Methylphenidate (Ritalin, Concerta, Metadate, and Methylin) is closely related to the amphetamines and has similar benefits and side effects. Thus, the decision whether to treat cataplexy with a medication depends on how much impact the cataplexy has on an individual’s life and the expected risks of the medications. • Overall, modafinil produces fewer side effects than some of the other wake-promoting medications, but it can cause headache, nausea, and occasionally insomnia. Some people with narcolepsy also have sleep apnea, and there is controversy as how to get dr. to prescribe provigil to whether sodium oxybate can worsen this condition. It is often quite sedating, so individuals should determine whether they can wake adequately if a child needs attention, a smoke alarm sounds, or they need to go to the bathroom during the night. provigil bruxism People using high doses recreationally can become addicted and dependent, requiring higher doses of the drug and exhibiting signs of withdrawal when the drug is discontinued. , • Even when the dose of sodium oxybate is held steady, it can take up to eight weeks for improvements in cataplexy to become fully apparent. References • The abrupt cessation of therapeutically administered sodium oxybate (GHB) does nuvigil vs provigil ms not cause withdrawal symptoms. Antidepressants mainly suppress cataplexy by increasing levels of norepinephrine and serotonin in the brain. Sodium oxybate can produce a variety of side effects, including headache, nausea, or dizziness, especially if provigil detection the person taking it wakes one to two hours provigil bruxism after use. However, there is no evidence that brain injury occurs in narcolepsy patients who take amphetamines at moderate doses on a regular basis. For most people this is not a concern, but the medication should be taken only in the way your doctor recommends. • At very high doses, such as those used by people who abuse methamphetamine, amphetamines can injure the brain. • Venlafaxine (Effexor) is one of the most commonly used medications for reducing cataplexy because the dosing is convenient, side effects are uncommon, and it is often very effective. Many people find it most convenient to take the longer-acting form in the morning and sometimes abruptly stopping provigil again at midday, with a shorter-acting pill prior to times when sleepiness is worst, such as in the late morning or afternoon. These two doses produce deep buy provigil amazon sleep through much of the night, and after several weeks of regular use, sodium oxybate usually improves daytime sleepiness and cataplexy. Amphetamines can disrupt sleep, cause headaches or anxiety, and, rarely, trigger altered thinking such as mania or psychosis. Further evidence supporting the use of sodium oxybate for the treatment of cataplexy: a double-blind, placebo-controlled study in 228 patients. How alertness and cataplexy improve over time is unknown; it is probably not a consequence of deeper sleep, as other sedating medications do not improve the symptoms of narcolepsy. • A 12-month, open-label, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. • Sudden discontinuation of any of these antidepressant medications can produce rebound cataplexy: severe cataplexy that can last provigil dementia several hours. • In contrast to the antidepressants, sudden discontinuation of sodium oxybate does not produce rebound cataplexy. • A large variety of amphetamines are clinically available, and individuals may respond better to one than to another. • Most amphetamines are available in short-acting forms that improve alertness for three to four hours, and longer-acting forms that last for six to eight hours. The greatest improvements occur when medications have been optimized, behavioral strategies are used thoughtfully, and any additional sleep disorders are brought under control. • Doctors generally start sodium oxybate at a low to moderate dose, and then slowly increase the dose over a period of several weeks, if needed. In contrast to the provigil generic prices antidepressants, sodium oxybate strongly reduces cataplexy, but it does not reduce provigil 20 mg REM sleep.