Hi Phil,
I had my first Transverse Myelitis attack (NOT NICE!) in 1991 and recovered fairly well from it. I was dx with "probable MS" at the time, but was advised that there was a chance that the TM attack would be an isolated occurence and it wasn't MS-related at all. (TM attacks are an indication of something occurring in the spinal cord).
Basically I just carried on, ignoring all the symptoms until I had another TM attack in 2003. This time I did not heal completely, had an MRI, and was given the official dx of MS.
I researched the efficacy statistics and side-effects of the mainstream drug options (CRABs) for about 2 years, before I was ready to make a decision. During this period, I had quite severe spasticity pain, and was very fatigued with terrible brain fog.
In Nov/04, my Neuro suggested an anti-depressant for the fatigue. I made my doctor and Neuro both "test" me for depression because I did not "feel" depressed. The tests came back that I wasn't clinically depressed. However, I went on one of the other MS boards with a cry for help about how my body was processing "stress". Whenever I encountered even the smallest amount, my spasticity SCREAMED at me.
Several people suggested anti-depressants . . . so now I was getting this recommendation from all sides.
I started on Celexa (20mg) in Jan/05, and almost immediately saw a difference in my fatigue level & brain fog. I guess once I had an emotional stabilizer in my system (the anti-depressants), the spasticity pain also become much less bothersome. I was not a 100% (maybe 50% better), but so long as I got my afternoon nap (Celexa forced me to sleep daily), I was reasonably functional the rest of the day . . . . yeeha.
So, when I finally decided on which MS drug to take, it was LDN. I started on May 20th, and have felt like a million bucks since the 21st. I realize that not everyone see's this immediate and drastic improvement, but I was one of the lucky ones!
I didn't want to take the LDN at the same time as the Celexa in the beginning (bok, bok), so I moved the Celexa from 11:00 pm to 10:00 am when I started on LDN. I took the LDN @ 11:00 pm instead. What I soon realized was that I'd wake up every morning really groggy, and I no longer wanted my afternoon nap.
After a few weeks, I was brave enough to move the Celexa back to 11:00 pm (same time as the LDN), and the morning grogginess went away . . . but afternoon naps were again a requirement.
I am working on weaning myself off the antidepressants this month, as I am hoping I no longer need them now that I am on LDN. I don't have the pain and fatigue I had for two years, and I feel great, so maybe the LDN will be enough. Guess I'll find out soon enough!
PHEW . . . so that was a long story!
What I was really trying to say is that it may not be the LDN that is causing the fluctuation in how we feel throughout the day. Other drugs, if we are using them, can enter into play too.
Now, what was the question again?
(BTW, is there a spellchecker somewhere on this board?)