2 replies to this topic

[3mp0w3r]

I am preparing for specialty exams.  Have had a few physical health problems recently (disc prolapse).  I spent last year working 70-80hrs a week and random night shifts which destroyed my sleep patterns.  Switched hospitals and working with better people now.  The bad year of shift work and dysfunctional staff burnt me out.  Age might also be a factor since I am approaching 40. I find I can't not hyperfocus like I used to.  In the past I could sit down and memorize material but now it is very tricky.   

 

These exams make med school look like a joke.  I need all the help I can get.

 

Considering the following combo:

 

aldafinil 

sunifiram 

cdp-choline

pyritinol

 

fish oil, ginseg, and creatinine will also be used.  

 

(Have occasionally used modafinil to combat fatigue.)

Tried piracetam ages ago and found I would get headaches with it.  Not sure if that had to do with the supplier.  (Starting a separate thread about advice for recommendations about this.)

 

So I am wondering what else to consider.  Half of my problem is getting myself to sit down and focus.  The other half is the focusing itself.  Despite the pending exams my motivation is low.  

I did 2 short overseas trips and have been hitting the gym regularly to get myself feeling better.  My head is slowly (too slowly) getting in the right space but the stakes are too high to wait for my current method.  

Any advice on supplements, drugs for motivation would be appreciated.   

 

 

[Ritchie]

Welcome To Longecity!

 

I have to ask, how is your diet, sleep and exercise regimen look like? A issue with any one of these regimens could be causing or significantly contributing to your issues.

Another thing I have to ask is that, is motivation, focus and alertness your only issue? Or do you also have issues with memory and other cognitive functions?

 

You could try precursor "loading". Like for example taking L-Tyrosine(Dopamine/Norepinephrine/Epinephrine precursor), and L-Tryptophan(Serotonin Precursor). I hear some people have great success with that specific stack for focus and depression.

 

Another supplement to look into is Sulbutiamine. It has been shown to improve memory and reduce fatigue. It even upregulates dopamine in the long term.

 

Have you had any experience with herbal supplements like Bacopa or Rhodiola. They seem to work well in some people but then have no effect on other people. 

 

Also, have you looked into the Racetams? You said Piracetam gave you a headache, but did you take a choline supplement with it? Some people get headaches when they take Piracetam without Choline.

 

I would reccomend you look into stronger racetams if Piracetam does nothing for you, Phenylpiracetam is the strongest however tolerance build up extremely fast.

I would like to mention though, that most of these nootropics will have mild/subtle effects. Most supplements with stronger effects are either damaging, addicting or you become extremely tolerant to them very quickly.

 

If I were you, I would take a regular nootrpic stack when you are reviewing, then take something stronger like Phenypiractam or modafinil during the actual exam.

 

Anyways, welcome to this Forum ! I hope you find what you are looking for.

[3mp0w3r]

Thanks Ritchie,

 

I would say that long term memory is an issue.  Part of it was sleep deprivation while I was studying early on.  I think doing shift work and 24hr on calls is incredibly unhealthy and has lasting effects on your mind and body.  That is part of the medical burnout.  The other part is being in your 30s or 40s and still studying and having medical debt while your friends are having families buying houses and having a life outside work.  Actually, I am out of debt now but the process is dragging on.  Getting close to the final sprint and feel like the glycogen stores are depleted and the other runners will pass me to the finish line.

 

I don't think the exercise is as big a contributor as the medical burnout.  However, I am going to decrease the intensity a little.  I am lifting heavy because I spent an entire year overworked and fatigued and lost too much strength/muscle.  When I say heavy, it is not that heavy, it just feels heavy lol.  I used to bench press up to 135kg but now don't even go above 80kg.  On a side note, I have had multiple low testosterone levels with blood tests.  Considering TRT but it is such a hassle.  Most doctors are completely clueless about testosterone.  I find it irritating.  They repeat what laypeople say after years of media programming.   I often have casual conversations with docs about TRT, chronic pain treatment, anti-aging,  the reversal of natural selection etc. When you ask the average dr about testosterone you realize they know very little. So as a result, being a doctor myself I am worried about having a stigma from requesting TRT.  It is kind of a similar idea with anti depressants.  Many doctors may feel depressed but wouldn't want anything on their medical records regarding such a script.  Since I have stopped doing the crazy hours on call, and started exercising, my impression is that the testosterone levels may be improving.  I will try to get this tested in the next few weeks to see if it is back into normal range.

 

My quality of sleep is an issue.  I know some nights that I wake up feeling great after only a few hours of sleep.

I am starting to take melatonin and might take 5HTP soon as well.  Will have to look into Sulbutiamine.

I actually looked into nootropics initially about 12 years ago.  I ordered piracetam from the UK.  Was studying for the MCATs at that time while working 50-60hrs a week in a software company.  I didn't take choline.  There wasn't that much knowledge back then as there is now.  At the time it was ineffective.  Haven't touched anything nootropic wise since.  

 

Sunifiram seems like an interesting option when I read the threads on this site.  I am worried about the headaches so thought trying something a little different from the other racetams might help.