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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by jms600 on April 8, 2004, at 16:52:52
Hello,
From the message I posted a few days ago, people seem to recommend Ritalin or Straterra for the dreaded "brain fog" (lack of concentration, inability to take anything in, constant daydreaming). I think its refered to as ADD.
Since I also suffer from GAD/Social Phobia I am concerned that Ritalin/Straterra may aggravate this. I have heard that Provigil has a more gentler action. Is this true??
How does Provigil compare with Ritalin/Straterra?
Is Provigil any good for improving concentration and increasing your ability to take information in? Or does it just increase wakefulness and no more??
Any information would be gratefully appreciated!
Posted by HelenInCalif on April 8, 2004, at 19:56:19
In reply to Ritalin v. Provigil, posted by jms600 on April 8, 2004, at 16:52:52
Hey jms,
I'd replied to your earlier post. I've used ADD medicines off and on for years (either ritalin or dexedrine), and I have also tried, for a much much shorter time, Provigil. For me they are very different: Provigil is a substitute for sleep, ritalin is a substitute for "natural focus." Based on my *limited* anecdotal evidence I'd say they complement each other but don't substitute for each other.If you have ADD and once you've tried ritalin and had experience with focus, you might later on be able to get focused without ritalin. But you have to know what it feels like before you can tell if other treatments get you there too.
Couple of other points:
1. do read that "Mood Cure" book- even if your root problem is ADD you don't want to exacerbate it with bad food / lifestyle choices. Like in my case I only have heavy-duty carbs just before bed: too many carbs in the day make me sleepy: sleepy = ritalin can't work = extra fogginess.2. also check for other "energy lowering" health problems. Are you overweight and/or snore? Sleep Apnea can cause major fog. Is your thyroid ok?
Posted by Dr. Bob on April 8, 2004, at 23:37:06
In reply to I've tried both. Re: Ritalin v. Provigil, posted by HelenInCalif on April 8, 2004, at 19:56:19
> 1. do read that "Mood Cure" book
I'd just like to plug the double double quotes feature at this site:
http://www.dr-bob.org/babble/faq.html#amazon
The first time anyone refers to a book without using this option, I post this to try to make sure he or she at least knows about it. It's just an option, though, and doesn't *have* to be used. If people *choose* not to use it, I'd be interested why not, but I'd like that redirected to Psycho-Babble Administration:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by jerrympls on April 10, 2004, at 23:58:47
In reply to Ritalin v. Provigil, posted by jms600 on April 8, 2004, at 16:52:52
I've been on Dexedrine, Adderall, Ritalin and Provigil (not all at the same time of course). Provigil helped my mood and concentration moderately - but it mostly just kept me awake. It - for me - does not compare to the positive concentration enhancing effecccts of Ritalin and/or Dexedrine.
However, I've read posts from some who say Provigil works great for "brain fog." We all react differently.
Hope this helpsJerry
Posted by utopizen on April 11, 2004, at 21:41:41
In reply to Ritalin v. Provigil, posted by jms600 on April 8, 2004, at 16:52:52
w does Provigil compare with Ritalin/Straterra?
>
> Is Provigil any good for improving concentration and increasing your ability to take information in? Or does it just increase wakefulness and no more??
>My doc has found his patients (he's a sleep psychiatrist) find the best relief from combining Straterra with Provigil at the same time, even when either hasn't worked alone. He deals strictly with ADD+sleepiness patients.
I've got ADD, Excessive Daytime Sleepiness, Obsessive Thoughts, Social Anxiety... I've tried all the stimulants, and am now on Desoxyn. Although recently I've had depression, which is just an insult to my energy levels and my sleepiness. Now I feel like I can't do anything, and am tired so much it's burdensome. The only way out appears to enter an exercise regimen, the obvious, and trial more meds.
I've tried Provigil in the past, and have failed. But my doc is convinced if I combine it with Straterra it'll help streamline my meds, so I won't need Klonopin eventually for social anxiety, won't need Desoxyn for my sleepiness and ADD, and won't need anything for my depression either.
Keep in mind Straterra was originally developed as an antidepressant, but they found in trials it happened to help people's attention spans. It may very well help your social anxiety, and hope it helps mine. And my ADD and sleepiness, hopefully, if I combine it with the Provigil.
Just keep in mind med combos often work even when you "fail" a single drug... so I'm going to eventually go on Provigl+Straterra. I've been putting it off until after the semester, but my little escapade of depression has made me feel so miserable I just want relief from that,
I mean, even the Desoxyn at any dose still leaves me with no energy to do anything, it's pathetic! Desoxyn is far more effective than Ritalin, especially at helping one's energy, but I would try the other stims before considering it. I've tried Adderall recently, and it fails as well to birng my energy levels back to where they were back when I use to take that last year.
If your underlying problem is depression, which for me took months to creep out of self-denial over until it got to the point where my quality of life was so pathetic I had to accept it, you should consider Straterra+Provigil, and you can always augment it with an antidepressant or antipsychotic and/or some Klonopin for your social anxiety... depression just exacerbatted my ADD+EDS to incredible levels.
Straterra alone may help with your social anxiety, may very well help with your ADD, and if it doesn't, you can always try some Ritalin later!
No rush to control everything, just take one day at a time. You're on the right track, and that's all that matters for now.
Posted by Bill LL on April 12, 2004, at 9:48:37
In reply to Re: Ritalin v. Provigil, posted by utopizen on April 11, 2004, at 21:41:41
I noticed in your response that you are a student. I'm very impressed with how you wrote your response. It is very clear and well written.
I have always had writing problems although I'm not as bad as I used to be.
Posted by utopizen on April 13, 2004, at 0:53:15
In reply to Re: Ritalin v. Provigil - utopizen, posted by Bill LL on April 12, 2004, at 9:48:37
> I noticed in your response that you are a student. I'm very impressed with how you wrote your response. It is very clear and well written.
>
> I have always had writing problems although I'm not as bad as I used to be.
>My 9th grade history teacher once returned a paper I had submitted him, and jokingly said, "you sound like an 80 year old man." Ever since then I've tried to work on using present tense, simplifying my sentences, etc., and noticed professors prefer that these days over long and rambling sentences.
I'm a writer's personality, and it sometimes shocks me that simply postings I write or E-Mails I send out impress others... I generally only expect that sort of response from a professor after I write a paper (I'm an English major).
It's great to articulate myself, since not getting my ADD dx'd until I was 18 led myself to settle for what is literally a 5th grade math level. If it weren't for the fact that verbal IQ is the only noticable trait you can get out of someone when you meet them, I'd be in a pretty bad situtation.
The only thing I hate about my ADD, truly, is my inability to overcome procrastation. It's added so much stress this semester, as I have two incompletes that have turned F's, and must write papers for these two courses on the hopes I can charm my way into getting both professors to correct my grade and not fail out of school right before senior year hits.
Thanks for the complement. Unfortunately, I think it's my eloquence that distractedd my parents from taking my inattentive problems seriously through high school... once I turned 18, I just did some damage control and went to a psychiatrist pronto.
Sadly, now I've got a lot of depression over my incompletes, making it harder to finish them... ak!
My p-doc once asked, after a year of seeing him for social anxiety and ADD, "if I was a writer." I was like, "huh?" but then realized, "oh yeah, writer, yeah, I'm an English major, it's the only thing I know how to do well." I suspect he saw Transplanation at the time, because I recently saw it and it's all about a writer coping with his social anxiety.
Now if I can only calm myself down to go to sleep despite the looming work not yet started, yet due tomorrow...
Now if I can only I can stop my obsessional thoughts, which will plague me into feeling compelled to send off emails and organize old emails rather than go to the library to get the books I needed to get to do work tonight...
I got another laptop off eBay for $500, hopefully this will help me feel more liberated from my iBook by allowing me to store most stuff on the iBook and use the Powerbook g4 as my library laptop.
Sounds crazy, but I get so obsessed with stupid things on my computer I setup a server on it to trade files, a firewire drive to store/backup files, and on top of these irrational excuses for not taking it out more often, I often simply feel sucked into whatever stupid silly thing I'm doing on my computer at the time... even using disk utilities at times. It's horrible. I'd rather simply have a spare laptop sanctioned away in my bag that is good to go whenever I need to use the library, rather than stare at this glaring magnet of my obsessional thoughts.
I've never once done a paper that wasn't an all-nighter, and I'm cujrrently a junior. It's no fun, I really hope Straterra plays around with a lot of gunk up in my brain, especially the obsessional thinking I never really thought much of until my therapist pointed it out to me. (I assumed you needed to have behavioral obsessions in order to have obsessional thoughts).
Posted by Bill LL on April 13, 2004, at 9:25:13
In reply to Re: writers and mental illness- utopizen » Bill LL, posted by utopizen on April 13, 2004, at 0:53:15
I'm optimistic about your treatment because it sounds like you have a competent doctor.
Posted by Questionmark on April 14, 2004, at 10:03:23
In reply to Re: writers and mental illness- utopizen » Bill LL, posted by utopizen on April 13, 2004, at 0:53:15
> The only thing I hate about my ADD, truly, is my inability to overcome procrastation. It's added so much stress this semester, as I have two incompletes that have turned F's, and must write papers for these two courses on the hopes I can charm my way into getting both professors to correct my grade and not fail out of school right before senior year hits.
This reminds me of myself-- see below.
> My p-doc once asked, after a year of seeing him for social anxiety and ADD, "if I was a writer." I was like, "huh?" but then realized, "oh yeah, writer, yeah, I'm an English major, it's the only thing I know how to do well." I suspect he saw Transplanation at the time, because I recently saw it and it's all about a writer coping with his social anxiety.
i've never heard of Transplantation. Is it a film? If it is i would freaking LOVE to see it. That would be so great.
> Now if I can only calm myself down to go to sleep despite the looming work not yet started, yet due tomorrow...
>
> Now if I can only I can stop my obsessional thoughts, which will plague me into feeling compelled to send off emails and organize old emails rather than go to the library to get the books I needed to get to do work tonight...>"Sounds crazy, but I get so obsessed with stupid things on my computer..."
> I've never once done a paper that wasn't an all-nighter, and I'm currently a junior. It's no fun, I really hope Straterra plays around with a lot of gunk up in my brain, especially the obsessional thinking I never really thought much of until my therapist pointed it out to me. (I assumed you needed to have behavioral obsessions in order to have obsessional thoughts).1) i believe "behavioral obsessions" are technically considered "compulsions."
2.(a) You're obsessive thinking and behavior and your extreme procrastination highly remind me of myself. i waste so much time obsessing on menial things that it's ridiculous. i also waste hordes of time doing things-- almost EVerything-- thoroughly and perfectly and what not, causing me to be extremely slow and take far more time in doing things than most people (i don't know if you have this last problem). And i procrastinate to the point of almost utterly destroying my life. i procrastinate everything. i, too, do not know if i've ever done a paper that was not an all-nighter or nearly an all-nighter. i am finishing my sixth (!) year of undergraduate school and am finally going to graduate-- after repeatedly failing a few of the same easy classes over and over again, all due to procrastination. i feel like i've wasted so much time and potential. But enough whining. However, one important thing i learned/realized about a year ago (through this board, and then through observing it more carefully in myself thereafter) is that...
2.(b) ... stimulants can make my obsessive-compulsiveness SO much worse, especially if taken consistently. i was originally diagnosed with just ADD in early highschool, and spent years (in intermittent phases) trying to help my wretched mental problems with stimulants, including caffeine. However, i learned recently (past few years) that i have OC Personality Disorder, which almost definitely is primary to and much worse than any amount of ADD i have. Then i learned that stimulants can often exacerbate obsessive-compulsive problems a great deal. After awhile of observing how i felt and acted when using stimulants, i realized that this was certainly the case with me. So my point to all this rambling is that your heavy use of psychostimulants may be compounding your obsessive problems-- possibly a lot. i know that you have narcolepsy as well (i'm pretty sure it's you), which would make this a difficult situation. But just be aware of this fact/possibility. It's such a catch-22 for me, too, because without stimulants i have so little ability to concentrate and be motivated and what not, but WITH stimulants i am so stinking obsessive and compulsive (perfectionistic and overly thorough, in my case). Okay, good luck with everything. Remind yourself this constantly (so as to not procrastinate as much)-- PRIORITIES! Ok enough, i'm done.(Post Script: This excessively long post is a great example of my ridICulous compulsiveness!!)
This is the end of the thread.
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