12 replies to this topic

[t234]

For the past year I've been having really bad fatigue and anxiety. The anxiety I have gotten relatively under control with Ativan. The fatigue seems to be a mystery, and none of the tests that doctors have done have found a cause. Anyways, the fatigue got so bad that I ended up just ordering modafinil online and taking that. It works great! The only problem is, I don't have enough money to keep buying it, and I would really prefer if I had a prescription. So I went to the doctors again and told her about the modafinil. She refused to presribe it because she had no experience with it, and it is counterindicated for anxiety. She refered me to a psychiatrist because she thinks all this is caused by ADD. I am sure he is going to prescribe me ritalin, and she also implied that there was a good chance he would. Would I be better off just continuing to order the Modafinil online? My concentration isn't great, but I think anyones concentration would be improved by ritalin.

[mentatpsi]

For the past year I've been having really bad fatigue and anxiety. The anxiety I have gotten relatively under control with Ativan. The fatigue seems to be a mystery, and none of the tests that doctors have done have found a cause. Anyways, the fatigue got so bad that I ended up just ordering modafinil online and taking that. It works great! The only problem is, I don't have enough money to keep buying it, and I would really prefer if I had a prescription. So I went to the doctors again and told her about the modafinil. She refused to presribe it because she had no experience with it, and it is counterindicated for anxiety. She refered me to a psychiatrist because she thinks all this is caused by ADD. I am sure he is going to prescribe me ritalin, and she also implied that there was a good chance he would. Would I be better off just continuing to order the Modafinil online? My concentration isn't great, but I think anyones concentration would be improved by ritalin.

A couple things
1.) What type of tests did they do: Psychological tests or Neurological
2.) Could you describe your fatigue more
3.) Modafinil, if prescribed for ADHD, typically is off label meaning it won't be covered by your insurance (which could mean it would be just as or more so expensive than the online vendor). The general procedure for ADHD is typically first placing on either Adderall, Ritalin, or Strattera, then if none work they might try to go through the insurance and make the modafinil under your prescription plan, I wanted to try the same thing but am hesitating so i can't speak from experience of having done so.

Another thing you should really look up is the side effects of Ativan/Lorazepam, there's possibility that it's part of the cause of your fatigue (though i'd imagine the fatigue started before administration):
http://en.wikipedia.org/wiki/Ativan

Still don't do anything regarding severe anxiety outside the consultation of your (is she a psychiatrist?), by which i mean don't get off anything based on this post :thumb: ... perhaps you'd have value over something else to reduce anxiety rather than something that works through GABA. Best regards.

[t234]

For the past year I've been having really bad fatigue and anxiety. The anxiety I have gotten relatively under control with Ativan. The fatigue seems to be a mystery, and none of the tests that doctors have done have found a cause. Anyways, the fatigue got so bad that I ended up just ordering modafinil online and taking that. It works great! The only problem is, I don't have enough money to keep buying it, and I would really prefer if I had a prescription. So I went to the doctors again and told her about the modafinil. She refused to presribe it because she had no experience with it, and it is counterindicated for anxiety. She refered me to a psychiatrist because she thinks all this is caused by ADD. I am sure he is going to prescribe me ritalin, and she also implied that there was a good chance he would. Would I be better off just continuing to order the Modafinil online? My concentration isn't great, but I think anyones concentration would be improved by ritalin.

A couple things
1.) What type of tests did they do: Psychological tests or Neurological
2.) Could you describe your fatigue more
3.) Modafinil, if prescribed for ADHD, typically is off label meaning it won't be covered by your insurance (which could mean it would be just as or more so expensive than the online vendor). The general procedure for ADHD is typically first placing on either Adderall, Ritalin, or Strattera, then if none work they might try to go through the insurance and make the modafinil under your prescription plan, I wanted to try the same thing but am hesitating so i can't speak from experience of having done so.

Another thing you should really look up is the side effects of Ativan/Lorazepam, there's possibility that it's part of the cause of your fatigue (though i'd imagine the fatigue started before administration):
http://en.wikipedia.org/wiki/Ativan

Still don't do anything regarding severe anxiety outside the consultation of your (is she a psychiatrist?), by which i mean don't get off anything based on this post :thumb: ... perhaps you'd have value over something else to reduce anxiety rather than something that works through GABA. Best regards.

1. I have taken blood tests, and they checked to see if the fatigue was caused by depression. I am scheduled for a sleep study currently. Beyond that, I'm not sure what else they will be able to do.

2. No matter how much sleep I get, I only have about five hours a day where I don't feel like going to bed. Even today, after a 15 hour sleep, I could have kept sleeping if I didn't force myself to get up. I used to work out everyday, and now I can only workout for 10 minutes before I start yawning and losing strength. The modafinil totally fixes this.

3. I don't think he will prescribe the modafinil, but if he did, my drug plan doesn't even look at what it is prescribed for, so that isn't a worry.

What I am wondering, is if he (psychiatrist) prescribes me ritalin, will I be better of with that than modafinil? The thing is, I really don't think I need it for ADD. My concentration is fine when I'm not anxious. However, he will most likely say I have ADD and prescribe it, depending on what I say to him. I will go along with it if the ritalin helps my fatigue. I just want to know if ritalin is something I should be avoiding when I could order modafinil online instead.

[mentatpsi]

I'm a bit biased against ritalin, i don't like the psychostimulants that much and if i had to choose i'd go with adderall. I've never tried modafinil before so i wouldn't be able to say anything positive or negative about it, but based on yours and others experiences it is neutral in my book, but still seems to be better than the psychostimulants though not as well researched (altering the region of the brain that controls sleep-wake cycles seems intuitively harmful to me, not with certainty however).

A couple things to look into tho

Rhodiola Rosea (Herb)
"The psychostimulant effects of R. rosea were studied in 53 healthy subjects and 412 patients with neuroses and asthenic syndromes (of both functional and organic origin).56-58 Symptoms ofasthenia (fatigue, decline in work capacity, trouble falling asleep, poor appetite, irritability, and headaches) responded favorably to R. rosea 50 mg three times a day. Treatment durations ranged from 10 days to 4 months. The asthenic states included both sychiatric and physical causes, for example, following influenza or other illness. In an open study of 128 patients aged 17–55 years, R. rosea alleviated fatigue, irritability, distractibility, headache, weakness and other vegetative symptoms in 64 percent of cases.'57 Improvement was assessed by psychological testing and work productivity." (http://www.rhodiolar...bGrams-2002.pdf, page 5)

Cognitive Behavioral Therapy
"Cognitive-behavioural treatments for CFS focus mainly on the factors that may be maintaining fatigue (discussed in more detail later in this article) rather than those that may have initially triggered it. CBT for this condition generally involves planned activity and rest, graded increases in activity, a sleep routine and cognitive restructuring of unhelpful beliefs and assumptions. Three of the four randomized controlled trials (RCTs) comparing CBT with a control condition found a positive effect of the treatment [1–3]. One of these studies found that some positive outcomes remained at 5-year follow-up [4]. The fourth RCT [5] and a controlled trial [6] did not find the overall beneficial effects of CBT, but the duration of the intervention in both the studies was much shorter than in the other three RCTs." (http://occmed.oxford...reprint/55/1/32, page 1)

Edited by mysticpsi, 09 December 2007 - 06:17 PM.

[stargazer]

ritalin combined with an SSRI should kick you back into full swing

[mentatpsi]

ritalin combined with an SSRI should kick you back into full swing

Yes ritalin is great for the now, but awful for the future, there are too many risks with the current "medical" methods of psychiatry when looking at ADHD, too many complications, too many uncertainty, and no longer a representation of a pure institution that cares about individuals but rather the money coming into their pockets, when matters get to that phase more research needs to be conducted by individuals to heal their own symptoms rather than relying on biased opinions. I wouldn't recommend ritalin or amphetamines (realize how most of the market as far as ADHD is filled with these solutions). Be it chronic fatigue or any other low brain activity like symptoms, one should always look for solutions that maintain overall health and not something that disrupts balance systems, there is no way individuals can account for what's being damaged and what's not, and no way you can take things that will keep the balance because too much is unknown. The reason they combine SSRIs in there is because most of the amphetamines cause stress, but they can really dull your senses and make you zombie like.


Regardless of which, try Rhodiola Rosea http://www.amazon.co...a...5075&sr=8-2

That one is only 10 dollars and a low dosage (100 mg). Do try it without Modafinil though considering it's an adaptogen as it might taint the effect of it. There's no risk in its usage, and the advatages that it contributes (better immune system, better focus and energy, better emotional control) outweigh the risks associated with ritalin. Plus if you don't like it you only wasted 10 dollars, compare that with the over 100 dollar price tag of modafinil.

Also look into Neurofeedback;
http://en.wikipedia....i/Neurofeedback

http://iospress.meta...ults,1:103177,1

It's been shown to be very effective in many various ailments.

Make your last resort ritalin or adderall, and be certain in every move you make, be content in those moves, and most importantly be patient .

Best of luck

Edited by mysticpsi, 12 December 2007 - 04:51 PM.

[dr_chaos]

Make your last resort ritalin or adderall, and be certain in every move you make, be content in those moves, and most importantly be patient .

Stimulants are no cure for tiredness. Rhodiola isn't either. Especially in an individual using ativan.

Yes ritalin is great for the now, but awful for the future, there are too many risks with the current "medical" methods of psychiatry when looking at ADHD, too many complications, too many uncertainty, and no longer a representation of a pure institution that cares about individuals but rather the money coming into their pockets, when matters get to that phase more research needs to be conducted by individuals to heal their own symptoms rather than relying on biased opinions.

So what is your conclusion on ADHD after conducting your own research?

[mentatpsi]

Stimulants are no cure for tiredness. Rhodiola isn't either. Especially in an individual using ativan.

Rhodiola rosea
"R. rosea L. (Crassulaceae) is a traditional medicinal plant in Eastern Europe and Asia, used as a CNS stimulant, antidepressant and antifatigue drug. Rhodiola rosea extract was evaluated for its effectiveness in mental fatigue in a group of healthy young physicians during their night duty (Darbinyan et al., 2000). The fatigue index was taken as the total mental performance during a 2 week study period. A significant improvement in these tests was observed in the treatment group. In a different randomized, double-blind, placebo-controlled study, a single dose of standardized Rhodiola rosea extract showed an antifatigue effect (Shevtsov et al., 2003)." http://www3.intersci...369670/PDFSTART (page 3 & 4)

Also anecdotal evidence shows improvement within chronic fatigue syndrome, though i agree with you when you say especially in an individual using ativan since it contributes heavily to the fatigue. I'm only giving some suggestions though, i cannot say anything with certainity. Regardless, your words have truth and wisdom so i wonder what you would suggest.

So what is your conclusion on ADHD after conducting your own research?

I've noticed for myself the best treatment is constant meditation (a couple hours a day, at minimum i shoot for 1, though i've neglected it recently), alongside gingko and ginseng, coffee, omega 3 fatty acids, and good eating habits. Positive thoughts and realism are always a plus since negativity only keeps you stagnant. I can say through all my meditation i have noticed a significant increase in mood, ability to regulate the body, increased ability to stay focused on a task, at best it dramatically reduced OCD, and have noticed decrease in these abilities only after supplementing with nootropics such as piracetam. I wouldn't say my experiments have been scientific, but my procedures are what keep me going in life.

Edited by mysticpsi, 12 December 2007 - 05:50 PM.

[dr_chaos]

Also anecdotal evidence shows improvement within chronic fatigue syndrome, though i agree with you when you say especially in an individual using ativan since it contributes heavily to the fatigue. I'm only giving some suggestions though, i cannot say anything with certainity. Regardless, your words have truth and wisdom so i wonder what you would suggest.

I'd suggest trying him to find out what causes his tiredness and avoiding any stimulant until there are absolutely no other options left. Else he'd risk harming himself by covering up a hidden medical condition.

I've noticed for myself the best treatment is constant meditation (a couple hours a day, at minimum i shoot for 1, though i've neglected it recently), alongside gingko and ginseng, coffee, omega 3 fatty acids, and good eating habits. Positive thoughts and realism are always a plus since negativity only keeps you stagnant. I can say through all my meditation i have noticed a significant increase in mood, ability to regulate the body, increased ability to stay focused on a task, at best it dramatically reduced OCD, and have noticed decrease in these abilities only after supplementing with nootropics such as piracetam. I wouldn't say my experiments have been scientific, but my procedures are what keep me going in life.

How much are you impaired? Have you tried working memory training, too?

[mentatpsi]

As far as t123, the mentality you're (dr_chaos) presenting is accurate, there is possibility that there are underlying medical issues, but the forum has no way of advising anything, the best thing as would be suggested based on this wisdom is to go to someone specializing in neurological evaluations. I see no problem with rhodiola though, but most likely it would taint any diagnostic so perhaps a later experimentation if it's found to be just the basic chronic fatigue syndrome with no underlying complications. t123 do you know of any practitioners in your area?

Regarding me, dr_chaos, and i will try to make this brief... I wasn't familiar with Working memory training till you made mention of it, but have been doing it myself by trying to learn music, making my own music and memorizing as much of it as possible without writing anything down. I have photographic memory so i try to implement this as much as possible to memorize moments and information so on and so forth and attempting to learn reading through minimizing sub vocalization stages. Aside from this, i have been going to neurofeedback, but it's been an on/off thing due to time constraints, will be doing it more often now and will be investing in a software that i've found useful. Thanks for the advice however, I will try to initiate more thorough working memory training now that i know it is effective alongside my current and planned. I wouldn't know how to rate my impairment level, since there are no grounds on which to rate that (one can turn impairments into strengths), I would say it's generally mild as i'm able to memorize large amounts of information though primarily short term... but i do well in school when the desire is there, so i'm not in a concern as far as that, only as far as progression and hoping rate of progression will increase with time and discipline.

Edited by mysticpsi, 13 December 2007 - 07:55 PM.

[Rags847]

Ever try Piracetam?
Stimulants didn't work well for me. I'm already motivated enough. Being able to concentrate on the reading material was my problem.
Piracetam's calming effects (theta waves, creativity) allows me to focus on the reading material and then later give sustained attention to my other thoughts. And Piracetam's enhancement of thought-production just furthered my desire to chew up the pages.
On 2.4mg of Piracetam and 250mg of CDP-CitiCholine, 2X/day, and have increased my reading 10 fold.
Modafinil, Oxiracetam, Aniracetam, etc. got my all hyped up, but didn't help with the focus and concentration.
Some relevant links:
http://www.healthboa...read.php?t=8071
http://brainmeta.com...p;mode=threaded
http://stocktonfp.co...ticles/ADHD.pdf

Edited by Rags847, 14 December 2007 - 09:50 AM.

[t234]

Hey guys - got an update.

The psychiatrist ended up prescribing me Zyprexa. It totally fixed my fatigue problems.

Now the problem is, I DO NOT want to be on Zyprexa. Pretty bad drug. It is interesting though that SSRI's did nothing for me, but Zyprexa had such a drastic effect. That leads me to think that, the anxiety is not serotonin related, and probably not dopamine related, because from what I've read, low dopamine levels aren't a major cause of anxiety. Another thing that Zyprexa affects is GABA.

I am seeing the Dr. soon, and I am going to propose investigating the GABA path. There is a drug out called Gabitril which inhibits the reuptake of GABA.

[unbreakable]

The psychiatrist ended up prescribing me Zyprexa. It totally fixed my fatigue problems.

That's kind of interesting, maybe the cause of your fatique is a schizoaffective disorder? Zyprexa isn't a stimulating drug, quite the opposite, but it helps with negative symptoms of psychosis.

It is interesting though that SSRI's did nothing for me, but Zyprexa had such a drastic effect. That leads me to think that, the anxiety is not serotonin related, and probably not dopamine related, because from what I've read, low dopamine levels aren't a major cause of anxiety.

Atypic antipsychotics like olanzapine work on dopamine and serotonin receptors (as antagonists).

I am seeing the Dr. soon, and I am going to propose investigating the GABA path. There is a drug out called Gabitril which inhibits the reuptake of GABA.

Look into Lyrica (pregabalin), I think it's a good drug for anxiety.

PS: What drugs are you currently taking (prescription/non-prescription)? Which dose?