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#1 LauraL

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Posted 17 September 2012 - 11:43 AM

My doctor is considering switching me from Nuvigil (currently at 250mg once a day) to Adderall (starting at 10mg twice a day). I was diagnosed with either N or IH (I know... vague, huh?... I don't have cataplexy) about six months ago, and initially the Nuvigil worked wonders. Now I'm sleepy again, and having trouble staying awake. My doctor and I decided to switch my antidepressants first--I'd been taking Celexa for years, which does cause drowsiness--so she switched me to Cymbalta. That does seem to be helping, but after I titrate up on that, if I am still sleepy she wants me to try Adderall.

I'm a bit nervous. I've never taken a stimulant other than Nuvigil, and I understand the side effects for Adderall can be more significant. I have a hard time tolerating caffeine! I don't consume it at all now, but did try it during the period between when my EDS started and before I got a diagnosis--while waiting for the referrals and test results. Even small doses (we're talking half a can of diet coke) would make me incredibly jittery, and by the time they wore off, I'd be sleepier than before. I also discovered caffeine triggered migraines for me, and I abandoned my caffeine experiment after that. That whole experience makes me nervous to try Adderall, but maybe it shouldn't?

I'm just wondering what others' experiences on Adderall have been? Effective? Side effects? I hate the idea of taking something stronger, but I really want to be awake during the day!

#2 Hank

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Posted 17 September 2012 - 12:50 PM

Laura- I have been on Adderall XR 30 mg for just over a year and it has been an enormous help during the day. I do not feel jittery at all and have been caffeine free since taking it. I find the XR to be very even and predictable throughout the day. I have not tried the short release. Caffeine gives a jittery rush followed by a crash. Just know that 10 mg is a small dose- which may be enough or you may need to adjust upward. You will need a new written Rx each month, so you will need to communicate with your doctor's office several days before you run out. You will also need to plan ahead if you will be travelling, etc. I have been very happy with the benefits from this. I hope it will be helpful for you.

#3 tjunderw

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Posted 17 September 2012 - 01:24 PM

Hi Laura! I was diagnosed about 5 months sgo and started Nuvigil as well. After my free first month and realizing I couldn't afford Nuvigil monthly I asked my doctor to swith to Adderall. I took 20 mg in the morning and 10 mg early afternoon, and I really could tell a difference. It's a hard feeling to describe, but on Nuvigil I felt broadly awake. In my mind I knew I could lay down and take a nap, but I also knew that I didn't feel it was necessary. On the Adderall however, I felt almost drunk about 20-30 minutes after taking my morning dose which lasted maybe 10 minutes. I found myself much more impulsive, awake yes, but sometimes I would stop at work and see an email open, 2 reports half written and be cleaning something and wasn't sure why. There were only a few good days on Adderall, and after that I felt sluggish again and overall blah. For the other 26ish days of my month on Adderall I would often forget to take my afternoon pill while I was a work or plan forgetfulness, but it didn't matter because I personallly just didn't get the wakefulness from Adderall like others do and could take a pill at 9pm and be asleep by 10. My mind on Adderall was busy but I didn't have the energy to get things done and even though I wasn't feeling very alert during the day I still experienced a 'wearing off' period around dinner time which made me feel even more tired than I already did.

For someone who says they don't tolerate caffeine, I would take close notice of how you feel in your first days on Adderall. I used to never feel effects from caffeine when I was younger, but I find myself on Adderall not physically jittery but my heart races like crazy in the evening or next morning, though I only take it on a very infrequent as need basis (back on Nuvigil now), so the stimulant boost might not effect you when your body is used to taking it daily. I would also be aware of your appetite as many people taking stimulants report decreased hunger and weight loss. And with a change in eating habits can come digestive changes, so keeping yourself in check will help.

My best advice is to be your own advocate and don't wait for your doctor to ask how you're feeling before you to say something isn't working. Try the Adderall and see if the pro's outweigh the con's because everyone handles medicine differently. If you don't feel comfortable on the Adderall, ask about mg dosages, Vyvance or other stimulant options. If these aren't options or end up not working for you, ask your doctor about trying maybe a low dose of Nuvigil/Provigil plus afternoon Adderall or any combo that will benefit you. Personally Nuvigil works better for me but no matter what anyone says about a certain drug, you could have a totally different effect. I say try the Adderall and go from there! Good luck!

#4 Megssosleepy

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Posted 19 September 2012 - 01:36 PM

Hi Laura! I was diagnosed about 5 months sgo and started Nuvigil as well. After my free first month and realizing I couldn't afford Nuvigil monthly I asked my doctor to swith to Adderall. I took 20 mg in the morning and 10 mg early afternoon, and I really could tell a difference. It's a hard feeling to describe, but on Nuvigil I felt broadly awake. In my mind I knew I could lay down and take a nap, but I also knew that I didn't feel it was necessary. On the Adderall however, I felt almost drunk about 20-30 minutes after taking my morning dose which lasted maybe 10 minutes. I found myself much more impulsive, awake yes, but sometimes I would stop at work and see an email open, 2 reports half written and be cleaning something and wasn't sure why. There were only a few good days on Adderall, and after that I felt sluggish again and overall blah. For the other 26ish days of my month on Adderall I would often forget to take my afternoon pill while I was a work or plan forgetfulness, but it didn't matter because I personallly just didn't get the wakefulness from Adderall like others do and could take a pill at 9pm and be asleep by 10. My mind on Adderall was busy but I didn't have the energy to get things done and even though I wasn't feeling very alert during the day I still experienced a 'wearing off' period around dinner time which made me feel even more tired than I already did.

For someone who says they don't tolerate caffeine, I would take close notice of how you feel in your first days on Adderall. I used to never feel effects from caffeine when I was younger, but I find myself on Adderall not physically jittery but my heart races like crazy in the evening or next morning, though I only take it on a very infrequent as need basis (back on Nuvigil now), so the stimulant boost might not effect you when your body is used to taking it daily. I would also be aware of your appetite as many people taking stimulants report decreased hunger and weight loss. And with a change in eating habits can come digestive changes, so keeping yourself in check will help.

My best advice is to be your own advocate and don't wait for your doctor to ask how you're feeling before you to say something isn't working. Try the Adderall and see if the pro's outweigh the con's because everyone handles medicine differently. If you don't feel comfortable on the Adderall, ask about mg dosages, Vyvance or other stimulant options. If these aren't options or end up not working for you, ask your doctor about trying maybe a low dose of Nuvigil/Provigil plus afternoon Adderall or any combo that will benefit you. Personally Nuvigil works better for me but no matter what anyone says about a certain drug, you could have a totally different effect. I say try the Adderall and go from there! Good luck!


Thank you for this... Ive tried many many different "wake up" meds and I preferred Adderall so I went back to it. But, as I was reading your post I realized thats exactly how it effects me! I am "sort of" awake but not really, my brain is so scattered, I normally do have 3 opened half answered emails, and I forget to eat, impulsive (YES :wacko: ), and I also forget to take the 2nd or 3rd dose, not because I am awake but just so out of it. Thank you again... I am calling my sleep doc now! We need to try something else I think... not sure if there is anything else to try tho :mad:

#5 drago

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Posted 30 September 2012 - 03:24 AM

I'm just wondering what others' experiences on Adderall have been? Effective? Side effects? I hate the idea of taking something stronger, but I really want to be awake during the day!


When I was first diagnosed with narcolepsy, I was put originally on Provigil (nuvigil didn't exist yet!). It never really worked for me -- it NEVER woke me up in the mornings (NEVER) and it NEVER kept me fully alert -- I was awake, but I was fuzzy/fatigued/dragging all day.

I was switched to Adderall. For the first day, it went something like this:

--first dose
---HYPERACTIVE--SUPERduper aware/awake -- for about 30 minutes
---then I'd fall asleep! once
---then I'd be fine, but still a little weak

--second dose
---HYPERACTIVE--SUPERduper aware/awake -- for about 45 minutes
---then I'd fall asleep! once
---then I'd be fine, but still a little weak

It got better in a few days, and soon I stopped having hyperactive/falling asleep issues. I'd say in like a week.

It never gave me "the shakes" or anything like that. I've been taking it (25mg/day) for three years now. The one big side effect is loss of appetite. I haven't been hungry in three years -- if I don't eat I might get nausea or my stomach might hurt, but I don't feel hungry. It's a problem if you work in the theatre (which I did) and it's easy to get caught up in a busy day and need hunger to remind you to eat breakfast, lunch, and dinner.


drago

#6 Stephan

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Posted 10 October 2012 - 09:22 PM

My doctor is considering switching me from Nuvigil (currently at 250mg once a day) to Adderall (starting at 10mg twice a day). I was diagnosed with either N or IH (I know... vague, huh?... I don't have cataplexy) about six months ago, and initially the Nuvigil worked wonders. Now I'm sleepy again, and having trouble staying awake. My doctor and I decided to switch my antidepressants first--I'd been taking Celexa for years, which does cause drowsiness--so she switched me to Cymbalta. That does seem to be helping, but after I titrate up on that, if I am still sleepy she wants me to try Adderall.

I'm a bit nervous. I've never taken a stimulant other than Nuvigil, and I understand the side effects for Adderall can be more significant. I have a hard time tolerating caffeine! I don't consume it at all now, but did try it during the period between when my EDS started and before I got a diagnosis--while waiting for the referrals and test results. Even small doses (we're talking half a can of diet coke) would make me incredibly jittery, and by the time they wore off, I'd be sleepier than before. I also discovered caffeine triggered migraines for me, and I abandoned my caffeine experiment after that. That whole experience makes me nervous to try Adderall, but maybe it shouldn't?

I'm just wondering what others' experiences on Adderall have been? Effective? Side effects? I hate the idea of taking something stronger, but I really want to be awake during the day!


This is very interesting to me. My dx coincides with a major upping of my Celexa. I've suspected it, but can't find a single reference to drowsiness being a side-effect of Celexa. (In fact, I do see insomnia as a side-effect.) What are you basing the assessment that Celexa causes drowsiness on? I'm currently in the process of reducing from 40mg to 10mg... I'm at 25 right now. Because 10 worked for me. It's a long story about how I ended up at 40.

Anyone have experience with Escitalopram (Lexapro) causing less drowsiness? Now that it's a generic I could try it--and it's cheaper than Nuvigil/modafinil if that can reduce my need for those.

#7 LauraL

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Posted 11 October 2012 - 12:30 AM

This is very interesting to me. My dx coincides with a major upping of my Celexa. I've suspected it, but can't find a single reference to drowsiness being a side-effect of Celexa. (In fact, I do see insomnia as a side-effect.) What are you basing the assessment that Celexa causes drowsiness on? I'm currently in the process of reducing from 40mg to 10mg... I'm at 25 right now. Because 10 worked for me. It's a long story about how I ended up at 40.

Anyone have experience with Escitalopram (Lexapro) causing less drowsiness? Now that it's a generic I could try it--and it's cheaper than Nuvigil/modafinil if that can reduce my need for those.


Drowsiness is a common side effect of both celexa and lexapro: http://www.drugs.com...de-effects.html, http://www.drugs.com...e-effects.html. But insomnia can also be a side effect--I think it just depends on the individual and how he/she responds to the drug. I took lexapro first, for about three years. The drowsiness was apparent from the first dose, and improved but never entirely went away. I dealt with it by scheduling more time for sleep (9-10 hours per night, on average). It was annoying, but manageable. The drowsiness was essentially the same on celexa as lexapro for me. It was a couple more years before I developed the sleep issues I have now, so for me, it didn't seem likely that it was caused by the antidepressants, although they certainly weren't helping. Since your symptoms were coincident with a dose change, that seems like it would be worth looking into.

Happy to report the cymbalta is definitely helping the alertness situation, so no adderall for me yet. It's not off the table completely-I'm still not as alert as I'd like to be--but I'm happy enough with it to not want to make any other medication changes right now.

#8 Stephan

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Posted 11 October 2012 - 06:25 AM

Drowsiness is a common side effect of both celexa and lexapro: http://www.drugs.com...de-effects.html, http://www.drugs.com...e-effects.html. But insomnia can also be a side effect--I think it just depends on the individual and how he/she responds to the drug. I took lexapro first, for about three years. The drowsiness was apparent from the first dose, and improved but never entirely went away. I dealt with it by scheduling more time for sleep (9-10 hours per night, on average). It was annoying, but manageable. The drowsiness was essentially the same on celexa as lexapro for me. It was a couple more years before I developed the sleep issues I have now, so for me, it didn't seem likely that it was caused by the antidepressants, although they certainly weren't helping. Since your symptoms were coincident with a dose change, that seems like it would be worth looking into.

Happy to report the cymbalta is definitely helping the alertness situation, so no adderall for me yet. It's not off the table completely-I'm still not as alert as I'd like to be--but I'm happy enough with it to not want to make any other medication changes right now.


Thanks. Actually I have Sleep Apnea as well. But it was around the same time that I noticed, hey I'm still really tired. The thing is I'm pretty reluctant to change SSRI. I started out on Wellbutrin, for which the potential side effects gave me anxiety (I take them for anxiety--not depression.) Then I took Celexa and it worked really well. After a few years, I tapered off but anxiety came back a few months later. Then the doctor put me on Zoloft instead--and I got much worse anxiety as a side effect. I told him to put me back on Celexa b/c it worked so well--the anxiety only came back because I wasn't taking it. So he did. Back on the 10mg. However, like 4 months later the anxiety wasn't completely gone--so I went to a psychiatrist who said 10mg was way too low and she would keep upping it until the anxiet subsided. The thing is, I know that 10mg worked for me before; but she put me up to 40mg. So, now I'm going to experiment with tapering back down to the 10 and see where it leaves me. But if the drowsiness is the same for both Celexa and Lexapro, I guess I'll still with the Celexa--since it works well for me.

Thanks for your input.