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Sllepy during daytime affecting my work on PROTHIEDIN.

Resolved Question:

have been taking Prothiedin 75 mg for last 10 years once before bedtime. It is working fine except that I feel sleepy during day time and my work and my career is getting disrupted due to this.
I started taking Modafinil 100 mg once in morning time after breakfast

and it gave me all the energies and alertness to carry out my professional work but it started giving me pains in legs and sole of my feet feels as if burning,

after 15 days use. Am I missing something which needs to be combined with Modafinil ? After stopping Modafinil, now for 7 days, my pains have recovered i.e. headache, Leg pains and Sole burning. There is still small amount of pain and burning of sole but that is perhaps due to diabetes i.e. I am taking Duotrol SR once a day before breakfast and taking AmlopressAT once before bedtime (for high blood pressure).

It seems I can no longer work without Modifinil because I feel sleepy all the day and use to sleep 4-5 hours during the day after a full night good sleep of 7-8 hours.

What should I take to avoid Pains? Please help.

Update: My HbAC1 was 7.1 ( 3 months back)
BP: 80/130 (with taking AmlopressAT as mentioned above)

Update: If I do not take Prothiedin, My head, neck, back of the neck where it joins to head all feels like inflammed. I tried switching to Escitalopram 10 mg, following the protocol tapering Prothiedin but after 1 month of switching completelt to Escitalopram 10mg, I lost my interest in any work and faced loss of interest on sex and felt decreased sensations. Then, I again switched back to Prothiedin taking again 1 month and now I am fine with Prothiedin but the sleepiness is not letting me do work even if i very much want to do.

 Update: I use to take Alcohol 3 drinks of 60 ml each on Fridays only for past 5 years.

Update: I used to smoke 19 years back and till date I do not take tobacco in any form.

 

Category: Psychiatrist

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Dr. Srikanth Reddy
Category: Sexologist
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 31 Doctors Online

Expert:  Dr. Srikanth Reddy
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Hello
Thanks for posting your query at DoctorSpring.com
I have gone through your question in detail and I can understand what you are going through.
Prothiaden is a good medicine for non-specific pains and it seems you are tolerating the medicine well except for the sedation side-effect. If you are not tolerating modafinil you may try armodafinil or methylphenidate as well as many a times the side-effects demonstrated by modafinil are not replicated by armodafinil or methylphenidate.
If these also show the same side-effects then it would be wise to switch the medicine prothiaden. I would suggest duloxetine or amitriptyline as the options for the non-specific pains that you are having instead of prothiaden.
Do discuss all these options with your treating psychiatrist and get the changes done.
Hope this helps,
In case if you have any further query, do let me know.
Kind regards
Dr. Srikanth Reddy


Patient replied :

Hi, Thanks for good advice, however I have some queries, Just concerned if the side effects are just symptomatic or the pain is indicative of some damage being taken place inside my body.

  1. Will it be damaging my system subtly (Liver, Kidney, Heart etc), if I continue it despite the pain?
  2. What kind of tests I should undergo to monitor the damages, if any, while taking Armodafinil/Modafinil/Duloxitine
  3. What can I do to minimize the damages? (Excluding Dutrol SR for Diebetes Type 2)

Can Duloxitine 20 be taken for 2 weeks to taper off Prothiedin (reducing it to 50 for 1 week and then 25 second week and completely off Prothiedin in 3rd week)
First Week => Prothiedin 75 MG + Duloxitine 20
Second Week => Prothiedin 50 MG + Duloxitine 20
Third Week => Prothiedin 25 MG + Duloxitine 20
Fourth Week Onwards => Duloxitine 20 (iicrease if needed)
Thanks in advance,


Expert:  Dr. Srikanth Reddy
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Hello
Firstly sorry for the delay as I had some issues with my internet connectivity.
Going directly to your questions proper:

  1. Will it be damaging my system subtly (Liver, Kidney, Heart etc), if I continue it despite the pain? Ans: Prothiaden may not by itself cause any damage. The pains that you have described could not be based on any organic cause. And that is the reason you have been on prothiaden and you seem to be having an improvement.
  2. What kind of tests I should undergo to monitor the damages, if any, while taking Armodafinil/Modafinil/Duloxitine ANS: YOu may get Vit D3 and Vit B12 levels done as deficiency of either of them can also present with similar problems. Otherwise regulr monitoring of kidney with Serum Urea/Creatinine and Liver Monitoring with Liver function test may be planned every year. Otherwise its not a very big concern.
  3. What can I do to minimize the damages? (Excluding Dutrol SR for Diebetes Type 2) ANS: NOthing much needs to be done. If any changes are noted the medicine needs to be changed.


Patient replied :

Hi,
Thanks for the excelent advice...I have started Duloxitine 20 and my pains have gone magically.
I have reduced Prothiedin 75 to 25 mg once at bedtime. And, Duloxitine 20 in the morning.
Even taking Modofinil ,now, is not causeing leg pains.
I plan to stop Prothiadin 25 after 2 weeks from now and I will keep taking single dose of Duloxitine 20 (or 40) after 2 weeks.
Is it fine?


Expert:  Dr. Srikanth Reddy
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Hello What you are planning is fine but it may require dose changes depending on the symptom profile. As mentioned earlier, I request you to keep your doctor informed about the changes in medicine that you are making. Kind regards

Dr. Srikanth Reddy
Category: Sexologist
Experience: 
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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