Nd Anger Mgmt and Question About Ritalin for Fatigue

Discussion in 'Fibromyalgia Main Forum' started by mme_curie68, Mar 1, 2006.

  1. mme_curie68

    mme_curie68 New Member

    Hi Folks -
    I'm new to this board but I've done some surfing and this one seems to have the most support for people.

    I was "officially" diagnosed this past Tuesday. I have to say that I am not thrilled to be eliminated from all the other categories of autoimmune dysfunction and given a diagnosis that is made by eliminating all the other diagnoses. My dismay is compounded by the fact that I am also Bipolar and have non-autoimmune thyroid disease also.

    Basically everything fell to hell after I had my second child at 37 and I've been on the doctor parade since giving birth 13 months ago.

    My problem is not so much the pain right now but the fatigue. Its killing me. I am so damned tired. Since my Rheumatologist bounced me back to my Psychiatrist for the medication balancing act, and telling me to exercise. I felt like telling him, "Thanks buddy - I know it will make me feel better but what's your strategy for giving me the energy to get to that point in the first place?!!!"

    My psychiatrist is going to try symptomatic treatment of the fatigue with Ritalin. Has anyone else tried this therapy? Any success?

    I am determined to try just about anything at this point. I work full time and I have already sucked up a third of my vacation days for the entire year and I want to have fun and enjoy my family again!!!

    On the plus side, I have worked in the pharmaceutical industry for the past 16 years and I know a lot about drugs, side effects, etc. I am an EMT in MA and I have a BA in Chemistry so I can help with some of the scientific mumbo jumbo!

    Thanks for being here!
  2. Cromwell

    Cromwell New Member

    What time are you takijng them and what are you taking. As you will be aware the fatigue caused by these can be strong.

    I find that when I am most fatigued I just let my body relax and respond as trying to fix it does not work. Rand R helps, Also hot Epsom salt baths, plus another poster said to add a little Bicarbonate of soda in and that does make a difference.

    Great to have you here as we all have lots of pharm questions...

    Be better


    Love Anne C
  3. mme_curie68

    mme_curie68 New Member

    Yep, after being on bipolar meds for the past 10 yrs I am aware that they make you feel drowsy - but I am talking about fatigue above and beyond the "usual" that a bipolar patient is "used to".

    It will be a tightrope, but I have a great psychiatrist who is not only a bipolar specialist but also treats fibromyalgia patients. I have decided I will try her suggestion and see if it helps.

    Thanks for the support - I needed to vent!
  4. Yucca13

    Yucca13 Member

    I think that your accomplisments are awesome. That must have been challenging - earning a BA in Chemistry (I have math phobia, so it is even more awesome) and meeting the EMT requirements. Congrats on your many accomplishments.

    Having young children is very exhausting - I remember well having four under seven years of age and the last two thirteen months apart (Irish twins). I never knew why it was so hard to keep up and why I felt so much body pain back then.

    After having RSD and then the diagnosis of Fibromyalgia about 15 years ago gave me more understanding of why everything was so much harder to do and why I felt like crap a lot of the time.

    My physiatrist, who I've been seeing for a year now, had no problem in trying many meds. At the moment, I'm on a low-dose pain patch, Dilaudid, 4 mg. every six hours as needed and Adderall, 5 mg. up to three times a day. Some days I take one or two, some days I don't take any. I can't say that they give me a tremendous burst of energy, but keep me moving along if I'm feeling wiped out and would rather go back to bed. I'm not sure if the Ritalin and Adderall are both methampetamine (very scary word) or not. Maybe you can post as to the similarities and/or differences.

    It is sure understandable your needing energy to take care of your family and do your job. I hope you can find something to help. Oh, yeah, and it is kind of weird when they say you have Fibro - diagnosing you by symptoms only usually. Back in 1990, I just stumbled upon an astute doctor that recognized the tender points and told me what it more-than-likely was. I remember being relieved and kind of dumbfounded in that hardly anyone had heard of the strange syndrome and what to do about it. Having it wax and wane in severity is something I've gotten used to. At least there is hope that a better time will follow a bad one!
    Best wishes,
    Val
  5. mme_curie68

    mme_curie68 New Member

    Since Fibro. is a diagnosis of exclusion of other autoimmune diseases (Lupus, RA), plus the tender points - trust me when I say everything else was "excluded" except for the "non-autoimmune" thyroid nodules. I have an internist, a psychiatrist, an otolaryngologist, an endocrinologist and a rheumatologist.

    It was my rheumatologist that made the diagnosis, after finding I met the tenderpoints criteria, but was negative for RA, SLE, etc.

    Thanks so much for all the feedback - I feel much better (at least emotionally).

    I think part of the problem I had such a hard time with it was that I was trained in an era when FMS was a "hack"/"new age" (insert your disbeliving diagnostic term here that is synonymous with "its all in your head" here) diagnosis and was not accepted in the medical mainstream.

    My doctor told me that he has just seen way too many people with the problem to think it's other than legitimate, and my psych. said the same thing also.

    I DO believe its a legitimate disease (don't get me wrong) - it's that as a scientist, I'd be much happier if there was a microbe or a new category of virus attached in a "know your enemy" kind of way.

    Thanks!
    [This Message was Edited on 03/02/2006]
  6. memawwade

    memawwade New Member

    I take Provigil which is not as extreme as Ritalin. It helps me not be so drowsy and I can think better. You might ask the doctor about that. God bless you and your family!!
  7. mme_curie68

    mme_curie68 New Member

    Thanks.

    Ritalin is methylphenidate hydrochloride. Adderall, interestingly (to me anyhow - LOL),is a mixture of equal amounts of four different amphetamine salts: amphetamine aspartate, amphetamine sulfate, dextroamphetamine saccharate and dextroamphetamine sulfate. DEA-wise they are both Schedule II drugs but in different drug code categories. Both are central nervous system stimulants. I'm going to try Adderall first because it's cheaper than Provigil. I'm on so many drugs now that paying less for the older drug is my first option - but if it doesn't work I will try another. Provigil or modafinil is a "wakefullness promoting drug" first used to treat narcolepsy but is more expensive than the ADD drugs.

    Thanks!
    [This Message was Edited on 03/02/2006]
  8. jfrustrated

    jfrustrated New Member


    Welcome.
    I tried ritalin for 3 months serveral years agon to see if it would relieve my level of fatigue. I have had cfs/fm for at least 8 years and am totally disabled. Had no effect at all. But it could be different for different people.

    I would suggest that you take any exercise very carefully. I really believe that my efforts to exercise, based on feelings of guilt and encouragements for well-meaning, but ill-informed, friends and doctors, have aggravated my condition.

    The cfs doctor I am now seeing puts it like this: "You keep trying to play basketball, but you've got a broken leg. No wonder you keep collapsing."
  9. tilla

    tilla New Member

    I have been on Adderall for the last few years, before that I took ritalin. I was told the same thing about seeing a psychologist before they would prescrib, but then a physician looked it up and it can be prescribed if you are having problems of narcolepsy. I am just tired all the time, so I was able to get it.

    My doctor just suggested I try provigil as I find I have trouble now coming up with words when I talk. He gave me a few samples to try. I tried one half pill today for the first time. I had to go lie down I was so sleepy, slept for 2 1/2 hours. He did tell me this when he gave them to me. He said they some times make people sleepy, so they take it at night.

    I am not sure what I want to take now. Hoping someone can help.

    Tilla
  10. connieaag

    connieaag New Member

    My 13-year old daughter has FM/CFS and is borderline narcolepsy. She started on Provigil and 100 mg wasn't enough, but 200 mg kept her up past midnight. She was switched to Concerta 3 weeks ago and it has been wonderful. She also switched from Zoloft to Cymbalta about 2 months ago, and takes that in the AM as well. The combo seems to get her through, although she leaves school at 1:30 and sleeps for 2 hours, and then is ready to go again. Both drugs directly affect the neurotransmitters more than others which is a probable FM cause I understand. Unfortunatly she was diagnosed with mono Monday, so she is back to being home-bound for the week, but prior to that was doing well.
  11. mme_curie68

    mme_curie68 New Member

    I have been on 5 mg adderall up to 3x/day since last Friday.

    I am finding that it does help, but the initial boost isn't quite enough, so after seeing my doc today, I am going up to 10 mg up to 2x/day and 5 mg if I need the third dose so I won't be too awake at bedtime.

    My internist and my psychiatrist agreed that I could also try 50 mg of Flexeril at medtime to try to relax the muscles and joints while I'm sleeping so that getting up isn't such a chore.

    On the psych. med front, I am already on 60 mg Cymbalta for depression, 600 mg Trileptal at night (I was on 1200 mg but it was interfering with my thyroid too much)and 600 mg Seroquel at night - the Seroquel is the "mood stabilizer" component for my bipolar but it also has the added effect of non-narcotic sedation to get me to sleep.

    Without this I would NEVER sleep anymore - since what started out as childhood depression grew into bipolar (lots of research suggesting that untreated depression can develop further into bipolar disorder - big Newsweek article on it a couple of years ago). I can remember episodes of depression going back to the fourth grade when I was 10. I was untreated until the age of 21.

    On the supplement front, I am beginning my own regimen with my docs consent of the following:
    multivitamin taken twice daily
    L-carnitine and Biotin to help with metabolism of long-chain fatty acids
    Acidophilus/bifido probiotic for GI tract and reproductive tract
    Melatonin at bedtime and i will add on valerian if I need to to try and reset my night waking - I wake up around 3x a night. I can go back to sleep but it has to be bad for the sleep cycle as a whole to keep coming up "all the way".

    I also changed my diet to all freshly prepared foods. No store over-processed stuff. My husband and I cook enough at dinner to take for lunch the next day.

    After being unable to lose weight for over a year, I am finally losing weight. I was feeling better, but frankly all of my stress around just being diagnosed with FM and who was actually going to TREAT me sent me into a massive flare.

    I'm just going to take it one day at a time and whatever works best for me is what I will do. I just had a "lymphatic drainage" massage this week, but I think it made everything worse. I had a warm stones massage about a month ago and that was fantastic - I felt great after and days after. I agreed to try the lymph massage because it is supposed to be good for FM but it didn't work for me - back to the lava rocks!


  12. connieaag

    connieaag New Member

    Kathyrn (daughter) has been on Flexeril at night since she was dx. She also takes Norflex in the AM as it is less sedating. We've been thru the whole antidepressant gamit as well and pain meds. She also takes 100mg on Minocin daily for the AP theraoy of killing off the micoplasms see roadback.org for that info. She gets massages once a week and has recently been getting deep tissue massages from her chiropractor along with adjustments. She uses heated steel tools to penetrate FM points.

    Connie
  13. Neenah

    Neenah New Member

    Hi-
    I'm very new to this Board but not to FM and CFS. I was diagnosed with FM on 11/13/91 when I woke up and couldn't get out of bed. Had previously thrived (ha!) on stress, Type A personality, ran multi-million $ organization. It dropped me like a stone. Could not get out of bed and shower on the same day couldn't sit up in a chair, couldn't read, hold a book etc. Six months later, a different Dr. diagnosed me with CFS. I have had every test(and more), tried most meds which often not only didn't work but I had paradoxical reactions which then threw me into a tailspin. Would take a half step forward and five steps back. Very frustated and angry. I don't want to go through all my tribulations, everyone here certainly sounds like they can tell the same story. I do have some unique things that might help some people. Just the stories I've read quickly here have helped me tonight. ANYWAY, I had a major flare ( can't think of the word I want)in 1999 and was in tough shape.I was already on Tramadol 50mg x 6/day (wonderful, but extremely dangerous med took myself off in 2003), 2cc injection Kutapressin daily, whichever antidepressant at that time,.5mg clonazepam @ night, etc. I was looking at total disability. Dr. prescribed Adderall 10mg x6/day. I was in the office the next day! I believe, however, in retrospect that it made me angry and lose my temper for awhile which I hadn't done before. I lowered dose slightly to 10mg x 5/day.
    For financial reasons alone, I decided to try Ritalin 5yrs. later in 2004. I tried it for 4 months.
    I slept on the couch for 4 months. Could not wake up. Tried Adderall XR. I got out of bed but just barely but couldn't sleep-literally. Yo-Yo. At least one day a week I would just stay up all night. Then, sleep from about 4pm til 10 am. Got new Dr. (Mine closed his practice.) He prescribed plain Adderall again this time 10 mg x 3 day. I've had some great days since and some terrible days since. For me, if I'm really in a flare-up no med makes a difference. If symptoms back off meds make a difference. Different symptoms come to the forefront on any given day. Any change in barometric pressure brings about pain and weakness and extended recovery time. I hope this is making sense. I'm trying to say that fom my experience nothing works for everyone and also nothing works for anyone forever except listening to your body and being as healthy as you possibly can. Sometimes just knowing this can help. I'm tired so will end and wish you very good luck.
  14. jaltair

    jaltair New Member

    I would hesitate to take ritilan if bi-polar. Could affect the mood stabilizer (?).

    I took Provigil and felt great the first couple of days, after that I was non-stop and really got anxious and irritable and had a harder time concentrating. Aside from those symptoms, I had to pay out of pocket as it wasn't covered by my insurance. My PMD had me do a sleep study after going off Provigil. The sleep study was normal. I'm just normally sleepy all the time from the CFS.

    I asked my PMD about the ritilan and she wouldn't prescribe it and told me that it wouldn't really help the underlying problems that are causing the fatigue.

    After struggling with FMS for several years and then being diagnosed with CFS, I recently found out that I have Lupus. My PMD and rheumatologist told me that the fatigue was from the Lupus.

    Having these problems is a circus parade of trial and error and testing and learning.

    Welcome to the Board, it certainly does provide the best info and support of any Board that I've found. Nice to have you!

    Hugs, Jeannette
  15. mme_curie68

    mme_curie68 New Member

    I have been accustomed to a certain level of "med-fatigue" since I was in my early twenties. The FM fatigue goes above and beyond what I have ever experienced previously.

    I am very mindful of my bipolar. I guess because I have had it so long now, I know when I am not right, not thinking rationally, etc. When very irrational thoughts seem rational I know I have to do something. So far I am not going "manic-y", but if I do I will contact her right away and she will try me on something else.

    Thanks, Mme Curie