Another Paxil Question For Jackie (and anyone else with advice)

Question:

::Thanks so much for your informative response. You are welcome ::I’m glad you mentioned that Wellbutrin can be a problem for people with ::anxiety. I do suffer from GAD. I had to take xanax for quite a while, ::but have been off it for several months and the Paxil CR I used to take ::seemed to handle the anxiety pretty well. It’s only when I had to switch ::to regular Paxil that I started having problems. BTW, have you heard ::when Paxil CR might be available again? I went to drugstore.com and it seems that paxil cr is available. I was able to add paxil cr to my shopping cart without getting a notice that it was unavailable. Call a local pharmacy and inquire about paxil cr`s status. http://www.drugstore.com/pharmacy/drugindex/rxsearch.asp?search=paxil+cr Good luck with your upcoming pdoc appt! Let me know how it goes. Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello Jackie: A while back, you were very helpful and answered a question for me about the sedating effects of Paxil. I was now wondering whether Paxil can ever cause dizziness. I occasionally feel just slightly dizzy when I stand up and when I’m walking. I’m wondering whether you’ve experienced anything similar. Also, in your prior response, you mentioned that Wellbutrin might help me offset the sedating effect of the Paxil. Since I’ll be seeing my psychiatrist in a few days, I was hoping to get your thoughts on the right dosage for Wellbutrin and on any other meds that help offset the sedation.

I’d change to a less sedating SSRI, such as Zoloft, Celexa, or Lexapro. Then you wouldn’t have to take two pills. Chip — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Jackie: I checked with my regular pharmacist. He said that CR is not yet available and no date has been announced. I wonder if you’ll get a notice from Drugstore.com that it made a mistake. Thanks again. DCH – Hide quoted text — Show quoted text – ::Thanks so much for your informative response. You are welcome ::I’m glad you mentioned that Wellbutrin can be a problem for people with ::anxiety. I do suffer from GAD. I had to take xanax for quite a while, ::but have been off it for several months and the Paxil CR I used to take ::seemed to handle the anxiety pretty well. It’s only when I had to switch ::to regular Paxil that I started having problems. BTW, have you heard ::when Paxil CR might be available again? I went to drugstore.com and it seems that paxil cr is available. I was able to add paxil cr to my shopping cart without getting a notice that it was unavailable. Call a local pharmacy and inquire about paxil cr`s status. http://www.drugstore.com/pharmacy/drugindex/rxsearch.asp?search=paxil+cr Good luck with your upcoming pdoc appt! Let me know how it goes. Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Chip: Thanks for your help. I have an appointment with my psychiatrist tomorrow afternoon and I’ll mention your suggestions. DCH – Hide quoted text — Show quoted text – Hello Jackie: A while back, you were very helpful and answered a question for me about the sedating effects of Paxil. I was now wondering whether Paxil can ever cause dizziness. I occasionally feel just slightly dizzy when I stand up and when I’m walking. I’m wondering whether you’ve experienced anything similar. Also, in your prior response, you mentioned that Wellbutrin might help me offset the sedating effect of the Paxil. Since I’ll be seeing my psychiatrist in a few days, I was hoping to get your thoughts on the right dosage for Wellbutrin and on any other meds that help offset the sedation. I’d change to a less sedating SSRI, such as Zoloft, Celexa, or Lexapro. Then you wouldn’t have to take two pills. Chip

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hello Jackie: A while back, you were very helpful and answered a question for me about the sedating effects of Paxil. I was now wondering whether Paxil can ever cause dizziness. I occasionally feel just slightly dizzy when I stand up and when I’m walking. I’m wondering whether you’ve experienced anything similar. Also, in your prior response, you mentioned that Wellbutrin might help me offset the sedating effect of the Paxil. Since I’ll be seeing my psychiatrist in a few days, I was hoping to get your thoughts on the right dosage for Wellbutrin and on any other meds that help offset the sedation. Thanks in advance, DCH — The charter is available at: http://readystump.algebra.com/~asapm

Response:

::A while back, you were very helpful and answered a question for me about ::the sedating effects of Paxil. I was now wondering whether Paxil can ::ever cause dizziness. I occasionally feel just slightly dizzy when I ::stand up and when I’m walking. I’m wondering whether you’ve experienced ::anything similar. :: ::Also, in your prior response, you mentioned that Wellbutrin might help ::me offset the sedating effect of the Paxil. Since I’ll be seeing my ::psychiatrist in a few days, I was hoping to get your thoughts on the ::right dosage for Wellbutrin and on any other meds that help offset the ::sedation. :: ::Thanks in advance, Helloooo DCH Yes, paxil can cause dizziness. It`s one of the most common side-effects. One of the pharmacies I used to fill my paxil script a few years back use to put a warning label on my paxil body about needing to change positions slowly. What happens is when you change positions quickly, like from laying down or sitting, to a standing position, your blood pressure drops a bit and you get lightheaded or dizzy. Google orthostatic hypotension to learn more about it if you like. This still happens to me, annoying but not dangerous. Try to change your positions slowly. Go to a sitting position and dangle first before standing, if you had been laying down. That should help. About the wellbutrin…….your pdoc will know best what dose to start you at, if he even chooses wellbutrin. I would say start with the absolute lowest and see if that helps. Keep in mind that wellbutrin is a stimulating antidepressant and many people with anxiety cannot tolerate it. Of course, there are always exceptions to the rules.Paxil sedation still a problem for you? How is it working otherwise? Take care Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Jackie: Thanks so much for your informative response. I am still having a problem with sedation. I don’t feel physically weak, but do feel like I haven’t had enough sleep. I do get 6 to 8 hours sleep a night so I don’t think that is a problem. I’m glad you mentioned that Wellbutrin can be a problem for people with anxiety. I do suffer from GAD. I had to take xanax for quite a while, but have been off it for several months and the Paxil CR I used to take seemed to handle the anxiety pretty well. It’s only when I had to switch to regular Paxil that I started having problems. BTW, have you heard when Paxil CR might be available again? DCH – Hide quoted text — Show quoted text – ::A while back, you were very helpful and answered a question for me about ::the sedating effects of Paxil. I was now wondering whether Paxil can ::ever cause dizziness. I occasionally feel just slightly dizzy when I ::stand up and when I’m walking. I’m wondering whether you’ve experienced ::anything similar. :: ::Also, in your prior response, you mentioned that Wellbutrin might help ::me offset the sedating effect of the Paxil. Since I’ll be seeing my ::psychiatrist in a few days, I was hoping to get your thoughts on the ::right dosage for Wellbutrin and on any other meds that help offset the ::sedation. :: ::Thanks in advance, Helloooo DCH Yes, paxil can cause dizziness. It`s one of the most common side-effects. One of the pharmacies I used to fill my paxil script a few years back use to put a warning label on my paxil body about needing to change positions slowly. What happens is when you change positions quickly, like from laying down or sitting, to a standing position, your blood pressure drops a bit and you get lightheaded or dizzy. Google orthostatic hypotension to learn more about it if you like. This still happens to me, annoying but not dangerous. Try to change your positions slowly. Go to a sitting position and dangle first before standing, if you had been laying down. That should help. About the wellbutrin…….your pdoc will know best what dose to start you at, if he even chooses wellbutrin. I would say start with the absolute lowest and see if that helps. Keep in mind that wellbutrin is a stimulating antidepressant and many people with anxiety cannot tolerate it. Of course, there are always exceptions to the rules.Paxil sedation still a problem for you? How is it working otherwise? Take care Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

::I saw my psychiatrist yesterday afternoon. In order to control the

Jackie: My psychiatrist told me that a number of his patients have successfully used Provigil. Hopefully, just taking the Paxil in the evening will do the trick, however. I’ll let you know what happens. – DCH – Hide quoted text — Show quoted text – ::sleepiness, he asked me to take my whole Paxil dosage before going to ::bed instead of half in the morning and half in the evening. If that ::doesn’t resolve the problem after a few days, he wants me to try taking ::100 mg of Provigil C when I get up in the morning. According to my ::psychiatrist, this drug is used to treat narcolepsy (at much higher ::doses) and shift work sleep disorder. He also said that it will not ::increase anxiety. If necessary, I can also take an additional 100 mg at ::noon. At least I didn’t have to pay for the Provigil since he had ::samples in his office. I’ll let you know how things are going after a ::few days. If you’re interested in reading more about Provigil, here’s a ::link to the Mayo Clinic’s description of the med. Dear DCH, I hope taking the paxil in the PM works for you! Just beware that some people, like me<g, can`t tolerate taking antidepressants in the evening. Strange as it sounds, taking paxil in the AM makes me feel tired…..but when I took it in the PM, it made me feel so restless that I had a hard time sleeping. This doesn`t About provigil, from everything I read about it, it seems there are better choices out there. You might want to browse through some archived posts on provigil. http://makeashorterlink.com/?R2BA1280B Good luck! I hope you find an answer for the paxil fatigue Jackie ~*~Anything preying on my mind would starve to death~*~

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi, DH, Best wishes with the med adjustment.  Keep us updated on how it’s going for you. smiles, Elise

– Hide quoted text — Show quoted text – Hi Jacqueline: I saw my psychiatrist yesterday afternoon. In order to control the sleepiness, he asked me to take my whole Paxil dosage before going to bed instead of half in the morning and half in the evening. If that doesn’t resolve the problem after a few days, he wants me to try taking 100 mg of Provigil C when I get up in the morning. According to my psychiatrist, this drug is used to treat narcolepsy (at much higher doses) and shift work sleep disorder. He also said that it will not increase anxiety. If necessary, I can also take an additional 100 mg at noon. At least I didn’t have to pay for the Provigil since he had samples in his office. I’ll let you know how things are going after a few days. If you’re interested in reading more about Provigil, here’s a link to the Mayo Clinic’s description of the med.

http://www.mayoclinic.com/invoke.cfm?objectid=3361ACED-6F3F-49BD-A92E… – Hide quoted text — Show quoted text – Thanks again for your help. – DCH ::Thanks so much for your informative response. You are welcome ::I’m glad you mentioned that Wellbutrin can be a problem for people with ::anxiety. I do suffer from GAD. I had to take xanax for quite a while, ::but have been off it for several months and the Paxil CR I used to take ::seemed to handle the anxiety pretty well. It’s only when I had to switch ::to regular Paxil that I started having problems. BTW, have you heard ::when Paxil CR might be available again? I went to drugstore.com and it seems that paxil cr is available. I was able to add paxil cr to my shopping cart without getting a notice that it was unavailable. Call a local pharmacy and inquire about paxil cr`s status. http://www.drugstore.com/pharmacy/drugindex/rxsearch.asp?search=paxil+cr Good luck with your upcoming pdoc appt! Let me know how it goes. Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~ — The charter is available at: http://readystump.algebra.com/~asapm

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

::I saw my psychiatrist yesterday afternoon. In order to control the ::sleepiness, he asked me to take my whole Paxil dosage before going to ::bed instead of half in the morning and half in the evening. If that ::doesn’t resolve the problem after a few days, he wants me to try taking ::100 mg of Provigil C when I get up in the morning. According to my ::psychiatrist, this drug is used to treat narcolepsy (at much higher ::doses) and shift work sleep disorder. He also said that it will not ::increase anxiety. If necessary, I can also take an additional 100 mg at ::noon. At least I didn’t have to pay for the Provigil since he had ::samples in his office. I’ll let you know how things are going after a ::few days. If you’re interested in reading more about Provigil, here’s a ::link to the Mayo Clinic’s description of the med. Dear DCH, I hope taking the paxil in the PM works for you! Just beware that some people, like me<g, can`t tolerate taking antidepressants in the evening. Strange as it sounds, taking paxil in the AM makes me feel tired…..but when I took it in the PM, it made me feel so restless that I had a hard time sleeping. This doesn`t About provigil, from everything I read about it, it seems there are better choices out there. You might want to browse through some archived posts on provigil. http://makeashorterlink.com/?R2BA1280B Good luck! I hope you find an answer for the paxil fatigue Jackie ~*~Anything preying on my mind would starve to death~*~ — The charter is available at: http://readystump.algebra.com/~asapm

Response:

Hi Jacqueline: I saw my psychiatrist yesterday afternoon. In order to control the sleepiness, he asked me to take my whole Paxil dosage before going to bed instead of half in the morning and half in the evening. If that doesn’t resolve the problem after a few days, he wants me to try taking 100 mg of Provigil C when I get up in the morning. According to my psychiatrist, this drug is used to treat narcolepsy (at much higher doses) and shift work sleep disorder. He also said that it will not increase anxiety. If necessary, I can also take an additional 100 mg at noon. At least I didn’t have to pay for the Provigil since he had samples in his office. I’ll let you know how things are going after a few days. If you’re interested in reading more about Provigil, here’s a link to the Mayo Clinic’s description of the med. http://www.mayoclinic.com/invoke.cfm?objectid=3361ACED-6F3F-49BD-A92E… Thanks again for your help. – DCH – Hide quoted text — Show quoted text – ::Thanks so much for your informative response. You are welcome ::I’m glad you mentioned that Wellbutrin can be a problem for people with ::anxiety. I do suffer from GAD. I had to take xanax for quite a while, ::but have been off it for several months and the Paxil CR I used to take ::seemed to handle the anxiety pretty well. It’s only when I had to switch ::to regular Paxil that I started having problems. BTW, have you heard ::when Paxil CR might be available again? I went to drugstore.com and it seems that paxil cr is available. I was able to add paxil cr to my shopping cart without getting a notice that it was unavailable. Call a local pharmacy and inquire about paxil cr`s status. http://www.drugstore.com/pharmacy/drugindex/rxsearch.asp?search=paxil+cr Good luck with your upcoming pdoc appt! Let me know how it goes. Jackie ~*~I`m an angel! Honest The horns are just there to keep my halo up straight~*~

– The charter is available at: http://readystump.algebra.com/~asapm

Response:

SWSD (Shift work sleep Disorder) Question

Question:

Hello, I’m 22. I was delivering papers and Dj’ing late in the night for nearly 6 months. I’m now trying to get my circadian rythms back into a normal day-time cycle for my new job and for college classes. In other words.. I now sleep all day.. and am awake all night. This isn’t insomnia by any means.. I sleep hard and well during they day, but it’s costing me job performance and productivity in my life. Does anyone else experience this? Can anyone suggest ways to correct it? I understand it isn’t fixable overnight since my body has adapted to the lifestyle I was living, but i’d like to get a start on making my life change from night owl.. to early bird. Thank you for your time and help. Kind Regards, Backa**wards in S. Cali

Response:

light therapy can help with this of course you will have to get UP at a reasonable hour to expose yourself to the lights in order for the circadian rhythm to kick back to normal so……. stay up all night and then start the light therapy…. and stay up all day and go to bed at the time that you want to go to sleep…… means for one tiring day, and a while using the light therapy to get up with…… but it will pay off in dividends for you kate <coolkid…@hotmail.com> wrote in message

news:1103022974.356265.107670@f14g2000cwb.googlegroups.com… – Hide quoted text — Show quoted text -> Hello, > I’m 22. I was delivering papers and Dj’ing late in the night for nearly > 6 months. I’m now trying to get my circadian rythms back into a normal > day-time cycle for my new job and for college classes. > In other words.. I now sleep all day.. and am awake all night. This > isn’t insomnia by any means.. I sleep hard and well during they day, > but it’s costing me job performance and productivity in my life. Does > anyone else experience this? Can anyone suggest ways to correct it? I > understand it isn’t fixable overnight since my body has adapted to the > lifestyle I was living, but i’d like to get a start on making my life > change from night owl.. to early bird. > Thank you for your time and help. > Kind Regards, > Backa**wards in S. Cali

Response:

MDs begin discussing modafinil (Provigil)

Question:

Type A’s perk up over modafinil, an anti-sleeping pill Doctors be ready: A medication for sleep disorders is bound to attract interest from people who are just plain sleepy. By Susan J. Landers, AMNews staff. Nov. 11, 2002. ————————————————————————— —– Washington — A surgeon awakens groggy after a restless night, feeling less than tip-top for a tricky, 12-hour procedure. A shift worker can’t cope with the circadian chaos caused by working when sleep is called for. A Wall Street lawyer puts in the usual 14-hour day and a night of socializing and must bounce back to make million-dollar decisions in the morning. All are sleep-deprived, and all could seek modafinil, a stimulant marketed in the United States under the name Provigil by Cephalon Inc., a biopharmaceutical company in West Chester, Pa. Used in Europe for several years, it was approved in late 1998 by the Food and Drug Administration for use by patients who have narcolepsy. But could this drug also be the answer for which some of those Type A’s have been looking? So far the medication has an admirable safety record. As word of its attributes spreads, it could be tapped as a support system for fast-paced lives — and become a topic between patients and primary care physicians. It is already prescribed off label for people with sleep apnea and depression, and studies have shown that it is effective for multiple sclerosis patients with excessive sleepiness. The military is interested in modafinil, and a study at Fort Rucker in Alabama found that the drug boosted the performance of sleep-deprived helicopter pilots. But another study done at Walter Reed Army Institute of Research, Silver Spring, Md., found that while modafinil works, so do six cups of coffee. Meanwhile, modafinil has become a big seller, with its sales doubling, $72 million to $150 million, from 2000 to 2001. The company is sponsoring studies intended to broaden the drug’s appeal and further boost sales. Only a half-hour of medical school training is devoted to sleep disorders. In late October, the company announced the results of its 12-week randomized, double-blind study of 209 patients with shift-work sleep disorder showing that modafinil significantly improved wakefulness. The results will be used to support Cephalon’s bid to expand FDA approval of the drug’s use for this indication, said Frank Baldino Jr., PhD, company chair and CEO. The disorder is recognized in the International Classification of Sleep Disorders: Diagnostic and Coding Manual and is also classified as a circadian rhythm disorder by the American Psychiatric Assn. But the inevitable question has arisen. If it works so well for people with sleep disorders, why not use it for people who are just plain sleepy? Not so fast, specialists say. "People have to understand, this isn’t better living through chemistry," said Thomas Roth, PhD, director of research at Henry Ford Medical Center in Detroit, which participated in Cephalon-sponsored studies of the drug. While modafinil is a welcome treatment for patients with narcolepsy and certain other sleep disorders, its long-term use by healthy people is not encouraged. "I don’t think people could support using something like modafinil long term in normal people based on what we know right now," said Meir Kryger, MD, director of the Sleep Disorders Center at the University of Manitoba, Canada. "I feel very nervous about giving someone a treatment for something that is not a medical condition, but is a lifestyle thing," he added. Dr. Kryger doesn’t prescribe modafinil for such patients. But with the drug seemingly poised at the top of a slippery slope that could well lead to its use as a so-called lifestyle drug, physician prescribing patterns are key. What primary care physicians should know about modafinil is an important issue, said Karl Doghramji, MD, director of the Sleep Disorders Center at Thomas Jefferson University Hospital in Philadelphia. "If I correctly understand it, the company’s future plans include the possibility of making an initiative to primary care physicians," he said. And the entry of primary care physicians into the sleep disorder picture would mean that many more patients would receive needed treatment, Dr. Doghramji said. But with surveys showing that only about a half-hour of medical school training is devoted to sleep disorders, primary care physicians may face a steep learning curve, he noted. "When do you, as a primary care physician, decide this patient has X disorder and go ahead and treat it, and when do you send the patient to a special center like a sleep disorders center?" he asked. "And if you do send a patient to a center, what do you do with the data you receive?" Take it a case at a time Decisions to use modafinil should be made on a patient-by-patient basis, said Neil B. Kavey, MD, director of the Sleep Disorders Center at New York Presbyterian Hospital/Columbia Presbyterian Medical Center. While there will be some clear and proper uses for it, others will be a judgment call, said Dr. Kavey, who has prescribed the drug for off-label uses. "It’s easy with the surgeon who is dealing with multiple traumas from accidents and who has to be up and up and up. You’re going to give that surgeon Provigil." Modafinil kept study subjects awake; so did six cups of coffee. But most agree that physicians would be very careful about prescribing modafinil solely to allow healthy patients to go for long periods without sleep. "I think most clinicians are very conservative in the use of medications," Dr. Roth said. Safety is an issue, he said. Despite its good record, modafinil is a medication, he noted, and it is intended for specific disorders. After all, "do we give people diet pills so they can eat bacon burgers? Do we give people Lipitor so they can eat yolks?" Carl E. Hunt, MD, agreed. "There is no substitute for a good night’s sleep on a regular basis," said Dr. Hunt, who directs the National Center on Sleep Disorders Research, part of the National Institutes of Health. The sleep center is fielding many questions regarding the use of modafinil for patients who do not have narcolepsy but who are chronically sleepy. "But there are no data that suggest that would be recommended or safe," Dr. Hunt said. Modafinil’s effect on such important physiologic benefits of sleep as learning and memory, mood and behavior, appetite and resistance to disease is unknown, Dr. Hunt said. The most common explanation for people being sleepy is they are simply not getting enough sleep, he said. In that population, no sleep medicine physician would recommend using modafinil because of the concern about side effects. "The price we pay for using it could be much more serious than any possible benefit one might get," Dr. Hunt said. ————————————————————————— —– ADDITIONAL INFORMATION: The specifics Provigil (modafinil): A central nervous system stimulant made by Cephalon Inc. and approved in 1998 Indication: Helps people with narcolepsy stay awake Market performance: Sales of modafinil doubled from $72 million in 2000 to $150 million in 2001 ========== FAIR USE NOTICE: This posting contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of political, human rights, economic, democracy, scientific, and social justice issues, etc. We believe this constitutes a "fair use" of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. For more information go to: http://www.law.cornell.edu/uscode/17/107.shtml If you wish to use copyrighted material from this posting for purposes of your own that go beyond "fair use," you must obtain permission from the copyright owner. -dave ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ |        Dave Jackson * http://www.AwakeInPhilly.org * Phila., PA. +   ~~eFax: 253-423-7208~~  *  mailto:usenet_u…@UNICORNcomcast.net |     Remove the mythical creature from my email address to reply |             Some make it happen, some watch it happen, |            and some say, "What happened?" – Unknown   ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Response:

Interesting stuff. My apnea is not really responding to CPAP treatment at this point in time, and my daytime fatigue levels have rendered me non-functional and on short-term disability. I believe Provigil is my next option, as wary as I am about stimulants. I can see a huge black market for this stuff, though, especially among the party-hearty crowd. (Oh, if they only knew how much energy they were already blessed with!)

Response: