Opioids Modafinil for Opiate/Depression Fatigue?

[kayaker318]

I take 40 mg of Oxycodone daily for chronic pain. I am also clinically depressed so taking Lexapro as well. Between these meds and a stressful situation at home where I am a primary caregiver I am exhausted; have low energy, and an inability to concentrate, etc. I decided to ask my Dr. for a Modafinil script and filled it a few days ago. So far I have taken the following before noon each day:

Day 1 - 50 mg.
Day 2 - 100 mg.
Day 3 - 200 mg
Day 4 - 100 mg.

The only real significant relief/energy/alertness was at 200 mg. This was also the dosage that caused the most side effects - not serious - just annoying. For example, intermittent nausea and a feeling like a low grade headache and overall general malaise. Once it wore off I felt like I had a hangover (minus the alcohol). I do know that the half life is 12-15 hours and felt like I was back to my old (tired) self after that time period. Today I went back to 100 mg which helped me complete tasks for a couple hours and then it wore off quickly. It seems that the 200 mg is the only level for me that lasts longer.

My question is can anybody share their experiences on Modafinal and opiates and/or depression/fatigue with special emphasis on how to reach the best dosage. I feel like I can do the 200 mg a day and endure the after effects if it's helping me stay awake and alert. But I don't know if I should be dividing it into 100 mg in am and 100 mg at noon for example. And has anyone taken a day or two off from it during the week? I read that some do that so they don't build a tolerance but I am tired every day so not sure if that's advisable.

And, this is a total one off but many posts talk about a particular smell to their urine which means they know the drug is working/legitimate. There is no difference in mine at all since taking modafinil. I am in the US and purchased it with a prescription from a pharmacy. I see they get their drugs from a major Indian manufacturer.

Any suggestions or advice would be most welcome.

 

[Lady Codone]

I used modafinil for a month in college for excessive daytime sleepiness. Don't recall the dosage but I didn't care for it at all. (I prefer straight stimulants like amphetamine).

Perhaps taking a half-dose and combining it with another stimulant like caffeine would produce fewer side effects? Or breaking your dose in half and taking it twice a day instead of all at once. Are you sleeping well at night? Poor sleep is a major cause of fatigue, and depression itself can cause poor sleep/lethargy. Perhaps dividing your oxycodone into two doses would cut back on the brain fog and drowsiness as well.

 

[keeping]

i used to be prescribed modafinil for benzodiazipine withdrawal and depression. i found it to be very therepuetic at 50mgs twice daily (morning and afternoon); i once took 200mgs in one go (just for kicks) and really did not enjoy the results.

also i advise against combination with caffeine as it can make you very anxious.

my urine did not smell any different but i noticed that as soon as my dose started working i suddenly needed a crap.

 

[phatass]

Modafinil, allthough from what i've read about it's benefits with concentration, and various other things, and works on dopamine, sounds from the way you describe it that something like Ritalin would be way more efficiant, here it can be prescribed "off label" for depression that doesn't respond to "normal" anti-depressants... Ritalin would also help for work, focus, concentration etc.

However Ritalin does have it's dangers, addictive ad abuse potential, side-effects... http://en.wikipedia.org/wiki/Methylphenidate plenty of info on Wiki, on whether or not in YOUR case, you think the pro's will outweigh the cons.

Don't know about other stim/amps (dex/lis/meth/amphetamine etc.), if they can be Rx for your situation, if they are "better" or "worse" options for your case. It will also depend on your doctor obviously doctors will be very reticent to prescribe strong stims with high abuse potential, to anyone, let alone if your doc knows your past problems with addiction (if this is the case). Over here, only a psychiatrist, slep specialist doc, neurologist and a few others can deliver the initial prescription, not a GP/ "normal" doctor...

But keep ya head up, for the monent though, stick to the Modafinil, as you may need a time of adaptation, and side-effects, may subside, and THEN look into ritalin as a last resort to treat your condition/pathology.

Hope this helps you explore your available possibilities to feel better!

P. nearly forgot, i read i think on the wiki Modafinil page, that Modafinil combined with a "normal" anti-depressant will be more efficient at treating depression than the anti-depssant alone, they have done studies that back this up... So yeah look into wiki Modafinil page.

 

[kayaker318]

Thanks @Lady Codone and @Keeping for your suggestions. And, ^phatass good info on the anti-depressant enhancement w/modafinil info, etc. I want to give that to my psychiatrist.

Believe it or not today modafinil worked wonders. Today is Day 5 and it feels like all of the good effects that I've been hearing about kicked in. It's strange because I was going to give it one more day (today) and then stop for good because it wasn't helping at all. I only took 200 mg at noon today. I'm actually shocked at the difference I'm feeling in comparison to 4 days prior.

I have had energy, feel mentally more aware, am doing tasks that I otherwise would push to the bottom of my list. Being depressed I have not wanted to interact socially -- especially on the phone with anyone. Today I felt like calling a friend and chatting which sounds pretty pathetic but that is huge progress for me with major depression and chronic pain. Additionally I think it helps with my pain meds -- meaning it was a couple hours beyond my normal time to take my meds before I realized that I needed to. Also when I first took it I could not fall asleep -- even when I took it in the morning -- was up til 5am on day one. Knock on wood, the past couple nights I have not had a problem. And, alleluia it is helping me with constipation that I face daily with my oxycodone. That alone is a reason to take it.

Of course, the jury is still out but I am very hopeful about these new developments.

Also great article here:
Simultaneous Use of Stimulants and Opioids
http://www.practicalpainmanagement....l/opioids/simultaneous-use-stimulants-opioids

 

[phatass]

Glad it's working out, definately give it a chance to adapt to, and see from there!

 

[WellTram]

I did an experiment as i am in situation where depression, pain, whole-body stiffness and chronic pain really complicate my human ability to enjoy normal daily life.

The point of this experiment Is taking an antidepressant, mostly 40mg citalopram / 20mg escotalopram or 20mg vortioxetine (for that empty sad feeling ),

modafinil 200-400mg and caffeine to add some energy to raised serotonine caused by antidepressant.
So basically i increased serotonine, dopamine, noradrenaline, orexine And of course other less famous neurotransmitters which are involved in focus, wakefulness and mood improvement.

Next ingredient is tramadol/dihydrocodeine/oxycodone (simply opioids) to increase endorphine release and for further increase in dopamine. This goes fine with antidepressants because together they work wonders for my depression and chronic pain. And opioid caused slight noddylike lethargy is not a problem with modafinil + caffeine involved.
This treatment makes me less sad, much more comfortable cause of pain being relieved And motivated to do something like walking a dog, reading books, cooking etc. Great improvement for my daily life.
Last things i use are levetiracetam and some benzos to avoid seizures (i have epylepsy) and to make my body less tense.

Using combination of these drugs in normal doses made huge improvement for my mental and also physical health. It made me functional and able to spread positivity to people around me.
But using high doses of these meds combined together Is very addictive and dangerous.

So, the point of my post Is that using certain drugs even if they are addictive can be life changing in a way no single medication or single drug is able to do. U just have to be careful and don't use too big doses because the best treatment Will change into serious addiction.


Last

 

[Dextro .45]

Phenylpiracetam is a general stimulant with dopaminergic properties and is VERY clean, clearheaded, and effective. Nootropics Depo Phenylpiracetam 100mg capsules order online

Studies tested Phenylpiracetam against Methylphenidate (Ritalin) and d-Amphetamine (Dexedrine) with test rats and Phenylpiracetam was chosen over the Ritalin & Dexedrine repetitively

I did an experiment as i am in situation where depression, pain, whole-body stiffness and chronic pain really complicate my human ability to enjoy normal daily life.

The point of this experiment Is taking an antidepressant, mostly 40mg citalopram / 20mg escotalopram or 20mg vortioxetine (for that empty sad feeling ),

modafinil 200-400mg and caffeine to add some energy to raised serotonine caused by antidepressant.
So basically i increased serotonine, dopamine, noradrenaline, orexine And of course other less famous neurotransmitters which are involved in focus, wakefulness and mood improvement.

Next ingredient is tramadol/dihydrocodeine/oxycodone (simply opioids) to increase endorphine release and for further increase in dopamine. This goes fine with antidepressants because together they work wonders for my depression and chronic pain. And opioid caused slight noddylike lethargy is not a problem with modafinil + caffeine involved.
This treatment makes me less sad, much more comfortable cause of pain being relieved And motivated to do something like walking a dog, reading books, cooking etc. Great improvement for my daily life.
Last things i use are levetiracetam and some benzos to avoid seizures (i have epylepsy) and to make my body less tense.

Using combination of these drugs in normal doses made huge improvement for my mental and also physical health. It made me functional and able to spread positivity to people around me.
But using high doses of these meds combined together Is very addictive and dangerous.

So, the point of my post Is that using certain drugs even if they are addictive can be life changing in a way no single medication or single drug is able to do. U just have to be careful and don't use too big doses because the best treatment Will change into serious addiction.


Last

Phenylpiracetam is banned from the olympics as a performance enhancing drug. It has genuine dopaminergic properties and is a safe and effective