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Dr. afraid of prescribing Dexidrine. I need it.
Aug 21, 2003

Aloha! I live on Maui, Hawaii. I am not taking any HIV meds. It has been almost two years. I found out I was infected in 1990. Because of too many side effects of HIv meds, i chose to stop them. the anti-depression/anxiety meds i was on was making me even more tired with my chronic fatigue syndrome. after researching sites like yours, i found out other methods for clinical depression and chronic fatigue syndrome. it involved taking dexedrine. my regular dr.(an infectious disease/internal medicine/top dr. on maui for Kaiser and also at the maui memorial hospital..(he was the physician who treated my ex who crossed over in 1993) was totally in support of my suggestion(he took me off of paxil60mg a day..to wellbutrin, which he said was an upper anti-drepressant). i brought in information from your site and several others stating that doctors were using that method aslo. but, he said he couldn't prescribe it as he didn't have a license.(He lied, he does, but because he had issued several narcotic type of drugs to his wife, the dea investigated him,and his brother who is a dr.and was doing the same thing, i believe they had to quit practicing for a while. then i saw he had been hired by kaiser. so he is afraid of them questioning him since it isn't approved by the dea/fda for my illness. my psychiatrist says the same them,he is very arrogant and wouldn't even look at the papers i brought in saying he doesn't care what other doctors are doing. although at this time he is prescribing, but always warns me he is not comfortable and may stop at anytime. i am taking one lisinopril 10mg.... .one 200mg wellbutrin ..one .5mg klonipin.....one 30mg dexedrine and a vitamin, (all in the morning). i take another 30mg of dexedrine in the afternoon around 1:00 or 2:00 p.m. nighttime, i take one 54mg tricor...1mg klonipin...one 100mg of desyrel...plus a vitamin. it has turned my life around and they both can see that. i was a mess before....i couldn't stop crying......had compulsive/obsessive behavior....and was sleeping like at least 18 hours a day. i told them you can either give me medication that will let me sleep my life away, or give me something where i can get up and do something besides sleeping. any advice/help would be greatly appreciated. one note, i was falling asleep at work and had no sexual desire to even watch pornos, so every 4-5 months, i would smoke ice/batu....and was honest to all my doctors about everything, but it seems to have backfired as they think i am a druggie...i have no desire to smoke it now, and never felt like i needed to smoke all the time.....it was just a treat once in a while so i could stay awake at work...i worked overnight...and i have a lot of porno that i missed watch. now i have energy and a sex drive. would moving to a bigger city where there are more cases like mine or where doctors aren't afraid of being investigated by the dea/fda? sorry this is so long, but it's all the facts. :)

mahalo for your kokua!

Response from Dr. Horwath

There are several published case series, which show that low-to moderate doses of dextroamphetamine (Dexedrine) or methylphenidate (Ritalin) can be quite effective in treating the fatigue, low energy, slowed thinking, and low concentraion that can occur as cognitive/mood symptoms due to HIV infection. These drugs are controlled substances and these indications are not FDA approved, but they are used this way in clinical practice. In addition, these are not benign drugs and should be used only when these symptoms cause significant impairment.

Persons in whom these drugs may be contraindicated include those with a history of seizures, CNS opportunistic infections (e.g. CNS toxoplasmosis, cryptococcal meningitis, etc.), CNS lymphoma, amphetamine or other stimulant abuse, and those with histories of cardiac arhythmia, hypertension, or psychotic disorders. Caution should also be used in those with advanced HIV associated dementia, in whom the side effects might include paranoia and hallucinations.

For all of these reasons, some physicians may be reluctant to prescribe these drugs. Nonetheless, they can be helpful and safe in selected people with impaired cognition, fatigue, and mood symptoms due to HIV infection.



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