8 replies to this topic

[donkey]

WOW! This got long......



Well hi. This is my first thread here, but I've been reading voraciously as I research nootropics and racetams in particular. I'm a 37 year old working mom who suffers from chronic depression with IMMENSE fatigue. I can't even describe to you the level of drowsy/foggy/sleepiness I feel every single day, except to say that I literally nod off at my desk, my eyes flutter and close with exhaustion and I sleep on my lunch hour just to get through the afternoon awake. In extreme situations I've gone to one of our private bathrooms and curled up on the floor for five minutes, hoping to relieve the tiredness with a cat nap.

The problem is that I was, for many years, an opiate painkiller addict. I had three herniated discs which my doctors threw pills at and said "let's keep an eye on it". Six years later, I had to check myself into detox because I was taking 200mgs of Vicodin and 75mcg of fentanyl EVERY DAY, and still weeping with pain. I had surgery to repair my back (thank god) and was put on Suboxone in May of 2008. For months I was ok. I took Suboxone and Effexor for depression. But I realized slowly that so much of my life was missing. I used to write every day. I've written two full unpublished novels, countless short stories. I used to throw pottery at a studio in Chicago. i used to paint, cook, bake, sew, scrapbook....and I wasn't doing anything. My life, once brimming with creativity, inspiration and fun, was just a robotic series of Sleep, Eat, Work, Sleep, Eat, Work. This story could go on forever but I'll truncate here to say that I took Provigil for a few months, then when it stopped working I took Nuvigil. Again, about three months in, it just stopped working completely. Now I take Suboxone, Effexor AND Wellbutrin. The worst part of my depression today is the knowledge that for a few months, back when I was taking Provigil, I was exactly who I used to be. My family, friends, my TWO year old recognized the change...I was happy...I was content. And then it stopped working.

Every day I have a headache. Sometimes all day, sometimes just the afternoon, sometimes for hours.

Every day I am exhausted, dragging myself to the train, to my office, to the train, back home.

Every day I am missing the full and wonderful life I used to enjoy. So I started researching Racetams (lead to them via research on eugeroics and dopaminergics). Like Provigil and Nuvigil, Priacetam and Choline sounded like a miracle. I ordered Piracetam and Alpha GPC and began taking it yesterday. I suppose it's keeping me awake, but I feel sort of sick to my stomach and I still have a terrible headache.


I guess what I'm asking is...is there any hope? Is this just my life now? My doctors tell me that I should just be happy I'm alive and off Vicodin, that everyone would like "an energy boost", that "not everyone is happy everyday". I've been written off.

Am I missing some supplement or is there a better stack? A better racetam? In about six months I'll be quitting Suboxone, but otherwise it looks like Effexor and Wellbutrin are permanent. I so wanted these racetams to work. What am I missing?

[Zoroaster]

Unfortunately I don't think the piracetam will do what you're hoping it will do. It's affect on alertness is pretty mild compared to something like provigil. If you are truly having immense fatigue while sleeping around 8 hrs per night then here's what I would suggest.

First make sure you've communicated this thoroughly to your doctor. Really let them know that your tiredness is debilitating and you are having to sleep on the bathroom floor during the day, etc. If you are just going in complaining of tiredness, your physician may not realize how severe your problem really is. You have to understand almost everyone complains to their doctor about tiredness, but tiredness like you've described is not normal and should be investigated. Be persistent if they don't understand. Since this is such a subjective symptom, a doctor will likely judge how severe the problem is by your level of distress about it.

Once they understand how severe the problem is, I'm sure they'll look into sleep problems, hormone issues, and the other conditions on the differential for tiredness. Then if there's a specific physiological cause it can be discovered and treated.

Of course it's likely that at least some of your tiredness (and maybe most of it) is simply due to your depression and is likely to remain until those issues are resolved or controlled. Until that time there are other things you can do.

First of course is to make sure you're sleeping well, second I'd say make sure you're exercising (you may feel too tired to go to the gym or run a few miles but even a daily walk around the block or an occasional game of tennis or something will help). Then make sure you're eating well, it's surprising how much a healthy diet can increase energy levels. It's also worth doing some research on supplements for chronic fatigue and experimenting there (while consulting your doctor). There are some supps like ALCAR, PLCAR, injected or sublingual B12, Rhodiola, and others that have actually shown to be beneficial for people with chronic fatigue in controlled tests. But once again, check with your doctor for interactions.

I think one of your answers could also be found in this statement, "My life, once brimming with creativity, inspiration and fun, was just a robotic series of Sleep, Eat, Work, Sleep, Eat, Work" I would ask, why is that? That seems like a problem you have some control over. If you used to spin pottery, write short stories, paint, etc and now you're living a robotic, sleep,eat,work lifestyle then I can see why you'd be depressed and tired. Note that I'm not trying to minimize your problems, but certainly withdrawing from activities that clearly meant a lot to you isn't going to help your situation. It may be that you've quit because you don't feel like you'd have enough energy to perform them. But like with exercise, many people with depression and chronic fatigue find that if they just take the leap and start participating in activities, their bodies find the energy to keep up. Not that you should just jump back into everything all at once, but slowly integrating more of these activities back into your life can only help, and you may find it's less draining than you fear.

On a related note I'm just a little bit worried about this statement, "Every day I am missing the full and wonderful life I used to enjoy. So I started researching Racetams..." Racetams will not give you your life back. No supplement or drug will give you your life back. If what you're missing is a full life with creative outlets and diverse activities then no substance will fill that hole. They will, at best, temporarily cover it up.

Assuming no other major condition is discovered by your doctors, I would definitely suggest finding a physician in your area who specializes in treating chronic fatigue patients. Often treatment for problems like this requires comprehensive lifestyle modification and cognitive/behavioral therapy. But they can be quite effective for motivated patients.

Anyway, I hope that was at least somewhat helpful. I know problems like this can be frustrating but you should maintain hope. Most people with chronic fatigue are cured eventually, with or without treatment.

[matthias7]

I've done this post before (not this exact post). Last one was worth while, the guy had problems and the shrink was slow. What you are asking is to cross check the shrink.

In brief:
Piracetam and choline will not help fatigue.

There is a newer version of Effexor out which is purer - less sides. Well worth checking. I forget its names and can't be hassled to find it out. Could reduce the fatigue, might not.

Wellbutrin - well know effect to cause a sudden crash, it certainly loses its effect. At a guess that is what is happening here. Thats because dopamine is just weird. In many countries it is not even classed as an AD and many shrinks stay clear of it. There are other routes "NRIs" mainly.

The thing I dunno is the synthetic opiate stuff, some of that stuff is very dangerous. There are ways to clear this which you've not mentioned and this needs drug approaches. There are a few ways forward.

Basically you are now taking a three AD augmentation. I have never heard of this: Really if thats how it is then there's nothing here we can do. You can't mess if thats your script because there is too much room for contraindication.

There are routes to clear the fatigue - don't get me wrong - both herbal and drug-related. There are loads of ways to do this in fact, stuff like adrenal fatigue and more "advanced" methods. I'd go through them except if a 3 augmented script isn't working ....

My opinion is that you are missing CBT, particulalry the bit about wanting 'a full life' ... that is exactly CBT to a tee. I think a few sessions of CBT would clear this up and you should lighten up on your reliance on pharmacology, i.e. a drug for every problem in life type approach.

I'll make this my last AD post. They can be (in theory of course) be powerful nootropics - which is what Wellbutrin is used for. On the whole IMO SSRI scripts are being used like the benzo scripts of the past.

Any shrink worth their salt who hears a patient wanting a 'meaningful life' would immediately refer them for CBT assessment.

Edited by matthias7, 21 November 2009 - 01:32 AM.

[LIB]

Do you feel cold often? Dry skin and hair?

Your post just really seems to me you have endocrine issues, and from what I gather, maybe hypothyroidism.

In my research I know I've came across something to do with narcotic drug use and hypothyroidism.

I take cytomel for my hypothyroid condition caused by mercury. Of course I'm not saying for certain this is your issue, but it just seems likely IMO.

Also, I think you need to find a new doctor. If you have that level of fatigue that you're talking about, and the Dr. gives you that sort of reply...I'd find a new one.

Here's a place to start.

http://www.functiona...es/patients.asp

Here's a page about hypothyroidism that can be very helpful. Like anything, there's some things I don't agree with, but it's a good place to start if you think lack of thyroid hormones sound like a possibility.

http://www.stopthethyroidmadness.com


Good luck, IMO, you have some medical issues that need to be dealt with first. Nootropics are just the icing on the cake.

Edited by LIB, 21 November 2009 - 02:21 AM.

[donkey]

LIB, my GP has often tested my thyroid because of my symptoms AND my dry skin...it's always come back normal. I've also had the gamut of blood draws: for blood sugar, cholesterol, liver function, a bunch of stuff I don't get.. ... My detox doctor and psychiatrist work together and I could never thank them enough for getting me back to "somewhat normal" after years of painkiller dependency, but it seems to me that their concern is simply "keep her off pain pills and keep her functioning". Quality of life is not high on their list of concerns. I've told both of them about my fatigue, in exactly the terms I used here, and I was told to "hang in there" and "stay the course". In fact, they disagree with each other as to what is causing the fatigue, so it's a zero sum game.

Anyway.

I think that perhaps my question was misinterpreted. I understand that my position in life is in my own hands...that the key to FULL recovery is within me, but it's as if I can't find the strength. I am seeing a therapist, and he seems to think that my problem is largely chemical in nature. It's just...I wasn't like this before. I feel like I've been given this second chance at life..the "happy ending" at the end of all those after school movies where I'm off the drugs and high on life. Except, I'm not. I don't experience 'highs'. I don't feel 'excitement' or 'passion' or 'giddiness'. I function, I work, I have fun with my daughter...but i just can't help but believe that my brain, my soul is meant to be doing more. A friend at work asked me a few weeks ago if I was doing ok. I said yes, just going through a rough patch. She said,

"You used to be so fun, full of joy. These last couple months...it's like you're fading away".

I've read about "adrenal fatigue". I've also read about how most doctors think it's bunk. I've read about 'endorphin deficient depression'. I've read about how narcotic opioid abuse leads to years of imbalance in the brain afterwards. This is what I'm trying to correct.

I know nootropics aren't a long term solution or a even a broad spectrum solution. I guess I'm just looking for a kickstart, or maybe a little burst of real happiness once in a while.

[LIB]

Do you fit any other the other symptoms of hypothyroid? Feel cold during the day? Look at the symptoms on the stopthethyroidmadness page. When I very toxic with mercury my lame Dr. finally agreed to test my thyroid. He was very annoyed I even asked because I'm a skinny guy, and usually you have weight issues if you're hypothyroid. but came back with the "normal" results. I also had SERIOUS fatigue and depression. I could barely, barely function. He just said oh hang in there, here's some antidepressants, see ya!

I did more research on my own. I realized my temps were not getting anywhere near 98.6. Your temp upon awakening should be 97.5 or above. Your afternoon temps should reach 98.6. My morning temps were 96. Afternoon, maybe 97.

I'm skinny because I also have high cortisol which breaks down my muscle. I take Phosphatidylserine for the high cortisol. Works great! I'm doing much better on straight t3 for thyroid hormone.

Also read on drlowe.com for more thyroid information.

Try http://www.thyroid-i...opdrs/index.htm for Endo's/Doctors that get good reviews with hormone issues.

Maybe thyroid/endocrine is your issue, maybe not. But, especially if you have insurance, I think more investigation into this area needs to be spent.

Hope that helps.

Edited by LIB, 21 November 2009 - 04:05 AM.

[matthias7]

I've read about "adrenal fatigue". I've also read about how most doctors think it's bunk. I've read about 'endorphin deficient depression'. I've read about how narcotic opioid abuse leads to years of imbalance in the brain afterwards. This is what I'm trying to correct.

No this is just the UK, who on the whole are stuck in the dark ages.

In the US there is widespread/growing acceptance. There are different regimes however and the weaker (in your case "safer") routes are not too effective.

Like anything however there can be "overkill". For example there is a point that an adrenal fatigue life style can be unnecessarily cumbersome, but to dismiss it is your call.

If you are seeing a therapist, okay. A top-flight adrenal fatigue program could be beneficial in this case. There is a slight problem regarding the use of pregnenalone and you would need to look into that carefully. A key part is addressing the consumption of carbohydrates vs. protein.

[matthias7]

Try http://www.thyroid-i...opdrs/index.htm for Endo's/Doctors that get good reviews with hormone issues.

Maybe thyroid/endocrine is your issue, maybe not. But, especially if you have insurance, I think more investigation into this area needs to be spent.

Great post. Thanks.

[matthias7]

A key part is addressing the consumption of carbohydrates vs. protein.

Just to add with a simple "adrenal fatigue diet" even if there is no difference a healthier diet can't hurt and in the long run mimimizes risk of diabetes that sort of thing. This is otherwise known as traditional food - meat and two veg that sort of thing.

My situation was much more benign however, using it to get through moderate/heavy caffeine usage (approx. 0.5g per day give or take a few cups of coffee).There are some great noots in that lot though

Understand your situation and appreciate that your practitioners arn't into quality of life issues. I think the number 1 approach here is to switch specific ADs because fatigue is a side effect. Apologies therein.

Plus in addition fatigue is a known side-effect of SSRIs for long term usage in notable proportion of patients. Of all the advice I've given this is probably the one that you should raise with your practitioners.

I honestly don't think this is a big issue to overcome. If you see it as a mountain, a mountain it will be, if you see it as a molehill, your half way to beating it.

Good luck.

Edited by matthias7, 21 November 2009 - 03:47 PM.