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July 6, 2006

On Beyond Ritalin
Posted by Teresa at 03:52 PM *

On Beyond Ritalin.

Comments on On Beyond Ritalin:
#1 ::: Writerious ::: (view all by) ::: July 06, 2006, 04:18 PM:

Yes, psychoactive drugs are a pain because people process them in such individual ways that finding the right kind and the right balance is difficult. But for those who need them and do get benefit from them, they can be miraculous.

I've worked with ADD adults who praise the stuff, and wish they'd been diagnosed years earlier so that the might have done better in school. I've worked with kids who were decidedly ADD, and boy oh boy, you could sure tell when the parents decided they'd "experiment" and see if Junior would "do okay" off the medication. Or worse, parents who realized the street value of the stuff and sold it instead of giving it to Junior.

But I also hope we're getting well past the recent days of over-diagnosis. Some kids are just wiggle worms, and all kids need to get up and move around during the day.

#2 ::: Bill Hooker ::: (view all by) ::: July 06, 2006, 04:38 PM:

If the point of that monstrosity was that it's harder than it looks to write verse that rhymes and scans worth a damn, they'd made it thoroughly after about two stanzas. If there was another point in there, something about over-reliance on prescription drugs or something, it pretty much eluded me.

#3 ::: Annalee Flower Horne ::: (view all by) ::: July 06, 2006, 04:39 PM:

lol, thanks for the laugh.

That reminds me of a really funny video I found a while ago... its a parody of the zoloft ads. Gets me every time:

http://www.astonishedhead.com/images/OVOID_123.swf

#4 ::: Tim Kyger ::: (view all by) ::: July 06, 2006, 05:27 PM:

I invite those two good doctors to come over to my house and stay for a day. They can take care of my two children, both with ADHD. They can take care of them without them having had their meds. Kathy and I, in the meantime, will go off and take a well-deserved day off somewhere else.

When we return, both those doctors will be drooling idiots.

#5 ::: Michelle ::: (view all by) ::: July 06, 2006, 05:32 PM:

hrm, those are the same symptoms for a bum thyroid...from the weight gain and acne to the depression, mood swings and plain craziness.

and that just takes one little pill.

#6 ::: Scorpio ::: (view all by) ::: July 06, 2006, 05:57 PM:

"“Came the SSRI’s in the past 15 years
As the answer to all (or a menace to fear?)
For ADD’s core, they don’t do very much
But they help irritation, depression and such
So if you are angry, distracted, and sad
Try CeLuvoPaxiProZolo-Kazad”

Yeah, but have you ever tried *kicking* one of those monsters? I stopped taking one two weeks ago. First the toothaches (cause by the pills) stopped; then the hip and knee pain (caused by the pills) stopped; then the irritability stopped; and then the brain-rattling started, and it goes on although it has been two weeks since I took a pill.

Avoid SSRI's if you can. It is really, really disconcerting to feel your cerebral hemispheres rattle in your skull when you turn your head, and the dizzy spells that go with it are no treat, either.

#7 ::: Avery ::: (view all by) ::: July 06, 2006, 07:12 PM:

I'd like them to come over to my house and help my find my car keys and the little RFID thing I need to get into the building every morning. Oh, and if they could do this development report I need to finish.

#8 ::: pat greene ::: (view all by) ::: July 06, 2006, 08:24 PM:

Ha ha. Very funny. Or not.

Psych meds keep me sane and alive. On the other hand, my brother views all psychiatric medicines as being evil, and has talked his wife into never taking them, and she is so depressed she is housebound.

#9 ::: David Manheim ::: (view all by) ::: July 06, 2006, 08:45 PM:

Oh the drugs I've been on,
congratulations to me,
I was off to great places;
the ward for psychiatry.

I had some prescripted,
and some I just grew,
Oh there were lots of drugs,
I sure could name a few.

On SSRI's I went up,
After dexadrine I fell down,
I had joined the high flyers,
who buy this illegally downtown.

Somehow, Someday I'll escape,
All those side-effects, and stop straying,
I'll find those unmedicated places,
it won't feel (in my head) like boom bands are playing.

With flip flapping between drugs,
hopefully I'll stay steady,
Ready for anything under the sky,
I'm the kind of guy that will be ready!

Oh the places I'll go, there are pills to be taken,
there are drugs to be scored, and concentration I need,
All the magical things done to me by those pills,
Will make cured completely, me of my ills,
Cured! I'll be medicated out of my ADD,
with the whole world watching me on TV.

#10 ::: Anna Feruglio Dal Dan ::: (view all by) ::: July 06, 2006, 08:55 PM:

Michelle, people always say that to me. First I mentioned it to my GP. He prescribed blood tests. Results: no bum thyroid. People kept on telling me that my symptoms are the same as hypothyroidism, so I went to a different doctor and told him again. He prescribed different tests, including hormone titration.

Result: no, some people REALLY ARE DEPRESSED.

And Scorpio, I do hope you have been going off them slowly. Kicking them all of a sudden is a seriously bad idea.

#11 ::: Brenda Kalt ::: (view all by) ::: July 06, 2006, 09:16 PM:

Sane and alive. Amen.

#12 ::: xeger ::: (view all by) ::: July 06, 2006, 09:36 PM:

Better living through chemistry. I'll toast to that.

#13 ::: Patrick Nielsen Hayden ::: (view all by) ::: July 06, 2006, 10:10 PM:

Experienced Making Light readers will have deduced that Teresa meant to post that as a Particle, and only accidentally made it into a full-fledged Making Light post. But we only noticed once there were a substantial number of comments.

In fact I sent her that link this afternoon; I came across it while reading a bunch of pages about adult ADHD. It amused me, despite the bad scansion and worse rhymes. I sympathize with the doughty, on-to-the-next-diagnosis attitude it seemed to me to encompass.

Needless to say, you'll never hear anyone at Casa NH suggesting the ADHD or related syndromes are somehow all in the imagination. We suspect we're still in the leeches-and-laudanum period of understanding this stuff, but we're firmly in favor of Better Living Through Better Brain Chemistry.

#14 ::: Brooks Moses ::: (view all by) ::: July 07, 2006, 12:50 AM:

Anna, for what it's worth, I seem to recall that there is some research out that suggests that, when a person (and I believe this was a study that was looking at women, not just men -- and I think it may have been specifically women) has many of the symptoms of hypothyroidism, that treating them for that is sometimes an effective treatment even when their blood hormone levels are in the "normal" range.

That said, there are certainly people who "really are depressed" for reasons other than hypothyroidism. (And, of course, the people whose depression comes from hypothyroidism really are depressed, too. Just ask my wife, who went through that. It's no less real just because it's mostly treatable hormonally.)

#15 ::: Dave Bell ::: (view all by) ::: July 07, 2006, 07:38 AM:

I think a big part of the problem is that brain function is entangled with the sense of who and what we are, so that drugs which change it are a chellenge to our sense of identity.

That thought leads off in all sorts of different directions. There are drugs which, even for apparently healthy people, boost mental abilities in ways that increase effective intelligence. If you're a certain kind of person, or an aristocratic bent, you don't have to use such a drug to feel threatened by it.

And there's a closely-related viewpoint that regards people with treatable chronic medical problems as somebow unfairly advantaged when they get their drugs.

According to an article in New Scientist (May 13), one of these IQ boosters is modafinil, originally intended as a prescription-only treatment for narcolepsy and other sleep disorders.

It's not so much that it is impious to modify the you which God made (or there wouldn't be so much expensive plastic surgery, and similar diseases of the rich), as an attempt to rig the market for beauty and intellect.

(And look at how they emphasise beauty, which can be manipulated more easily.)

We're almost in Marching Morons territory, and I wonder who the current pseudo-aristrocracy would cope with a world in which they had to work hard at keeping it running, however perfectly its other inhabitants reflected their desires.


#16 ::: Jen Roth ::: (view all by) ::: July 07, 2006, 10:30 AM:

Scorpio, when last I went off Zoloft, I had to taper down my dosage over the course of three months to avoid the symptoms you describe. You're right, the withdrawal can be very nasty. On the other hand, tapering down that slowly *did* work.

#17 ::: Michelle ::: (view all by) ::: July 07, 2006, 11:33 AM:

Michelle, people always say that to me. First I mentioned it to my GP. He prescribed blood tests. Results: no bum thyroid. People kept on telling me that my symptoms are the same as hypothyroidism, so I went to a different doctor and told him again. He prescribed different tests, including hormone titration.

Result: no, some people REALLY ARE DEPRESSED.

I totally agree that some are and it's great that you were tested first...thyroid disorders go undiagnosed for over 15 years on average while docs are trying to deal with the symptoms which mimic more life threatening dieases such as depression and cancer. yes, I consider depression life threatening. I have extreme hypothyroidism. Before it was diagnosed I had been through rounds of drugs for psychotherapy, cancer tests, skin creams, diets etc...I thought I was going insane. Now I take synthroid every day, and unlike prosac or ritalin (which I have been on) things are clear without the numbness. There are side effects. Lossing weight is impossible. I have to work out 5 days a week to maintain 189lbs, I'm strong but I look like a walking funhouse mirror svelt from the front, fat and flabby from the side. There are unafordable options for that so maybe when I win the lottery.

Besides that little complaint, it's nice having a clear head and being able to enjoy life. For those that deal with add, adhd and/or depression that is not thyroid related I hope that one day they can get a drug that works more like a freedom fighter and less like a gate keeper. That's from my own experience.

#18 ::: mary ::: (view all by) ::: July 07, 2006, 01:55 PM:

At thirty-five I couldn’t sleep;
I’d lay awake in bed and weep.
I’d drive along the river levee
And gauge the speed of my old chevy*
And wonder where the drop was deep
Enough to put me fast asleep.

Throughout the days at home my son,
Then two years old—not so much fun—
Followed me and asked me why
The birds could walk and also fly.
And also: What’s that? Is it pretty?
Do you like it? Lord have pity…

He wanted value judgments, see,
I almost lost my sanity.
Visiting the doc one day,
We started in the usual way.
“How are you?” “I’m fine,” I lied,
and then sat in the chair and cried.

Finally, I told him, “See,
I calculated the trajectory
To get out where the river’s deep.
The problem is, I just can’t sleep.”
No problem with the diagnosis:
He didn’t think it was psychosis.

Final verse. (The whole crowd cheers.)
((It could be worse, after beers.))
The moral of this ode sublime:
We all need drugs from time to time.
Oh little pills that set me straight,
You kept me from a tragic fate.

*actually at that time I was driving a Honda—sorry, didn’t rhyme.

#19 ::: BSD ::: (view all by) ::: July 07, 2006, 02:23 PM:

I am a firm believer in Better Living Through Neurochemistry. I love my ritalin, even if I only spot-use it nowadays (I only get the screaming paranoia if I take it regularly rather than "as needed")

#20 ::: Molly Black ::: (view all by) ::: July 07, 2006, 04:27 PM:

I definitely believe in better living through Neurochemistry. However I'm one of those people that went through over a dozen different medications before we found out that my depression wasn't the issue: My anxiety was.

Apparently now that I'm on the highest dose of Xanax (and yes, it's for life, I know that) things aren't all wonderful and fantastic. But I no longer want to die and cause fights with my loving and incredibly patient husband all the time. Being bi-polar and ADHD and having PTSD and an anxiety issue and several disabling conditions (such as hypothyroid, fibromyalgia, losing my gall bladder and also my full reproductive system) made it a long slow and hard process. So I understand both the travesty of psychiatry (which I balance with my psychologist for actual therapy) and the good that can eventually come out of it if it's necessary.

Plus the Fibromyalgia doesn't help. Yup, I'm a wreck, but I'm personally glad for the drugs the doctors give me. Without them I wouldn't be sitting up and able to type this for as long as I have. It would have taken more like half an hour.

#21 ::: Paula Helm Murray ::: (view all by) ::: July 07, 2006, 09:53 PM:

I've had a craptastic week. And I was really beating myself up for it and I remembered, 'you have a prescription for Xanax and this is what it's for." (anxiety, my boss has lost her mind and right now I really really need to stay employed.)

They're teensy doses, but they soothe the anxiety without making me very sleepy. which is good.

Scorpio, take care of yourself, I'm counting on you at least riding shotgun to worldcon.

#22 ::: Jon H ::: (view all by) ::: July 07, 2006, 10:23 PM:

Please forgive the tangent, my perplexity commands that I ask:

What in the heck is a mortician's twitch?

The link leads to an item in a Christie's auction of medical and scientific items. The item in question is "A [?]19th-Century mortician's twitch, a small turtle with moving limbs in a glazed turned ivory case with handle to the underside -- 2.8cm. (1.1./8in.) dia. "

I am mystified.

#23 ::: Lori Coulson ::: (view all by) ::: July 07, 2006, 10:30 PM:

Molly: Ah, another fibromyalgia sufferer! It took me seven years to get that correctly diagnosed.

I don't know how many times I heard "it's all in your head" starting in 1979 (the first doc prescribed codeine and Valium). Finally, in 1986 I had a flare-up that presented like an attack of rheumatoid arthritis...

After letting my internist try to treat that for 6 months and having adverse reactions to every drug he prescribed, I gave up and went to a rheumatologist. He took a history, looked me over, poked a few places, then said, "I'm not certain you have RA, but I'm sure you have fibromyalgia."

He prescribed Flexeril -- and I was able to sleep again. He had to up the dose after a while, but it's still working. I know I'd be on the warpath if the FDA ever tried to ban it.

#24 ::: Marilee ::: (view all by) ::: July 08, 2006, 01:41 AM:

Jon H, I'm guessing it's an embalmed turtle that the mortician made for fun.

#25 ::: eric ::: (view all by) ::: July 08, 2006, 01:54 AM:

Only tangentially related, I've seen a few articles lately starting to talk about liver toxicity from Acetaminophen in a manner that is not exactly reassuring. I already knew that it was one of the more dangerous things for a kid to get into in whole bottle amounts, but the amounts now getting attention are the listed max doses for Extra Strength.

This week in the local paper there was an article with:

In the study, 106 participants took four grams of Tylenol -- equivalent to eight extra-strength Tylenol tablets -- each day for two weeks. Some took Tylenol alone and some took it with an opioid painkiller. Dummy pills were given to 39 others.


There were no alarming liver test results among the people who took the placebos. But nearly 40 percent of people in all the other groups had abnormal test results that would signal liver damage
and
The maker of Tylenol, McNeil Consumer & Specialty Pharmaceuticals, said its own research found much lower rates of abnormal liver results.
finally:
Overdoses of acetaminophen are the leading cause of acute liver failure.

I'm guessing that in the next 5-10 years, there is going to be a legal circus surrounding acetaminophen and especially the many meds that contain acetaminophen as one of several ingredients, since it's so easy to take them without realizing exactly what they contain.


#26 ::: Julia Jones ::: (view all by) ::: July 08, 2006, 11:56 AM:

eric: the legal circus is already happening in the UK, although being the UK it's more along the lines of imposing much tighter controls on the sale of potentially toxic quantities of paracetamol. If I recall correctly, it started some years ago after several well-publicised cases of accidental overdose brought it to public attention just how easy it is to kill yourself by accident just by taking a painkiller *and* a "cold cure" *and* something else without reading the labels.

I am extremely unhappy about the US insistence on packaging mild opiates with paracetamol/acetaminophen. It's done very deliberately, but given the toxicity of paracetamol it's very easy to take a lethal overdose through accidentally taking too much rather than deliberately taking extra to get high. Aspirin has its own problems, but as someone who is depressive and isn't aspirin sensitive I prefer to have the choice of aspirin as the combination drug, a choice one has in the UK.

#27 ::: Jules ::: (view all by) ::: July 08, 2006, 01:42 PM:

although being the UK it's more along the lines of imposing much tighter controls on the sale of potentially toxic quantities of paracetamol.

Well, yes. Not that they work. Standing at the supermarket queue a few days ago, I overhead the assistant telling a customer, "We can't sell you that many paracetamol. You'll have to keep these in your basket and queue up again to pay separately for them."

And paracetamol being what it is, a large enough dose to do substantial permanent damage (if not kill you) is only a couple of days worth of regular dose -- 10 grams (20 standard strength tablets, where 8 a day is the recommended maximum) is reported as producing severe toxicity in most subjects. For alcoholics, this is reduced to 6 grams (a day and a half's regular dose). The person at the supermarket would (I believe) have been buying at least 48 such tablets (3 packs of 16) to be refused service. A dose of 50 tablets is reportedly fatal in most cases.

(all figures from wikipedia)

I am extremely unhappy about the US insistence on packaging mild opiates with paracetamol/acetaminophen.

It's not as if it isn't common over here, too: e.g. "cocodamol", which is usually 8mg codeine and 500mg paracetamol, and is available without prescription.

#28 ::: Kevin Reid ::: (view all by) ::: July 08, 2006, 09:30 PM:

Jon H:

What in the heck is a mortician's twitch?

The link leads to an item in a Christie's auction of medical and scientific items. The item in question is "A [?]19th-Century mortician's twitch, a small turtle with moving limbs in a glazed turned ivory case with handle to the underside -- 2.8cm. (1.1./8in.) dia. "

From the description in your comment, I'll guess that it's a device for seeing if a body is moving subtly, and therefore alive, by means of loosely suspended parts that can easily be seen to move if their container is moved.

#29 ::: P J Evans ::: (view all by) ::: July 08, 2006, 10:58 PM:

In the study, 106 participants took four grams of Tylenol -- equivalent to eight extra-strength Tylenol tablets -- each day for two weeks.

That's a lot of Tylenol. Maybe they should just say don't use it for more than three days at a time without talking to a doctor. (The label on the bottle I have says don't use for more than 10 days of pain (or 3 days of fever) without talking to a doctor.)

#30 ::: Julia Jones ::: (view all by) ::: July 08, 2006, 11:22 PM:

Jules: At least in the UK you can get co-codeine with aspirin or ibuprofen rather than paracetamol. The last time I checked, in California it was almost impossible to get codeine either alone or in combination with aspirin rather than paracetamol (at least on a dental prescription).

I just bring a couple of packs of Codis and Nurefen Plus back with me every time I visit the UK. Perfectly legal as long it's declared to customs, and I prefer to have the OTC dose level anyway. I'm one of those peculiar people who is both sensitive enough to get the pain-killing effect even in OTC strength, and unable to comprehend what the appeal is in being high.

#31 ::: Marilee ::: (view all by) ::: July 09, 2006, 01:08 AM:

Julia, I take plain codeine (my liver was damaged by a med the doctors tried during the first renal failure, so I can't have acetaminophen) and although it's Schedule 2, you should be able to get it with a scrip. I have to go to a larger Kaiser clinic to get it, our pharmacy doesn't carry it.

#32 ::: Julia Jones ::: (view all by) ::: July 09, 2006, 02:56 AM:

Marilee - if I need prescription strength, it's for dental surgery, and my dentist won't do codeine-only. He said that in theory he could prescribe it, but the amount of hassle it would cause him isn't worth it, and I can't blame him. I know with them it's not just unwillingess to prescribe narcotics at all, because both dentists I see at that practice prescribe co-codeine without hesitation where it's clinically justified, and have given me "just in case" scrips a couple of times where an abscess was forming but they couldn't find it to treat it.

#33 ::: Jon H ::: (view all by) ::: July 09, 2006, 05:59 PM:

Kevin writes: "From the description in your comment, I'll guess that it's a device for seeing if a body is moving subtly, and therefore alive, by means of loosely suspended parts that can easily be seen to move if their container is moved."

I think you've got it!

I was thinking it was intended for determining if the body is still alive, but the only mode of use that came to mind was somehow moving the handle in the back and making the turtle move in "view" of the body.

Obviously, that wouldn't be very effective....

I hadn't thought of it being a passive device with loose-hanging legs.

Thanks!

#34 ::: Lin Daniel ::: (view all by) ::: July 09, 2006, 06:01 PM:

When I came off Paxil, I took three weeks to slowly spread the time between doses. Then I stopped. For a couple of days there, I had the feeling my brain wasn't quite connected to my skull. I'd turn my head....... and then my brain would follow. Very strange feeling.

#35 ::: Margaret Organ-Kean ::: (view all by) ::: July 10, 2006, 09:24 AM:

Kevin is right about the mortician's twitch - according to Christie's specialist in scientific and medical instruments,

"A mortician's twitch was used to see if the corpse was actually dead, it was placed on the body or the coffin"

Yeah, I couldn't resist. I emailed Christie's and asked. I can't figure out why a turtle though.

#36 ::: yuubi ::: (view all by) ::: July 10, 2006, 01:15 PM:

I got some oxycodone/ibuprofen (`Combunox') when I had my wisdom teeth out 2 months ago. The pharmacy didn't have a generic for it, and one doctor hadn't heard of oxycodone with an NSAID but thought it was a good idea, so the stuff may be relatively new.

#37 ::: Laurence ::: (view all by) ::: July 10, 2006, 01:26 PM:

OMG! Sorry to contribute to the topic drift, but I've seen those little turtles with their heads loosely attached, such that the slightest touch will make them move. I always thought they were kind of creepy. Now to discover that they're used to find out if someone is really dead . . . ewww.

Are they always turtles?

#38 ::: glinda ::: (view all by) ::: July 10, 2006, 05:47 PM:

yuubi:

The neurologist I used to see for migraines prescribed vicoprofen (hydrocodone plus ibuprofen) for me about 10 years ago. Alas, I lost "real" insurance and went on Medicaid, and it wasn't covered. I'm now on Medicare, which does cover it, but can't have it because I'm taking max doses of naproxen. (ghods I miss Vioxx, but that's another rant entirely.)

I should check with my pharmacy to see if Medicare covers the hydrocodone plus aspirin, and get myself off the damned does-no-good acetaminophen...

#39 ::: A. J. Luxton ::: (view all by) ::: July 10, 2006, 06:44 PM:

Careful with ibuprofen, too. I think I may have sustained some mild kidney damage taking it for repetitive stress injuries. My skin itched and I passed water too quickly; I went to the doctor and got tested inconclusively; I went off the ibuprofen and my skin stopped itching after a few weeks, and I stopped needing to go to the bathroom all the time.

In our state, they have just made sudafed prescription-only. This is hellishly annoying.

#40 ::: Marilee ::: (view all by) ::: July 10, 2006, 09:14 PM:

glinda, my nephrologist says anybody who ever takes any amount of ibuprofen (or other NSAIDs) has a 2% chance of developing some level of kidney damage. Be careful. Make sure they're checking your BUN & creatinine.

#41 ::: glinda ::: (view all by) ::: July 10, 2006, 10:52 PM:

A.J., Marilee:

Thank you; yes, my doctors have me tested every three to six months, both for liver and kidney stuff (among other things). Much fun (not.)

#42 ::: Meg Thornton ::: (view all by) ::: July 11, 2006, 02:35 AM:

Put me down as another of the "better living through Neurochemistry" set. I have hypothyroidism (200 mcg of Oroxine per day to maintain metabolism) *and* depression. The depression is endogenous, and I've pretty much had it since I started menstruating regularly (age 14, in other words). I may well improve when I go through the menopause, if it's hormonally linked, although at this stage I have at least another 20 years before I get to find out. In the meantime, I'll keep taking the Zoloft.

I was literally amazed at the difference going onto SSRIs made for me. I'm one of the lucky ones - they do what I need them to and don't give me any adverse and discomforting side effects. The main difference I noticed between "before meds" and "after meds" is that in the "after meds" life, I have a lot more energy. Made me realise just how much effort I had to put into coping with depression.

#43 ::: Marilee ::: (view all by) ::: July 11, 2006, 11:35 PM:

glinda, I was at labs every six weeks for a long time and the doctors had just moved me to two months when they moved me back last week because I might have lymphoma. I'm not sure why they're taking so long to get back to me about the PET scan with contrast, unless they're having trouble finding one my size. The local hospital has an MRI my size, but not a PET.

#44 ::: David Goldfarb ::: (view all by) ::: July 12, 2006, 02:29 AM:

Tangent to earlier discussion of acetaminophen: Can anyone recommend a good decongestant? I've started using a CPAP machine (and man, do I realize now that I should have started earlier!). Also, the last couple of weeks I've had a cold -- which has made using the machine difficult, although thankfully not impossible. Still, it would be nice to have a drug for such a situation that doesn't put my liver at risk.

OTC would be nice but is not essential; causing drowsiness is not a problem and might even be a plus.

#45 ::: Fragano Ledgister ::: (view all by) ::: July 12, 2006, 07:53 AM:

David Goldfarb: I use a c-pap myself, and my doctor has forbidden me decongestants. However, she prescribes flonase, which helps. I find that the c-pap has, as a side effect, reduced my once semi-permanent sniffle. You can also use a saline nasal spray to dry up the excessive mucus.

#46 ::: Lori Coulson ::: (view all by) ::: July 12, 2006, 10:39 AM:

David Goldfarb: OTC - Mucinex OR Robitussin Expectorant. The former is a tablet, the latter the liquid form of Guaifenesin.

For me, this is the only decongestant that does not trigger a sinus infection.

#47 ::: TexAnne ::: (view all by) ::: July 12, 2006, 10:49 AM:

Lori beat me to it. Guaifanesin rocks. Don't forget to drink gallons and gallons of liquid with it; it dries out everything, not just the crud.

#48 ::: mary ::: (view all by) ::: July 12, 2006, 11:05 AM:

David--I suffered from chronic congestion for years due to allergies. I tried all the OTC decongestant tablets and none of them worked. I got "bounce back" from most of them, making the congestion worse. Afrin worked but you quickly become dependent on it and gradually build up a resistance to it. Back in April/May I was in Arizona for a couple of weeks (attending my father's death.) One of the docs treating my father took pity on me and wrote me a prescription for Nasonex. It's a nasal spray that contains a steroid. I use it once a day, in the morning. You don't become addicted to it and you don't build up a resistance to it. It took about a week for the affect to kick in fully, but since I started using it I haven't become congested--not once.

#49 ::: Patrick Connors ::: (view all by) ::: July 12, 2006, 12:47 PM:

I'm a CPAP user myself and often use plain old generic Benadryl. However, after reading the rest of the thread so far, I believe I may switch to guaifensin. I am, however, the poster guy for chronic recurring sinus infections - and was for years before I started on CPAP - so anything that dries me out is probably a good thing.

#50 ::: Lori Coulson ::: (view all by) ::: July 12, 2006, 02:35 PM:

Patrick Connors: I use Benadryl on very rare occasions, when I need to abort an oncoming migraine -- but NEVER as a decongestant.

The problem with *any* antihistamine is that it can dry the mucus membranes to the point that it blocks the mucus into the sinuses, and voila, you have the perfect breeding ground for infection.

My doctor warned me not to take any OTC multi-symptom cold remedies for this very reason. I got a massive sinus infection from self-treating with Thera-Flu. (Said infection felt like someone had detonated a grenade in my face...)

Guaifenesin makes mucus more liquid so the body can eliminate it with greater ease. Drinking lots of fluids is recommended. It is very safe, last time I looked it up in the PDR it had no known interactions with other drugs.

#51 ::: Patrick Connors ::: (view all by) ::: July 12, 2006, 06:08 PM:

Lori: Thanks for the tips.

#52 ::: Marilee ::: (view all by) ::: July 12, 2006, 07:54 PM:

Fragano, when I took flonase, I had constant nosebleeds.

#53 ::: Fragano Ledgister ::: (view all by) ::: July 13, 2006, 12:19 PM:

Marilee: Ouch! I get occasional ones.

#54 ::: Loren MacGregor ::: (view all by) ::: July 14, 2006, 06:45 PM:

Hmm hrm hoorn. I had tell me quite seriously yesterday, "You can't have ADD! You're really smart!"

I don't know how well the poeredy works out in the end; I couldn't pay attention that long. I don't think Focalin was mentioned. Wellbutrin was. Paxil. Prozac. More. Less. Stop that one, try this one. Nausea, weight loss (hmm, could they be connected?), temperature spikes, sweating, freezing, jitters, paranoia, distractability, irritability, mood swings, hyperesthesia, headaches -- but I'm sure that with the next increase or decrease in dosage or med change or burnt entrails or engram or something I shall be all right again. I'm ALL RIGHT! Er. Yes.

Actually, I liked the poem. To Ritalin ... and beyond!

Best. Buzz. Whrr.

#55 ::: bryan ::: (view all by) ::: July 21, 2006, 04:48 PM:

on modafinil: I am currently taking adrafinil but not noticing much of anything. is there a difference - the only one I can pick out from the literature should be how fast it works if so I guess modafinil will have no affect on me. Also, can the modafinil effect(if any) be spread further by judicious use of adrafinil?

#56 ::: yeah ::: (view all by) ::: August 16, 2006, 06:08 AM:

im really high on ritalin.
ha ha ha.

really


i
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