Living with Narcolepsy

Meds No Longer Working

Hello everyone. I’m a new user and this is my 1st post. I’ve been living with narcolepsy for >20 years. I have tried Provigil, Nuvigil, all kinds of anit-depressants but the only thing that has ever helped is Adderall. I’ve been taking 30 mg twice daily for 2-3 years and it has lost all effectiveness. Does anyone have any suggestions?

Hi there.

I was diagnosed almost 20 years ago and the most useful thing for me has been to avoid long-term dependence on medication, which always came with severe unpleasant side effects. I also think the silver bullet approach to disorders by some doctors is ridiculous, as these are complex issues that a single pill is unlikely to fix. None of the medication ultimately helped me have a healthy balanced life, but behavioural therapy and a strict lifestyle did.

So I suggest you look at all the non-medicated aspects of your life that you can control, like routine in sleeping and eating times, sleep hygiene in terms of tech habits and light regulation in your room (black out curtains!), cutting out all foods that interfere with hypocretin (eg concentrated sugars and starches), eating more foods that promote orexin production (eg fermented foods), exercise (for the same reason), as well as as mindfulness-based cognitive therapy (to deal with mood imbalances that worsen cataplexy) and other behavioural therapies.

Funnily enough I have not yet tried Adderall.

Hope this helps.


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And I have to agree with kaiza. My situation is pain related and not sleep, but whether it’s pain meds or sleep meds my body builds up a tolerance to the medications and I find I need more and more of the meds to do the same thing. I’ve found I need to regulate my intake or when I have a severe need they tend not to work.

I also agree with Kaiza in regard to examining other life aspects/treatments outside of the medication realm. Chemical treatments can work short term, but long term they can really mess with the mind and body, well, they do with me.

Merl from the Moderator Support Team

I have to use Modafinil twice daily along with Adderall twice daily to even have a chance on having a productive day. Maybe you could try that, to see if it works. Hope the info helps, good luck.

I’ve also tried a lot of different medications and Adderall is the only thing I find that has helped me. I’ve been able to maintain the same dose (one 30 mg extended release and two 20 mg instant release) by taking “drug holidays” (or just not taking the medication on days I’m not working or have a social obligation) - so I’ve avoided increasing tolerance by skipping days. I’ve been on the same dose for maybe 6 years now. So I’d say that maybe varying how you take the medication (instant vs extended release, how often you take it in a day - hey, maybe it would work if you did a lower dose more frequently? Not a doctor, just an idea) and also incorporating those days off may be something that could help. Best of luck.