MS and narcolepsy

[plkp]

Dx with ms in july of 2010. I am having trouble staying awake at work. It's gotten to the point I'm afraid of losing my job. My primary care provider wants to start me on some meds used for ADD. Has anyone on here had this type of problem, and how did you handle it?

[immisceo]

Narcolepsy is considered to be a distinct medical condition. It is possible to have both, but I don't think that's what your discussing. Most medications for ADD or ADHD are stimulants of one sort or another, and prescriptions for stimulants are often used to combat MS-related fatigue. I believe several of our community members use Provigil in this capacity. I don't have fatigue to that extent, so coffee usually does the trick. Hopefully folks with personal experience will chime in.

[Joiedecour]

Modafinil is a drug for narcolepsy prescribed for MS fatigue. I am interested in knowing if you have narcolepsy or MS fatigue. Recently I have been experiencing extreme fatigue for which my neuro prescribed amantadine. It is working. The next step would be modafinil but I was told that many of their patients use Ritalin or adderall. Both are addictive so they start with the ones with least side effects first. So far amantadine has been helping get me through my day without crashing. Might be worth asking about it.

[plkp]

My neurologist gave me samples of Nuvigil 150mg, they were to strong couldn't sleep for a couple nights. I cut them in half and they seem to work better for me.  My insurance denied paying for them, so my health care provider perscribed me Provigil, insurance denied that one also.  Going back today to discuss another option.  Ritalin was suggested, so we might try that one.  I'm just tired of being tired!

[mikeysmom1995]

I'm very surprised that your.doc would want to start u out on such strong, and addictive meds before trying the alternatives first. ADD meds should be the drugs of last resort.
I just started taking Provigil for fatigue and so far so good.
I would inquire about less addictive alternatives first.
Best of luck.
Regards, barb

[plkp]

It's my insurance company ( blue cross and blue shield ) that wants me to take the ADD meds. Apparently they are cheaper than Provigil. We are still trying to find a way to get the provigil.
I'm afraid, if I don't stop dozing off at my desk I will lose my job.

[RB99]

I sometimes fall asleep at work and suffer from fatigue. I don't take anything for it partly because they don't like prescribing for it as they don't think any of the drugs work effectively. ( I am in Ireland) They told me to do more exercise, so I did and that helps somewhat, but what really helped was working form home 2 days a week and being able to take a nap during the day, or after work when I get home. I literally would be falling asleep whilst talking to someone and would slur my words. I hope you find something that works and if you do please let us know!

take care
x

[jensequitur]

Before I was diagnosed I would get the worst fatigue. It always happened around 3:30 pm. It was so bad that I would be falling asleep at my desk. I would try to keep my eyes open, and they would roll back in my head.

I eventually started going to the bathroom and catching a very few zzzzzs in the stall. I found a way to balance my chin on my hands. If I could actually fall asleep for a few seconds, it brought me out of that fatigue loop and I was able to stay awake.

Personally I think that medication is not the answer for fatigue. The best remedy is actually just to take a nap. If you have a problem with your employer, you can get a note from your neurologist. If I'm really pooped, I can go into the break room and fall asleep in one of the chairs. (We have one of the old office chairs with a high back in there - I've been able to sleep for a good hour, even with the ice machine going.)

Sleep also helps heal neurological damage. It's your brain's way of saying, hey, go offline, time for a reboot.

[Joiedecour]

So what did you decide to do? I wanted to add to this discussion that when naps didn't cut it, and when I napped and still dragged, I did start amantadine, and a few weeks in now I can say it makes a difference. Not a huge difference but the difference between being unproductive and productive. When I chatted with the nurse she told me the clinic had many patients on stronger, more addictive meds like Ritalin and Adderall, and that it was just simply a case of to what extent fatigue was impacting their lives. For me, that's the point. Fatigue was interfering with my life in a major way, and when the naps and reducing workload didn't work, I was willing to try amantadine. But I know that particular drug doesn't work for all.

[SarahL2491]

I took Provigil with no success, then neuro moved to Adderall and tried two different strengths, both just made me sleepier.  He is leaving me to just "naps" for the winter, since the heat seems to intensify my fatigue, and wants to try amantadine in the spring, when the heat and humidity return.

It's different for each of us, and you just have to find the one that works for you.  Fatigue is one of our number 1 pests.