is going extremely well - I have supportive family and friends, good grades, am on track to get into medical school, engage in hobbies which I enjoy, have no money problems, and am reasonably good looking. Any thing that bothers me about my life I am doing things about, but I will still be okay if these things stay the same.

These are the things that made me think depression:

when I am not asleep I do not have the energy, willpower, motivation, or cognitive wherewithall to study. Things I used to love doing - reading, learning Spanish, playing trivial pursuit, having interesting debates with friends - are now too mentally taxing.

These aren't necessarily sleepiness-related, although they could be. Trying to get into med school is a stressful thing; what if in your heart of hearts you didn't really want to be a doctor, but were under pressure from your family to succeed? If I was in that situation, I would probably have the same symptoms you're having. I could be entirely on the wrong track here, so feel free to ignore my armchair analysis or clarify as you wish. I don't really want to pry or be annoying, but I probably am...

#5 EastofEden

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Posted 13 July 2011 - 02:30 PM


I really don't think I am depressed. I must have filled out the screening questionnaire five times - each time I see a new doctor. The only depression-related symptoms are fatigue/sleepiness. Other than the sleep and related issues my life is going extremely well - I have supportive family and friends, good grades, am on track to get into medical school, engage in hobbies which I enjoy, have no money problems, and am reasonably good looking. Any thing that bothers me about my life I am doing things about, but I will still be okay if these things stay the same.

These are the things that made me think depression:

when I am not asleep I do not have the energy, willpower, motivation, or cognitive wherewithall to study. Things I used to love doing - reading, learning Spanish, playing trivial pursuit, having interesting debates with friends - are now too mentally taxing.

These aren't necessarily sleepiness-related, although they could be. Trying to get into med school is a stressful thing; what if in your heart of hearts you didn't really want to be a doctor, but were under pressure from your family to succeed? If I was in that situation, I would probably have the same symptoms you're having. I could be entirely on the wrong track here, so feel free to ignore my armchair analysis or clarify as you wish. I don't really want to pry or be annoying, but I probably am...


I appreciate all the help and advice, so no worries about annoying me or prying!

I must be a rare breed, because I really and truly love the idea of practising medicine and would willingly do it for free. My parents think I am crazy for applying and actively discouraged me doing so at one point in time, so the pressure is only coming from myself.

And unlike most of my pre-med friends, I have very little anxiety about medical school. I have excellent grades and extracurriculars, and I have the ability to do well on the MCAT - if not on the first attempt, then next summer.

I have an extensive family history of both bipolar disorder and unipolar depression, so I am very familiar with the symptoms. I would have no problem admitting that I had a mental health problem, if I thought that was the case. It just doesn't have the stigma for me that it has for many other people because family members whom I love deal with these issues every day and I don't think any less of them for it.

Since being prescribed Dextroamphetamine, I have woken up on my own before 8 AM and have studied for more than an hour straight for the first time in over two months. Even if I never figure out what is wrong with me, I am happy having found a solution.

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#6 maxwatt

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Posted 14 July 2011 - 03:46 PM

You might try adding about 800 to 1000 mg of folate to your regimen in the form of 5-tetrahydrofolate. some 10% of the population suffers from an SNP (genetic polymorphism) which reduces the ability to metabolize folic acid, Supplementing the active form of the vitamin bypasses the need for enzymatic conversion that is inefficient for those with this genetic quirk. I found supplementing greatly helped my somewhat similar but less severe symptoms.




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