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Nuvigil... And Xanax Too?

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#1 ApparentlyNarcoleptic

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Posted 08 July 2013 - 08:41 PM

So I found out around the end of April/early May that apparently I'm narcoleptic... which made lots of things I've been experiencing for the last decade+ make lots of sense!  My sleep dr put me on xyrem and we, so far, have me up to 3.75 twice nightly.  He also gave me Nuvigil 150mg tablets.  For one week I took a half (75mg) and it did absolutely nothing.  For most of the following week I took the whole pill and went completely (swear word) crazy, plus it worsened a breathing issue I had already been having (stress related).  As of my last appt on Friday he told me to try 3/4 of a nuvigil pill because he's hesitant to put me on traditional stimulants (I have MVP with gurg, a history of stress related health issues, and a history with anxiety - even though most of my drs don't listen to me).  For the last three days I've been taking it as one dose in the morning.  I must admit - I'm completely miserable and feeling quite crazy.  The trouble breathing has been back since yesterday (today being day 3).  I'm slightly manic, completely fogged, hallucinating more often while awake, one half of me is totally wired but unable to concentrate, and the other half of me wants to fall down wherever I may be and sleep.  My memory is shot and I can barely think straight.  As of tomorrow I plan to spread the dose out - 1/2 in the morning and the other 1/4 later on - and I'll give that a few days to see what happens.

 

On another note, I had a follow-up with a different doctor today and (insert glorious music) someone FINALLY listened to me!  I explained what's been going on with my sleep dr, the narcolepsy, the new meds, plus all of my health issues from the present and going back through my history.  He gave me a prescription for Xanax 0.25mg tablets and said I can take up to 4 whole pills per day (I can also cut them in half if I feel they're too strong), but to use them on an as needed basis.  This was on the provision that my sleep dr says it's ok to use this with the meds he's already got me on.

 

I was just wondering if anyone has had any similar experiences, has been on these meds together, or can lend any advice.  I would have cried on my drive home had it not been for my personal mantra of "There's no crying while driving."  I feel like my life has been spiraling down and then we threw narcolepsy on top of everything, and then things kept getting worse and I'm just falling apart.  I'm feeling very lost, lonely, and confused.  All I want to do is feel calm, well rested, and take a deep breath.  I don't think that's too much to ask in life! :-)



#2 Hank

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Posted 08 July 2013 - 09:17 PM

This is a potentially lethal combination. Make absolutely sure you do not take the Xanax and Xyrem. You are already having a breathing problem and both Xyrem and Xanax are respiratory depressants that enhance each other.

 

I will write more about Xanax, but want to post this first.



#3 Hank

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Posted 08 July 2013 - 09:40 PM

If you have trouble with anxiety, this may be a side effect of your medication. I had a similar reaction. You should discuss this with your sleep doctor. I you need to be on an anxiety medication, an SNRI, like Effexor could be a good option. It is an antidepressant that is used to treat Cataplexy also. It is also used to treat anxiety.

 

Xanax is a benzodiazepine. There are safer options for you. This really is a dangerous combination.



#4 Ferret

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Posted 08 July 2013 - 10:49 PM

https://online.epocr...ug Interactions

 

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#5 DeathRabbit

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Posted 09 July 2013 - 10:26 AM

You could take the Xanax earlier in the day, but I would not take it within 6 hours of sleeping, just to be safe. I am on Xanax myself (no Xyrem though), and I find it to be most effective if taken in the mornings anyway. So if you wake up feeling like it might be a bad day, I bet there's no real danger there. Xanax has a very quick onset and a very short half-life (11 hrs) . It is considered to be against best practice though. But so is alcohol usage on Xanax, so I think a lot of times those warnings are overly paranoid, as I've taken Xanax in the morning, then gotten brickfaced that night, and I haven't died yet. So I woudl check with the sleep doc before using the Xanax, just to get him on board if nothing else, so he doesn't potentially freak out on you later, and I would only take two before lunch.



#6 ApparentlyNarcoleptic

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Posted 10 July 2013 - 06:51 PM

Thanks everyone!  I was given the prescription late on Monday so I emailed my sleep dr when I got home to ask his permission to fill the rx as well as to let him know that 3 days on 3/4 150mg Nuvigil was NOT going well - planning to spread out taking 1/2 in the morning & 1/4 later in the day starting the following day.  Tuesday afternoon I hadn't heard back so I called and the receptionist said they would make sure he answered me the same day.  He did finally get back to me and said it was ok, but to take it 4-6 hrs after taking the nuvigil and that we'd discuss my nuvigil side effects at our next appt (a month away).  Tuesday I had taken 1/2 nuvigil in the morning, got the email, filled the rx, and called the xyrem pharmacy.  I explained to them the xanax, the nuvigil, the side effects, the stress/anxiety problems, and the email from the dr.  THEY said that if I take a xanax I should wait 6hrs to take xyrem.  I also made sure to explain that I've been having this breathing problem on and off since March 2012, and that I don't think the nuvigil is causing the problem but instead is making an existing problem worse.  I am also completely positive that the breathing thing has nothing to do with the xyrem.

1) The problem was part of my life before xyrem.

2) When I take xyrem and wake in the morning I'm fine and breathing... as the day progresses and stress/anxiety sets in (with OR without nuvigil) that's when it comes back.

3) I do not consistently experience trouble breathing.  It happens in bouts when triggered by certain stressors or massive quantities of anxiety/stress.

4) While on xyrem (again, with OR without nuvigil) the trouble breathing goes away when I'm sufficiently calm, happy, and/or distracted.

 

I have a massive history of health issues that have been caused or made worse by anxiety/stress - but my the drs who could actually prescribe me anxiety meds just keep looking at me like I'm crazy.  Now that I know I have narcolepsy I KNOW I'm not crazy.  On Monday, as I finally began to feel the mental and emotional break-down that I've been fighting tear me from the seams, one of my drs finally paid attention.  I explained very thoroughly to him everything going on currently and the last decade+.  He did an EKG on the spot because I felt like my heart was racing and pounding out of my chest.  Thank goodness my heart is functioning properly, but just seemed to be beating with greater intensity.  He listened intently, asked many questions, clarified anything needing clarification - and a sadness fell upon his face.  He looked me straight in the eye and admitted that I needed something for times like that.  He wrote me the rx under the condition that I get approval from my sleep dr, and I didn't fill it until I had approval.  

 

When I took my first ever xanax yesterday within 30 minutes I could breath, I wasn't manic, I couldn't feel my nerves vibrating beneath my skin, and though I was still aware of the many problems causing me stress and anxiety I felt like I could finally function.  This is most certainly not something I plan to take all day every day.  I'm glad to know the time allowances on everything so I can manage all of these meds appropriately.  My anxiety is already not so good as it is, and any daytime medications stand the risk of making that worse.  It's a relief to have something (at least for now) that I can take during those times that I really need help.