#narcolepsy treatment

[thefamilymed]

Buy MODALERT 100 Mg or 200 Mg Tablets Online: Enhance Focus and Wakefulness

MODALERT is a popular nootropic medication used to promote wakefulness, enhance focus, and improve cognitive function. Available in 100 Mg and 200 Mg dosages, MODALERT contains Modafinil, a powerful stimulant prescribed for treating sleep disorders like narcolepsy, obstructive sleep apnea, and shift work sleep disorder. This guide will explore the benefits, uses, and how to buy MODALERT 100 Mg or 200 Mg tablets online, making it an essential tool for those seeking to stay alert and focused throughout the day.

What is MODALERT?

MODALERT is a prescription medication containing Modafinil, a wakefulness-promoting agent that helps individuals stay alert and combat excessive daytime sleepiness. Originally developed to treat narcolepsy and other sleep-related disorders, MODALERT has gained popularity among professionals, students, and shift workers for its off-label use in enhancing cognitive performance and maintaining focus.

How Does MODALERT Work?

MODALERT works by altering the neurotransmitters in the brain, particularly dopamine, to increase wakefulness and alertness. Modafinil, the active ingredient, inhibits the reuptake of dopamine, enhancing its effects on the central nervous system. This action helps reduce fatigue, improve mental acuity, and maintain alertness without the jittery side effects commonly associated with other stimulants.

Uses of MODALERT Tablets

MODALERT is primarily used for:

Narcolepsy: Reduces excessive daytime sleepiness and helps individuals with narcolepsy maintain wakefulness during the day.

Shift Work Sleep Disorder: Assists shift workers in staying alert during irregular working hours.

Obstructive Sleep Apnea: Used alongside other treatments to improve wakefulness in patients with obstructive sleep apnea.

Off-Label Use: Often used off-label to enhance focus, concentration, and cognitive function in demanding work or study environments.

Key Benefits of MODALERT 100 Mg and 200 Mg Tablets

1. Promotes Wakefulness and Reduces Fatigue

MODALERT 200 Mg effectively combats excessive sleepiness, allowing users to remain alert and productive throughout the day, making it ideal for those with demanding schedules.

2. Enhances Cognitive Performance

Many users report improved memory, concentration, and overall cognitive function, making MODALERT popular among students, professionals, and anyone needing to boost mental performance.

3. Long-Lasting Effects

The effects of MODALERT can last up to 12-15 hours, providing extended periods of wakefulness and focus, which is particularly beneficial for shift workers or those facing long study sessions.

How to Use MODALERT 100 Mg and 200 Mg Tablets

Dosage: The recommended starting dose is MODALERT 100 Mg, taken once daily in the morning. For those requiring a stronger effect, MODALERT 200 Mg may be used. Always follow the dosage instructions provided by your healthcare provider.

Administration: Take the tablet with water, with or without food. Avoid taking MODALERT late in the day to prevent interference with your normal sleep schedule.

Precautions: Do not exceed the prescribed dose, as higher amounts can increase the risk of side effects.

Potential Side Effects of MODALERT

While MODALERT is generally well-tolerated, it may cause some side effects, including:

Headache

Nausea

Dizziness

Insomnia

Nervousness

Severe side effects, such as skin reactions, chest pain, or mood changes, are rare but require immediate medical attention. Always consult your healthcare provider if you experience any unusual symptoms or if side effects persist.

Precautions and Warnings

Before using MODALERT, consider the following precautions:

Medical History: Inform your healthcare provider of any history of heart problems, high blood pressure, or mental health conditions.

Avoid Alcohol: Consuming alcohol while taking MODALERT can increase the risk of side effects like dizziness or impaired judgment.

Pregnancy and Breastfeeding: Consult your doctor before using MODALERT if you are pregnant, planning to become pregnant, or breastfeeding.

Who Should Not Take MODALERT?

MODALERT may not be suitable for everyone. Avoid using this product if you:

Have a known allergy to Modafinil or any other ingredients in the medication.

Have a history of heart conditions or uncontrolled high blood pressure.

Are experiencing symptoms of anxiety or severe mental health disorders without consulting a doctor.

Buying MODALERT 100 Mg or 200 Mg Tablets Online in the USA

Purchasing MODALERT tablets online offers a convenient and accessible way to enhance wakefulness and focus. Here’s how to buy MODALERT 100 Mg or 200 Mg tablets online:

1. Choose a Trusted Online Pharmacy

Select a reputable and licensed online pharmacy that sells authentic MODALERT tablets. Check customer reviews, ensure the pharmacy is accredited, and offers secure purchasing options.

2. Check Prescription Requirements

MODALERT is a prescription medication, so a valid prescription from your healthcare provider is required. This ensures the medication is appropriate for your needs and is used safely.

3. Compare Prices and Discounts

Online pharmacies often provide competitive pricing. Compare different websites to find the best deals and consider bulk purchase options for added savings.

4. Secure Payment and Fast Delivery

Opt for pharmacies that offer secure payment methods and fast, discreet shipping. This ensures that your MODALERT tablets arrive quickly and maintain your privacy.

Why Buy MODALERT 100 Mg or 200 Mg Online?

Buying MODALERT online in the USA offers several advantages:

Convenience: Order from the comfort of your home without needing to visit a physical pharmacy.

Privacy: Discreet packaging ensures your purchase remains confidential.

Availability: Access different dosages, including MODALERT 100 Mg and 200 Mg, to match your needs.

Tips for Safe Use of MODALERT Tablets

Follow Prescribed Dosage: Use MODALERT exactly as directed by your healthcare provider to avoid complications or reduced effectiveness.

Monitor Side Effects: Be aware of potential side effects and consult your doctor if severe symptoms occur.

Avoid Late Dosing: Taking MODALERT too late in the day can disrupt your sleep schedule. Stick to morning doses to prevent insomnia.

Frequently Asked Questions About MODALERT

Q: How long does MODALERT last? A: The effects of MODALERT can last up to 12-15 hours, depending on the dose and individual response.

Q: Can I take MODALERT with other stimulants? A: It is advisable to avoid combining MODALERT with other stimulants unless directed by your healthcare provider, as this can increase the risk of side effects.

Q: Is MODALERT safe for long-term use? A: MODALERT can be used long-term under medical supervision, but regular follow-ups with your healthcare provider are recommended to monitor its effectiveness and any potential side effects.

Q: Can I buy MODALERT without a prescription? A: No, MODALERT is a prescription medication, and a valid prescription is required for purchase.

Conclusion

MODALERT 100 Mg and 200 Mg tablets offer a powerful solution for managing excessive daytime sleepiness and enhancing cognitive performance. Whether used to treat sleep disorders like narcolepsy or as an off-label aid for focus and productivity, MODALERT provides reliable, long-lasting wakefulness. Buying MODALERT online provides a convenient way to access this essential medication, allowing you to maintain alertness and stay on top of your daily demands.

Always consult your healthcare provider before starting MODALERT to ensure it is the right medication for your needs. With the proper guidance, MODALERT can help you achieve better focus, stay awake, and improve your overall cognitive function. Order MODALERT 100 Mg or 200 Mg today and take control of your wakefulness and productivity.

[jamoncitofail]

Saiki has narcolepsy because I said so

[anonymusbosch]

oughhhhh medical system.

[myxmodalert]

Armodafinil Dosage

Learn all about Armodafinil dosage in this comprehensive guide. Armodafinil, prescribed for narcolepsy, obstructive sleep apnea, and shift work sleep disorder, typically starts at 150mg/day for adults, with variations based on age and liver/kidney health. Discover its uses, including off-label applications like ADHD and bipolar disorder. Understand how to take it, missed dose protocols, and potential overdose symptoms. Delve into administration guidelines, onset of action, and its half-life. Uncover crucial warnings, precautions, and common side effects. Whether you're considering Armodafinil for its benefits or already using it, this guide has you covered.

[rahulp3]

Narcolepsy Treatment Market Size & Share 2022 - 2028

The Global Narcolepsy Treatment Industry From an expected US$ 4.77 billion in 2022, the market for narcolepsy treatment is projected to grow at a CAGR of 5.7% to reach US$ 6.67 billion by 2028. (2022-2028).In its recently released market intelligence overview, Future Market Insights (FMI) underlines the significant need for narcolepsy treatment in North America. Given the growing inclination towards the use of prescription medicines and adherence to the same on a long-term basis, the narcolepsy treatment landscape in Europe will experience significant revenue growth.

The neurobiology of sleep has advanced significantly over the past few decades, mostly as a result of the proliferation of animal models for investigating the neurological functions of the brain and any potential complexities. This also takes into account the part the brain plays in sleep.

Request a Sample of this Report Now!https://www.futuremarketinsights.com/reports/sample/rep-gb-7641

[drjcsuri]

Managing Narcolepsy: Effective Treatment Approaches

Narcolepsy, a neurological disorder characterized by excessive daytime sleepiness and sudden muscle weakness (cataplexy), can significantly disrupt daily life. Fortunately, several treatments are available.

Medications like stimulants and antidepressants can help manage excessive sleepiness, while sodium oxybate can control cataplexy and improve nighttime sleep. Lifestyle adjustments are also crucial.

[kosaacupuncture]

Narcolepsy Testimonial - KOSA Acupuncture Narcolepsy can easily be treated. It is one of the simple reflections/indications of an unhealthy liver and healthier liver with adequate treatment will treat narcolepsy, automatically and naturally. Learn More: https://saahm.net/narcolepsy-testimonial-kosa-acupuncture/

[onlinemedibazar-1]

The Dos and Don'ts of Buying Adderall 30 mg Online: Your Guide to Safe and Effective Treatment

Adderall 30 mg is a prescription drug used to treat narcolepsy and attention deficit hyperactivity disorder (ADHD). Adderall 30 mg, which contains the active chemicals amphetamine and dextroamphetamine, can help increase attention, concentration, and productivity, making it an excellent medication for people with ADHD and narcolepsy.

While a prescription for Adderall 30 mg from a registered healthcare practitioner is required, many people are resorting to internet pharmacies to get the drug. Online pharmacies provide convenience, privacy, and, in many cases, lower pricing than traditional brick-and-mortar pharmacies.

When purchasing Adderall 30 mg online, however, it is critical to take caution. Some internet pharmacies offer counterfeit, outdated, or tainted medication, and others do not. To safeguard your health's safety, only purchase Adderall 30 mg from a reliable online pharmacy.

You may conduct research and read online reviews to identify a reliable online pharmacy, check for accreditation from organisations such as the National Association of Boards of Pharmacy (NABP), or ask your doctor for advice. Before distributing Adderall 30 mg, ensure that the online pharmacy demands a prescription.

When buying Adderall 30 mg online, be sure to supply the online pharmacy with correct information about your medical history and current prescriptions. This information will assist you in determining whether Adderall 30 mg is safe and effective for you to use.

To summarise, while purchasing Adderall 30 mg online might be a handy alternative, it is critical to exercise caution and only acquire the drug from a reliable online pharmacy. Before using Adderall 30 mg, make sure you have a prescription from a competent healthcare provider.

[wanderingandfound]

Usually when I'm on my period I don't want to eat anything, but this time I've been nearly ravenous since day 1.

[princessnijireiki]

the additional full SCOPE of narcoleptic hypnagogic hallucinations, however? you will be shocked to hear that part is also not a good time

weirdest casualty of long Covid (besides. yk. the Incurable Disability) is in terms of linguistic processing I can truly no longer talk or sing as fast as I used to

not that I was super fast before, but one of the days I was sickest, words actually stopped... meaning anything? like I was at work, I was hitting my DT script, but was pushing through on pure muscle memory phonetically. I could process what I was hearing or reading just fine, but could not talk outside of this heavily repetitive workplace script, which is actually very dystopian now that I think about it. virus hitting the brain means I'm a zombie that can't speak except to say, "HIII :) whatcanIgetstartedferyouthismorning?"

anyway, thought it was just fatigue, but went to my car on my break, watched a trending video of people trying to rap along to Fergalicious at double speed. I could LIP SYNC to it just fine. I tested my theory. but I could NOT get my mouth and voice to work at the same time to actually sing/rap it. even now, tbh, I have to make myself NOT think about it while rapping it to get the words to flow out or I get stuck. like it's truly something in the brain for where you process speech, but not where you process just lyrical phonics like music. I have to consciously make a REAL effort to turn off the "word" part of my brain to be fast again.

I speak perfectly legibly, I can genuinely get up to decently fast normal talking speeds, just not Northeastern fast-fast. but it comes up in music a surprising amount, and it's kind of annoying to have lost as a skill.

[writingseaslugs]

Diasomnia: When You're Sick

The last dorm, and probably the one dorm you don’t want taking care of you…minus Silver. Hope you guys enjoyed this dorm series, I know I did. Now if you’ll excuse me, I need to skedaddle back to work. Also the intro is the same for all parts, so if you’ve read it once, you’ve read it all.

Disclaimer: All characters in this series are aged up. For more information about my version of this world and the type of reader you can expect, please click the “Au Information” below!

Request Information | Masterlist | Au Information

Diasomnia: When You’re Sick

The worst thing to ever happen to you while attending Night Raven College had to be, hands down, getting sick. You were alone in the dorm with only ghosts and Grim to keep you company, and as much as you loved them, they couldn’t take care of you when you became sick. This meant you had to make do and hope that everything was alright. Normally if you were under the weather, you’d just suck it up and go to class so as to not worry anyone. This time however, that wasn’t an option.

You woke up with every muscle in your body feeling sore and aching with even the slightest movement. Your stomach churned something fearsome and you had a runny nose and cough to boot. You had no idea what illness you had fallen to. Having so many symptoms…you could only assume it was the flu or something akin to that.

Still, there was no way you were making it to class like this. So begrudgingly you told Grim you weren’t feeling good and needed to rest, and to go to class and get your homework so you could do it later. The demon cat was grumpy about not having his henchman, but eventually gave in, leaving you alone to rest in your room and hope that whatever you had would go away.

Malleus Draconia

Sebek will be the one mentioning you being sick in passing, noting how Grim had been out of control due to your absence. That’s all Malleus needs to hear before he’s sneaking away from his retainers and going over to your dorm. Thankfully you’re asleep when he appears in your room. He’s standing over your bed, looking over you and placing his large hand over your forehead, noting that it’s warmer than it should be. This prompts him to call up Lilia to inform him of the situation. That’s where the trouble begins.

Malleus has no clue how to care for a human, so it’s already off to a rocky start. Lilia himself knows a little bit, as he had to take care of Silver. The thing with Silver is, other than the narcolepsy, he was always a fairly healthy child…according to Lilia. Really he just always missed the signs that Silver was sick or though it was just a quirk. So now you have two fae over your bed, trying to figure out what’s wrong as you slowly wake up and meet their eyes. You might have a heart attack that devolves into a coughing fit as Malleus is frantically trying to help you.

You’re going to be the one needing to tell them they need to get you the school nurse, and no this is not the time to experiment with treatments. Malleus does so, just because you seemed really adamant, and it’s a good thing. The nurse is nervous with both Lilia and Malleus in the room, but eventually manages to figure out how to take care of you, and even noting that the stuff served in the cafeteria is best for your recovery. Once Lilia knows Malleus has it handled, he leaves. Malleus is doing everything the nurse says, with a little flourish of magic, to make you get better faster. He’s pretty good at reading you as well, so if you move slightly he’s already fluffing your pillow to make it more comfortable, and asking if you’d like more water. He can be very doting normally, and it only increases once you’re sick.

Malleus is going to be relieved, but also not trusting that you’re totally better. Be expecting him to take care of you for a solid week after you’re better, visiting you after classes and bringing you meals, as well as checking your temperature the entire time. It’s not that he doesn’t trust your word, he just doesn’t trust the nurse having the best treatment plan. If he could have it his way, he would’ve brought you to Briar Valley to have one of the doctors there check you over.

Lilia Vanrouge

Lilia had just decided on a whim to visit your dorm the previous night, wanting to see what you were up to. When he found you curled up in bed shaking, clearly still asleep and unaware of your current condition, he decided to just stick around until the morning. After Grim leaves for school, he makes his grand appearance and is asking you what’s wrong. He’s not as concerned as he should be, since he’s seen Silver like this many times and his son has always made a full recovery. Still, he is a little upset to see you in such a state.

He’s not the best, at all, but he kind of knows what to do. He’s taken care of Silver while he’s sick so he assumes he knows what he’s doing…he doesn’t. If you had a fae illness, he'd be perfect. He could treat that almost as well as a normal doctor. A human illness though…well he’s less experienced in that. Still, he’s going to try and do his best before calling the nurse to get whatever medications he needs to hand you. At least he’s willing to call in help once he figures out he doesn’t know how to make you better.

He’s pretty attentive, if not a little teasing while he takes care of you. Again, he knows you’re not dying so he can have a little fun with it. He will try to put some medicine on a spoon and pretend to be a bird as he brings it to your mouth. Show him the most unimpressed look and he’ll break out into a fit of giggles. Just make sure when it comes to meal times, you request being brought something from the cafeteria, letting Lilia know that his seasonings would be too much on your stomach right now. He agrees and brings you proper food, even if he really wants to add something to it.

He’s going to be over the moon when you’re all better, telling you how happy he is and asking if you want to do something fun now. There’s no resting time after being sick, he’s been so good the past few days waiting for you to be better, that now you need to go and do something with him. He’ll be happy if you agree to sit with him in his dorm room and play a few rounds of a video game though. He’s just happy to have you back honestly.

Silver

He’s another one who finds out through Sebek. He’s half asleep when Sebek begins shouting about how you’re missing and Grim is causing havoc and how he won’t stand for it. Silver only hears you’re missing and after asking he finds out you’re sick. He knows just how bad it can be, being sick with nobody to take care of you. Most of the time Lilia didn’t even realize Silver was sick growing up, so he was on his own. This is going to prompt him to go ahead and check in with you.

Silver is actually pretty good at figuring out what to do while you’re sick. Since he normally took care of himself growing up (even if half the time it was sleeping it off) he at least knew the basics. When he noticed you had  a fever he was looking for things to help with it, alongside something for your cough and stomach. In no time he had all the things he needed to take care of you, and was able to do it without much of an issue. Good news for you, he is very quiet while he speaks to you, so you don’t need to worry about his presence causing you more of a headache.

He’s not perfect at it, but he tries to keep a good schedule up to make sure you’ll be okay. He can cook you something to eat as well, that tastes pretty okay so he doesn’t need to worry about running to the cafeteria before it closes. For the most part though, you both are asleep. In fact, sometimes you need to nudge him awake to grab your medicine, which he will sleepily do and mumble something about being sorry about falling asleep like that.

He’s relieved to know you’re all better and that he managed to help you, but he’s exhausted afterwards. Let him crash at your place and possibly also check in on him to make sure he didn’t catch whatever you had going on. Once he’s awake he’ll just smile and say he’s grateful you’re feeling better, but he needs to get going since you’re both behind on school work. He doesn’t need anything in return for helping you, but if he ever does get sick it wouldn’t hurt to help him out. He was good to you, so returning that favor is needed…especially since Lilia might not even notice Silver is sick…again.

Sebek Zigvolt

He’s going to notice right away once he sees Grim by himself, doing whatever he wants. He’s going to say the only reason he’s going to check in on you is because the sooner you’re better, the sooner you can control Grim. After all, Grim being crazy can disturb Malleus and cause distractions, and he would be a horrible retainer if he allowed that to happen. Nobody but Lilia and Silver would comment about how he was more fidgety the moment he found out, and how he bit down on his bottom lip, gnawing it with worry for you.

Sadly he’s another one who’s totally hopeless when it comes to taking care of someone else. More or less…it’s a bit disastrous. He’s too loud and causes headaches by accident, and he hasn’t the faintest idea on human illnesses despite being half human himself. Normally when he got sick, nobody knew if it was a fae or human illness, so he was treated for both. Which doesn’t bode well for you since he’s going to use that to try and treat you initially.

Once he realizes his efforts aren’t making you better, he’s going to call Silver to help out. He doesn't want to bother Lilia for something like this, and Silver is the only human he likes other than you. Thankfully Silver explains what to do and Sebek will do so, but stumbles a bit. At least you’ll slowly be getting better, and he’s not an idiot and will make sure you’re eating good food. He’s determined to make you better, and eventually he forgets all about the horrible excuse he told others, letting his worry take over for you. After letting him know his voice is a bit too loud, he’s going to quiet down for you. 

He’s relieved to know you’re better and for a while he’s significantly less tense, and everyone notices. Lilia is going to be teasing him about it, making poor Sebek go bright red since he’s been outed for caring about a lowly human. When you thank him, he’ll go back to the lie he told everyone else about wanting Grim to be properly handled, but the red on his cheeks is persistent enough to let you know that it’s a horribly fabricated lie…though you would’ve been able to tell either way.

[nyxxxx-onepieces-dragun]

Ace Boyfriend HC

A/N: Js a bunch of fluff and random things that came to mind and its quite long but enjoy ;3 Characters: Ace x Fem!reader mentions of other characters aswell this is a SFW HC but I might make a NSFW one so stay tuned for that!

SFW HC:

When you first started dating Ace would love to give you sweet little love letters. It's sweet yet not too much and they would say something like "your my never ending thought, A."

definitely be prepared for the ultimate princess treatment. Oh your hungry? he's already running to Thatch asking demanding it be made for you right then and there, your feet hurt? no problem he'll just give you a piggyback or carry you bridle style.

I think Ace would be too shy to approach you despite his confident and gentleman appearance he just doesn't want to mess things up so instead he asks you out via letter that went along the lines of "Lets flip a coin. Heads, your mine. Tails I'm yours." he definitely didn't have Marco put it on your desk in your cabin

He loves physical touch it reminds him that he's not alone and your like the calm in his storm keeping him there and anchored.

Also if you want him to melt while you both are chilling in his cabin he's on his stomach sleeping soundly just go over and start massaging his back, bonus points if you dance your fingers over his Whitebeard tattoo, now its a daily thing for you and if you don't do it please do it he'll be all whiny and pouty "Y/nnnn~ please can you rub my back?? I promise just for 15 minutes!" you do it for about three hours hehe

He never ever takes you out on missions with him, afterall he is the 2nd division commander and he takes on some serious missions but when you do arrive on a new island you best bet he is right there at your hip keeping a protective arm draped over you and watching out for anyone who might try anything he's so golden retriever please love this man with all your heart

He's great at being big spoon and being your personal heater but he looooves being little spoon it makes him feel safe and calm in your arms as you run your fingers through his raven locks all that day's stress washes away and he feels content knowing that someone will always be there for him no matter what.

One time Ace tried to set up a romantic little boat date and everything was going great the moon was high up stars twinkling in the sky as you both ate fruit together he was sat across from you and before you knew it his narcolepsy kicked in and his face was now in your chest as he snored soundly.

At first you were confused and a bit flustered since he was so...close but you ended up just running your fingers through his hair waiting for him to awake and when he did...this man got redder than a tomato apologizing over and over again.

But the more frequently it happened the more bolder he got and at some point he would just stay there burying his face more into your chest which in return landed him slaps on the back of his head and scolding while you were a flustered mess "so comfy~ OUCH! it's not my fault I fell asleep!"

this is my first time writing I'll try to get better in the future but Thanks for reading this reposts are welcome just credit me! & <3

[gatorbites-imagines]

Peter B Parker who has a narcoleptic boyfriend?

Narcolepsy= having sudden sleep attacks, that are uncontrollable.

I feel like his spidey sense could probably sense when on is going to happen, so he has Reader cuddle up to him so he (Reader) doesn't fall/ get hurt.

Peter B Parker x Narcoleptic male reader

Headcanons

This is short but I hope you enjoy.

Imagine a universe where you are his Gwen, except you are a man and have your own name, just the same background as Gwen.

You two went to the same school and became close, you discovered he was spiderman back when you were still teens. You were in love with him, but he liked MJ, so you supported him whilst nursing your crush.

He and MJ got divorced, you supported Peter any way you could because you loved him. After the whole thing with the first movie, he came back and had more hope for himself and started bettering himself.

Peter got better and realized his feelings for you. Of course, he wouldn’t confess his love to you immediately, but time passes and things happen and you two become official.

Because you two are close, he’s always known about your narcolepsy. Back when you were teens hed wake you up if you fell asleep during class, or he would let you sleep against his shoulder or on his lap.

He’s always kept an eye on you to make sure you don’t fall asleep at random times, and his senses are in tune with you. That’s because he’s always paying attention to you because he loves you, but also to make sure you don’t fall over or knock into stuff in case you fall asleep.

If you fall asleep around your guy’s shared home, he catches you with his webs or in his arms and pulls you close. Puts you in his lap when he’s working on his spiderman equipment, or lets you sleep with your head in his lap.

He would help you find treatment for it if you wanted it, since he knows that you maybe might not be comfortable with the idea of taking stimulants. Either way, he supports any decision you make.

If you fall asleep when he has to go out as spiderman, he tucks you into bed or puts a blanket over you as you sleep on the couch, kisses your forehead, and swings out to fight crime.

You’d try to stay awake when he’s out as spiderman, because you worry for him and his safety. Some days you are awake when he gets back, and other days you are dead asleep. Peter always appreciates it when he gets home and sees you on the couch waiting for him.

He would pick you up and bring you to bed with him, cuddling you to his chest and just amazed with the fact that he has you in his life.

[heysawbones]

Let's Talk about Xyrem.

Xyrem ("oral sodium oxybate" or the sodium salt of gamma-hydroxybutyrate) is used in the treatment of narcolepsy, as well as (sometimes) idiopathic hypersomnia. Even if you don't have narcolepsy or any related conditions, you may find this run-down interesting. Here's why:

Gamma-hydroxybutyrate is roofies. That's right. Date rape drug. Right here.

The drug is so tightly controlled that there is one pharmacy in all of the United States that can fill it. Doctors must be approved and participate in a special program to even prescribe it.

Nobody really knows how it works in the treatment of narcolepsy.

I was prescribed Xyrem quite some time ago - at this point, nearly a year back. It took six-plus months of insurance, doctor's office, and central pharmacy wrangling to get the drug to my door. The whole time, I wondered: what should I expect from Xyrem? How do I know if it's working? How do I know if it's not working? What's it like? Lists of side effects and contraindications are readily available online, but I couldn't find a single detailed testimonial. This bothered me.

I've been on Xyrem for about a month and a half now. Here's what I can tell you about it.

You have to wake up at night to take a drug that's meant to improve your sleep. Everybody I explained this to found it funny. The standard practice is to split your dose in two - to take one half at bed, and the other half two to four hours later. If you're on Jazz Pharmaceuticals brand Xyrem and not the generic, they send you a tiny little alarm clock with a light on it to facilitate this. I have never needed it.

It takes 3 weeks to titrate up to the "full" dose, which is also the maximum dose. From there, you can titrate back down to a lower dose if you're experiencing unpleasant side effects. I'm in the process of doing this myself.

It doesn't necessarily knock you out. From the way the drug is described, one might get the impression that the moment it kicks in, you're going to be unconscious. I didn't find this to be the case. Your mileage may vary; I don't always fall asleep at all on the first dose, but it does at least get me sleepy enough to fall asleep on the second.

You have an unusual amount of agency in how you take Xyrem. This surprised me, especially given how tightly controlled possession of this drug is. For example, I metabolize Xyrem really fast. If I take it in two doses, I will sleep a maximum of 6 hours. I take the same amount of medicine and split it into three doses instead to compensate for how fast I metabolize it. That way, I'm more likely to sleep about 8 hours. This isn't just accepted, it's encouraged. You can even take a bigger dose first and a smaller one second, or vice-versa. The only hard and fast rule is: do not go over the max dose.

If you take it with alcohol, or within 4-6 hours of alcohol, it could kill you. A lot of drugs warn you not to take them with alcohol. I cannot stress enough that if you have ignored that warning in the past: do not ignore it here. Do not. Xyrem is a powerful CNS depressant. Alcohol is a CNS depressant. It really can kill you.

It works(?) Like many drugs that act on the brain, nobody is really sure how Xyrem works. It doesn't affect the most common (known) cause of narcolepsy (a lack of orexin/hypocretin). It's theorized that the drug acts on GABA receptors in a way that "consolidates" the fragmented sleep architecture of narcolepsy.

Narcolepsy can be thought of as an autoimmune disorder of sleep architecture. The sleep architecture of a narcoleptic is irregular, both within itself and from night to night. People with narcolepsy tend to have less of the deep sleep stages than they should. Narcoleptics also have a high percentage of stage 1 (light) and REM sleep. It's theorized that excessive REM occurs because it is of poor quality/does not serve its intended function, so the brain spams REM in an attempt to compensate. A diagnostic trait of narcolepsy is the ability to enter REM within 8 minutes of falling asleep - if sleep architecture is normal, this does not occur. While not all people with narcolepsy have cataplexy, cataplexy itself is actually REM intrusion into waking life. The narcoleptic brain is that screwed up about REM. Xyrem appears to regulate shifts between sleep stages and reduce the nightly percentage of REM sleep. I used to dream nightly. Subjectively, I do not dream at all on Xyrem.

The only difference between Xyrem and Xywav is salt. A full 9g dose of Xyrem contains 1,640mg of sodium. The maximum sodium intake recommended by the American Heart Association is 2,300mg. One of the few things I saw said about Xyrem prior to taking it was that it was disgustingly salty. It is very, very salty. I don't mind it, though. I've seen it said that Xywav tastes much worse, but I can't attest to that.

Subjective experience

Xyrem comes Priority Air Mail in a sizable cardboard box. An adult with ID must be present to sign for it. The first month's prescription comes with a light-up alarm clock. This kit and all subsequent kits come with:

The medicine, in however many bottles are required

A number of syringes, marked with common doses

A number of pill bottles

You put water in the pill bottles. They tell you to put about 60ml, but as far as I can tell, this is to make the saltiness tolerable. I made a little game of this - I try to put the same amount of water in each pill bottle, gauged by nothing but sound. I've gotten pretty good at this. I have my nightly dose split 3 ways. After adding the drug to the water, I close each bottle and swirl it a bit. I don't know if this actually does anything.

Xyrem works best if you're already tired when you take it. Hilariously, I have ADHD in addition to narcolepsy. Nighttime sleepiness isn't a thing I Do naturally. Consequently, the first dose of Xyrem only puts me to sleep about half the time, and it takes a while even when it does. I know myself well enough to know that if I wait until I'm actually "sleep for the night" tired to take it, I might be up until 3 or 4 AM. Instead, I take the first dose at around 11 PM. Even if it doesn't put me to sleep, it DOES make me sleepy enough that the dose I take 2-3 hours later will definitely work.

I was very careful to set alarms the first week or so of taking Xyrem, but I've never needed them. For reasons that are unclear to me, I always wake up when Xyrem is fully metabolized. Without more Xyrem, there is no urge to go back to sleep. When I've run out of doses for the night, I'm up for the rest of the day. There's no napping.

Some people have pretty nasty side effects with Xyrem. Headache and nausea are the most common. I had both of those, once each. The headache lasted all day but was otherwise unremarkable; the nausea was genuinely awful. The only persistent side effect I have, is tremors.

While I was waiting for Xyrem, my sleep specialist put me on Adderall. Nobody would prescribe this for ADHD, but you'll do it for narcolepsy? Sure, whatever I'll take it. I mention this because I thought it was possible that Adderall was causing tremors. I ran a little experiment: I took Xyrem but no Adderall one day and still had tremors. I took Adderall, but no Xyrem the night before, and the tremors subsided. It's definitely the Xyrem. While this is a known possible side effect, I can't find any information on how or why Xyrem, a CNS depressant, would cause something that seems very much the opposite of a depressed central nervous system. I am currently titrating back down from the max dose in an attempt to see if a lower dose will mitigate the tremors. If that doesn't work, I'm not... entirely sure what to do. Xyrem is a weird drug. It's strange not to dream at all; it's strange to wake up twice a night and still get better sleep than I ever have. Executive function has improved considerably, given that both neurological issues that cause executive dysfunction are being treated. Still: the tremors are, I will not lie, distressing. Not as bad as they were on Wellbutrin, which I was forced to discontinue! But - disruptive and distressing, nonetheless. I'm hoping that the tremors will stop eventually, or that dose adjustment will help.

Overall: would recommend if you have narcolepsy. You wouldn't think that a drug that obligates you to wake up multiple times a night could improve your sleep! Well, bucko, if your sleep architecture is already so disordered that you have narcolepsy: it can.

[myxmodalert]

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[arb0k]

if you're interested in more anecdotes i am a non-ADHD person who takes Adderall (my prescription is as a Narcolepsy treatment) and i feel very normal on it! my experience has been similar to yassifiedgollum's- low doses initially made me sleepier, until it settled on what i'd say is a normal energy level. (high doses give me a high as expected).

i have problems with concentration and short-term memory that the Adderall improves, but those are both also common symptoms of fatigue, and notably i never had major issues with them during my school years, only after the onset of the sleep disorder (which was pretty distinctive, i started randomly passing out in public for the first time when i was 22).

so my gut instinct would be to agree with you that Adderall is just Like That (or at least that the dividing line on how it hits you isn't ADHD exclusive)

every time i do amphetamines it re-shocks me that we put kids on these. these are like, real drugs.