Invest in ME Conference 12: First Class in Every Way
OverTheHills wraps up our series of articles on this year's 12th Invest in ME International Conference (IIMEC12) in London with some reflections on her experience as a patient attending the conference for the first time.
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Need help with stimulants

Discussion in 'General ME/CFS Discussion' started by redaxe, Jul 24, 2015.

  1. redaxe

    redaxe Senior Member

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    Sorry I know this is probably not the best title for a thread but I'm looking at getting back into some serious study and examinations soon. I've been fortunate enough that my CFS/ME condition appears to have stabilised somewhat so I've decided to take a gamble and do some studies.

    However the biggest problem I still face is daytime tiredness. At this point I'm looking for stimulants to take in the morning to get me through the day. I'd like to try Adderall but that is unavailable in Australia. I don't have the time to see a Psychiatrist to attempt to get Ritalin but I'll consider that anyway so what options do I have for over-the-counter stimulants.
    -I've considered caffeine pills.

    But I'm also thinking of
    -Nicotine gum (I'm a non-smoker)
    -clenbuterol (I'd have to order online -also unavailable in Australia)

    On the subject of Nicotine is it possible it can help with Orthostatic Intolerance. Wiki says that Nicotine is harmful to the heart because it constricts blood vessels forcing the heart to pump faster but with the autonomic dysfunction in CFS/ME isn't our problem that our blood vessels don't constrict enough - hence we don't get enough blood pumped to the brain so nicotine could possibly be helpful?

    Does anyone have any suggestions with this? I don't like the idea of taking heavy stimulants habitually but I really want to achieve more this year so I've decided it's worth the risk.
     
  2. redaxe

    redaxe Senior Member

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    Thanks anyway but I just got some help from someone private messaging so hopefully I'll have a solution.
     
  3. AaroninOregon

    AaroninOregon noob

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    Hippietown
    I haven't noticed any increase in OI issues when using nicotine.

    It is interesting that wiki says constricted blood vessels cause the heart to pump faster, as I have found that the opposite effect is true.

    If I take a cold shower my heart rate goes down to to blood vessel constriction and if I take a hot shower my heart rate goes very high.
     
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  4. redaxe

    redaxe Senior Member

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    I'm curious about this too. Remember though what wiki says assumes normal vascular function. I don't even pretend to understand the mechanism behind orthostatic intolerance but it sounds like we have the opposite problem - we may have lower blood volume or our blood vessels are not constricting effectively causing the blood to pool in the lower body.

    Another place wiki says https://en.wikipedia.org/wiki/Postural_orthostatic_tachycardia_syndrome
    If that fails, midodrine (or another vasoconstrictor, but excluding any that increase the heart rate) may be prescribed.[5] Midodrine works by narrowing the blood vessels, preventing blood pooling, and raising blood pressure.[5] If symptoms and tachycardia persist, a clinician may choose to add a cardioselective beta blocker such as bisoprolol, which preventsdilation of the blood vessels and tachycardia.[5]

    Midodrine sounds pretty similiar to what nicotine does
    Ironically some scientists are claiming nicotine is the best cognitive enhancer known. I'm not sure if that's an exaggeration - maybe the smokers who lurk on these forums can weigh in.

    “To my knowledge, nicotine is the most reliable cognitive enhancer that we currently have, bizarrely,” said Jennifer Rusted, professor of experimental psychology at Sussex University in Britain when we spoke. “The cognitive-enhancing effects of nicotine in a normal population are more robust than you get with any other agent. With Provigil, for instance, the evidence for cognitive benefits is nowhere near as strong as it is for nicotine.”

    http://www.scientificamerican.com/article/will-a-nicotine-patch-make-you-smarter-excerpt/
     
  5. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I think dr goldstein tried nicotine gum or patches with some cfs pts some good results. Might be worth a try
     
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  6. panckage

    panckage Senior Member

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    @redaxe I found a puff from an electronic cigarette works for 15min or so. The best (smoothest) stimulant I have found though is kratom but it looks like its been banned by some stupid clueless politicians in your country
     
    Last edited: Aug 27, 2015
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  7. digital dog

    digital dog Senior Member

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    Apparently there is a drug that you can take that mimics nicotine. Izabella Wentz talks about it in her thyroid book.
    Nicotine is good for the thyroid!
    A lot of smokers get thyroid problems when they come off.
    I hate cigarettes but it did cross my mind...
     
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  8. jess100

    jess100 Senior Member

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    I have had a lot of luck with Yerba Mate tea. Some days I actually feel great. I really like the Chocolatte' (expensive) but the roasted Mate is good too. I also occasionally drink about a 1/2 small bottle of Mountain Dew, and that really gets me thru the day but I have to do that really early or I can't sleep. I know it's not good for me, but really neither are the prescription drugs I take every day.
    I hope this helps
     
  9. barbc56

    barbc56 Senior Member

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    I take nuvigil and it really helps without making me hyper or crash as caffeine does.it works in a different part of the brain than other stimulants. I rarely get a crash.but I think that may be because of the fact I'm awake most of the day, so I seem to sleep better. It does help with energy but that's relative. I would say 75- 80% for six hours but certainly not close to being able to work or even being as productive.But it definitely helps my quality of life.

    I do have to say that there have been times I have taken Nuvigil when awakening and fallen back to sleep as long as eighty hour, so I just go with that as obviously I need the sleep.

    I like Nuvigil better than Provigil as Nuvigil is missing something that causes side effects.

    I would also not reccomend it for people with insomnia but then I have hypersomnia so don't really know about that.

    I don’t take it every day.

    Barb
     
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  10. redaxe

    redaxe Senior Member

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    Yeah I've actually started on modafinil/provigil. It definitely has made a massive difference to me. I can concentrate on things in the daytime to a level that I'm not sure I ever had even back in uni. Finally I feel like I'm actually able to get my brain to perform at a level that matches my level of education and intellect.
    When you able to spend 6 hours straight programming that's not my old self that's modafinil.

    I've heard of nuvigil but the impression i get is that it is a bit controversial.

    It might be better than provigil but since provigil recently came off patent a lot of people think nuvigil was just released to get a new patent drug that does the same thing so it can keep making revenue.

    If your insurance is willing to pay for nuvigil i'd definitely try it but otherwise I think the extra cost is not worth it for a drug that is so close to provigil.

    But yes dosage and frequency are difficult to determine. Some say take the minimum to get an effect and take days off to reduce tolerance to the drug. But others report that if you don't get tolerance and it always improves you then taking it every day is fine. The drug just becomes a part of you like a daily cup of coffee. These people (you can read about them on the bulletproof exec) want to survive on 4 hours of sleep a day to succeed in their entrepreneurial jobs and have a full family life.
    I think every person just has to evaluate how the drug works for them and then realistically decide what it is they want to get from it.
     
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  11. barbc56

    barbc56 Senior Member

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    @redaxe

    Out of curiosity, what is the controversy with nuvigil? I may have missed this.

    It is very hard to get approved for Provigil or Nuvigil.

    Barb
     
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  12. redaxe

    redaxe Senior Member

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    I don't think its a controversy in a negative sense it's more just a debate about whether nuvigil is better than provigil. Because provigil recently came off patent the drug manufacture foresaw the revenue loss so they went ahead to make what they claim is a more effective version of the drug by manufacturing it with only one chiral form.

    What I mean by chiral form is that complex molecules can take on different enantiomers. The easiest way to understand this is to look at your hands. They are both look identical right? But place one hand on top of the other hand and you'll see that they are different. Your 5 fingers in each hand are arranged in a differently despite being identical.

    Chirality is something that drug manufacturers must always be mindful off. Turns out that for drugs some chiral forms can be useless or even harmful even if the other form is beneficial. Both chiral forms must always be studied by drug companies. Now for provigil the drug is manufactured and sold with both chiral forms.
    Nuvigil on the otherhand just gives you the one chiral form, that is supposedly more active - the drug company claims it is more effective and it may well be.
    So chemically they are the exact same drugs but the level of effectiveness & the side-effects of the drugs may not be equal.

    However because nuvigil is patented it is much more expensive so the drug company will naturally encourage people to use nuvigil rather than generic provigil. So it's really up to the patient to decide what is best for them. It's a cost vs effectiveness debate really for people trying to work out what works best for them.
     
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  13. Stretched

    Stretched Senior Member

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    <<However the biggest problem I still face is daytime tiredness. At this point I'm looking for stimulants to take in the morning to get me through the day. I'd like to try Adderall but that is unavailable in Australia. I don't have the time to see a Psychiatrist to attempt to get Ritalin but I'll consider that anyway so what options do I have for over-the-counter stimulants...

    Does anyone have any suggestions with this? I don't like the idea of taking heavy stimulants habitually but I really want to achieve more this year so I've decided it's worth the risk.>>

    As a long time, low dose Adderall user in a 'Synergy Trial-like' supplement protocol (posted recently in the forums), I believe you're going to also be dealing with resolutions of anxiety and depression in your pursuit.

    In that regard, @'Hip' wrote a very comprehensive piece in that thread dealing with the efficacy of different supplements related to some of the likely implications of your search. I would venture an opinion she could answer your query and offer other considerations that lie between the lines, and offer specifics.

    You might want to review that 'supplements...don't work' thread, then call on her to see if she is willing and available to post a reply in this thread. (No doubt others, myself included would be interested in her thoughts as well.)
     
  14. digital dog

    digital dog Senior Member

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    T3
    T4
    Armour thyroid
    5HTP
    high dose B vitamins
    Vitamin D
    LDN
    Start VERY low and assess each one SLOWLY.
    Keep away from stimulants...maybe a cup of coffee or two. Do you really want a nasty dependency?
     
  15. redaxe

    redaxe Senior Member

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    Believe me I've tried a lot of those things you mention and the results are generally minimal to unnoticeable. They are also very expensive.
    Modafinil actually has a very low addictive risk after decades of use and is generally regarded as having lower risks than drugs like ritalin and adderall
    If it is a habit forming drug its only because it is so good at improving mental performance that long term users simply conclude that they would rather continue to function at their new level rather than go back to poor performance, sleeping 10 hours a day & feeling grumpy and crap all the time as they used to.
    What I've come to conclude is - life is short. I've already lost much of what should be the prime of my life and at least a quarter of million dollars in missed income and assets from losing a career due to being a cognitive vegetable that needs to sleep 12 hours a day.
    If a pill can get me back to a level that allows me to partake in the world where every other approach has repeatedly failed than that's what I'll do.
     
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  16. digital dog

    digital dog Senior Member

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    Sorry redaxe, didn't mean to cause offence.
     
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  17. A.B.

    A.B. Senior Member

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    I thought modafinil was for daytime drowsiness. Does it work well for mental fatigue as well?
     
  18. redaxe

    redaxe Senior Member

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    No worries. Sorry I wasn't intending to bark - In some ways I'm just pissed at myself that I didn't try this earlier. While I agree that it's good to make sure diet, nutrition and hormones are fine that still doesn't cover all neurological bases. For instance there are some brain hormones like orexins/hypocretins that medicine is currently unable to boost by nutrition, vitamins or hormone replacement therapy and in those cases stimulants & sleep enhancers are really the only option we have at the moment.
     
    Last edited: Aug 28, 2015
  19. redaxe

    redaxe Senior Member

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    Well this is tricky - I don't know if it's always easy to distinguish between the two. One thing though that I've noticed myself and I've seen many others on Phoenix Rising is complaining about daytime drowsiness and late night insomnia so i'd suggest at least some of us might benefit from modafinil
     
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  20. barbc56

    barbc56 Senior Member

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    Provigil/Nuvigil seems to help with my mental fatigue. Even though it works a bit differently compared with other stimulants, it's similar in that it can help with system overload. But this probably depends on the individual.

    Coincidentally, the last time I saw my psychiatrist for a med check we talked about how Nuvigil as well as Clonazepam (Klonopin) seem to help me with system overload. But because Nuvigil keeps you awake you would not want to take it at night.

    Barb
     
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