4 replies to this topic

[2pooped]

I thought I had truly lost it but after some research I don't think I have COMPLETELY lost it. LOL. I am fairly new with dealing with N, at least a confirmed dx as I have had issues for years. My current treatment is .5 mg Klopin at night and 125 mg Nuvigil with 20 mg Adderall at 6 am, then 20 mg Adderall at 10:30 and same dose at 3:00 pm. The problem I have is I am experiencing even more sleepiness than even before. The new part of my treatment is the addition of Adderall. I have found that stimulants can cause this effect in some. Has anyone here experienced this? I wondered if I have this problem because I also suffer from multiple sclerosis. I plan to discuss with my dr but wanted to give the treatment adequate time. Thanks for any help you might offer.

[Hank]

I take AdderallXR 30 mg. Before Dx of N/C I was prescribed Klonopin by a neurologist who made my primary Dx PLMS (Periodic Limb Movements of Sleep) and never considered N/C. Klonopin is a long acting benzo which has strong sedating effects. There are safer alternatives to consider. Klonopin also changes sleep architecture and supresses REM sleep. Dose withdrawal occurs over time as the dose becomes less effective. Withdrawal causes a REM rebound and requires a long slow taper over 6 months. After I moved off Klonopin, I was able to discontinue Provigil, which I took in addition to Adderall. My sleep doc said she would never treat a sleepy person with a long acting sedative like Klonopin. I already had severe EDS and was then fighting the sedation of 1.5 mg Klonopin, which has a 24+ hour half life. Over time, the half lives begin to stack and the sedation is around the clock- this is brutal on top of the EDS from N. From my experience, I would suggest considering the effects of Klonopin as a possible source of your increased sleepiness. Your experience may be different from mine, especially with MS, but my experience with Klonopin was devastating to me.

[2pooped]

I take AdderallXR 30 mg. Before Dx of N/C I was prescribed Klonopin by a neurologist who made my primary Dx PLMS (Periodic Limb Movements of Sleep) and never considered N/C. Klonopin is a long acting benzo which has strong sedating effects. There are safer alternatives to consider. Klonopin also changes sleep architecture and supresses REM sleep. Dose withdrawal occurs over time as the dose becomes less effective. Withdrawal causes a REM rebound and requires a long slow taper over 6 months. After I moved off Klonopin, I was able to discontinue Provigil, which I took in addition to Adderall. My sleep doc said she would never treat a sleepy person with a long acting sedative like Klonopin. I already had severe EDS and was then fighting the sedation of 1.5 mg Klonopin, which has a 24+ hour half life. Over time, the half lives begin to stack and the sedation is around the clock- this is brutal on top of the EDS from N. From my experience, I would suggest considering the effects of Klonopin as a possible source of your increased sleepiness. Your experience may be different from mine, especially with MS, but my experience with Klonopin was devastating to me.

Thanks for your reply. My sleep dr is who prescribed the Klonopin and did so at such a low dose (.5) that he thought I wouldn't have problems. He did tell me that I could try 1/2 of the .5 if I had problems with it hanging on. I have done that but after a couple of nights I start with acting out dreams and LOTS of movement. I was also treated for PLM years ago. I think you have hit something tho since the EDS has worsened which brings your comment about half life stacking very possible in my situation. My dr isn't very interested in xyrem for me because of the MS and lack of research in that area, he is concerned about the safety in my situation. If you don't mind, what nighttime, if any, meds do you now use?

[Hank]

My sleep doc replaced Klonopin 1.5 mg (Rx'd by a neuro, started at .25 and reached 1.5 over time) with Neurontin 100 mg up to 300 mg, which is considered a low dose. Neurontin achieved the same effect for keeping me still at night but I had trouble sleeping and added Lunesta 3 mg. Klonopin lengthens sleep but supresses stage 3 and 4 sleep. So while sleep is longer, it is not higher quality. For me, Klonopin was like painting myself into a corner. As the dose increases to maintain the same results, the side effects become greater. Then, the only way off Klopopin was a long, slow taper (absolutely necessary) which was rough, since it causes a REM rebound- but you are still at 1/3 of what I was on. Most people with PLM are over 65 (primary) and Klonopin is considered a first line treatment. Most people with PLM don't need treatment. PLM is common with N and is considered secondary. So, PLM wich is secondary to N should not be treated the same way as primary PLM in seniors. My sleep doc shocked me when she said that a long acting sedative should never be given to a sleepy person. Eventually, dose withdrawal requires that you increase the dose to achieve the same effect.

[ImSleepin]

I have found Klonopin to be sedating in the past, though I have not taken it anytime recently. When I did take it a couple times years ago, it put me to sleep pretty quickly so it was difficult to take it during the day if I was directed to.

I do take Adderall, though, however I don't take it everyday. My neuro also suggests to take at least one day off a week so that it doesn't build up in your system and you don't build up a tolerance. I have my dose split into 10mg pills so that I can take it slowly throughout the day. Some days I take more, some less, I gauge it based on how I feel and whether I'm able to go home and sleep in the afternoon or evening at all. This is something I've discussed with my doctor, so he is aware of how much I am taking. I would take off at least a day a week to give your body a break and to prevent a tolerance to it if you can.