Melatonin experiments

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Last night I came across a pop-science video about the link between ADHD and sleep disruptions, and it raised an interesting point: many of the ADHD symptoms are also symptoms of sleep deprivation, and the sleep disruption aspects of ADHD might actually be the underlying cause of many of them.

I’ve always had great difficulty with sleep, with trouble falling asleep at night but then being incredibly fatigued during the day. And I can’t help but wonder how many of my other issues are just plain due to crappy sleep. Maybe my chronic pain isn’t because of an underlying neurological cause, but is because I’m not properly sleeping and healing at night?

I’ve had three sleep studies at this point. The first in-home study vaguely diagnosed me with obstructive apnea, and is why I got a CPAP machine. The CPAP machine didn’t help at all, so a second study to rule out narcolepsy happened. Then the third one verified that CPAP doesn’t actually make a difference for me.

Anyway, one of the things mentioned in the video is that there’s been some success with treating some forms of childhood ADHD with time-release melatonin. So starting tonight I’m going to try taking time-release melatonin and see if that helps me any.

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ugh meds, ugh work

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I’ve been on guanfacine for about a month now, and I still haven’t stopped feeling drowsy and tired all day, to the point that I’ll often just fall asleep in the middle of things. Even when I’m doing things like grocery shopping I’ll suddenly feel really tired and need to take a couple moments to brace myself. It’s almost like it’s causing narcolepsy or something.

Last week I talked about this with my psychiatrist and we decided to try combination therapy with strattera, a stimulant-based med, since my ADHD responded well to the Adderall (aside from my blood pressure spiking badly).

So far, it hasn’t been helping at all. I’m getting the panic and anxiety from stimulants, while also being drowsy all day. What’s even worse is I’m also getting frequent muscle spasms, which is apparently a common reaction to some ADHD meds. And ironically, the treatment for that? Guanfacine.

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Guanfacine and naltrexone updates

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I’ve been on low-dose naltrexone for a whole month now, and I don’t think it’s really helping with my pain.

And I’ve been on guanfacine for two weeks, and while I’ve noticed a slight improvement in my focus (and a general lowering of my blood pressure, which is of course to be expected), holy cow am I drowsy all the time. Like, to the point of nodding off while sitting still or whatever. I hear that this effect goes away after a couple weeks, and I really hope it does soon, because even though I’m generally getting a full night’s sleep every night I still wake up exhausted and end up taking little mini-naps throughout the day. Heck, even while going grocery shopping I occasionally feel like I’m going to fall over.

On the plus side, caffeine doesn’t give me as big of a panic attack now (although I still feel a bit of one) so that’s at least filling in the gaps while I try to stay awake at work.

Bonus thing: yesterday I tried coating my glasses with soapy water (based on seeing an article in Glamour) and it actually works pretty well! The article suggests thoroughly cleaning them, but I just mixed a little bit of liquid hand soap with a glass of water and dunked my glasses in them and let them drain. It’d probably also work pretty well to dilute some dish soap and swap it on with a cotton swab or something.

Miscellaneous goings-on

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I’ve been on guanfacine for a few days and so far I’m not noticing that my focus has changed any, but on the plus side my blood pressure is great now. So, that’s good.

I don’t know if it’s from the naltrexone or the guanfacine but my dreams have been pretty vivid and weird, but usually in a good way. Unlike when I was on the Wellbutrin and my dreams were vivid and stressful.

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So much for Wellbutrin

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Yesterday I was feeling pretty off, in a “wow I think my blood pressure is spiking again” way. And I happened to have an appointment at the pain clinic, and they measured my blood pressure at 160/90, which is, you know, Pretty High. At the time I chalked it up to having walked over there in a hurry, but throughout the afternoon and evening I kept measuring it and it remained that high.

And then all night long I had a hell of a time sleeping. I only got around 3 hours of sleep total; most of the time I was just lying awake, blood pounding in my ears, feeling like I was going to die. At 3 AM I also checked my blood pressure again and it was 160/100. Yikes.

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Current state of affairs

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I’ve been on Wellbutrin for a couple of weeks now and the effect has been interesting. I’m definitely finding it easier to focus on things like chores (and heck, my kitchen is the cleanest it’s been since the remodel got finished, and my dining room is well on its way to not being a disaster), but on the other hand it’s disrupting my sleep a lot and I end up feeling tired throughout the day. My dreams have also been way more intense.

Right now I’m feeling sick with my usual winter sinus crap, so I’m a bit wobbly and a lot nauseous.

Between the Wellbutrin and playing DDR my pain levels are a bit lower but still not amazing, and I’m still finding it easy to hit a fibro wall™. Tomorrow I have a followup with my pain doctor to try to finally get on low-dose naltrexone. I also have the next two weeks off from work and hopefully I won’t end up just working too hard on personal projects instead. (That said, I have a couple of creative output gift swaps with deadlines coming up that I really should start on at some point.)

Anwyay I guess I don’t have a lot else to say. Oh well.

Updates

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Had an appointment with my psychiatrist today. Turns out I was supposed to get a drug screen some time ago, oops. But I’m not that interested in stimulant-based meds anyway. For now we’re going to try Wellbutrin, which is I think what we were talking about last time anyway and it doesn’t need a drug screening. So that starts tomorrow morning.

DDR pad arrives sometime tomorrow as well. Just in time, too, the pad I’m borrowing from Spud has decided that the down button doesn’t really need to work right.

I hope all this stuff helps me to get motivated at work, because holy crap I am having a hard time finding the energy to actually, y'know, work.

Pain management and ADHD medication

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I seem to be stuck in an annoying situation.

Short recap: I have both ADHD and fibromyalgia. These two conditions tend to have a lot of overlap (they are both thought to essentially be dopamine dysregulation issues), and both of them have a “let’s try different things out” treatment regimen.

Because of ADHD I have great difficulty in focusing on my work.

Because of fibromyalgia I have great difficulty in focusing on anything other than pain.

The medications which help me with fibromyalgia preclude me from being prescribed medications which help me with ADHD.

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Nortriptyline updates

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I’ve been at 30mg of nortriptyline for 6 days now, and I’m trying to figure out if this is how I felt on it before. Going through my nortriptyline tag I see that I actually was up to 40mg on my initial tapering, and after sitting there for a while I decided it wasn’t doing enough for my pain and that’s when I tapered down to 20. In one entry I complained that it wasn’t helping my sleep at all, and how it was making me constantly dizzy and tired and headachey.

This time around it’s definitely helping my sleep, and I’m not dizzy, although I am quite tired (despite actually getting a full 8 hours of sleep every night, for once!) and today I had a headache all day. Also plenty of nausea. But at least I got a nice long walk in.

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ADHD and fibromyalgia and nortriptyline

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Yesterday I finally met with a new psychiatrist (having lost access to my previous one back in, oh, March), with the intention of figuring out what to try next in terms of ADHD medication.

As a recap, the first medication I tried (Concerta) just made me irritable and gave me tachycardia, and the second one I tried (Adderall) worked really well for my brain but also made my blood pressure skyrocket.

Anyway, on Tuesday I had also met with my pain doc and the decision we came to was that we should try increasing the nortriptyline again, since 20mg is doing something but not enough, and I couldn’t really remember why I felt like 30 was too much. He wants me to target 40-50mg for my eventual long-term dosage.

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