Posted by Rick on June 10, 2000, at 20:06:04
In reply to how about a brittish monograph? » Rick, posted by michael on June 10, 2000, at 17:35:50
Thanks for the European monograhps on modafinil, Michael.
I ran the French monograph (the original, not your copy) through Alta-Vista translation, and it turned out to say pretty much the same thing as the British one.
Wow, I never realized how much more thorough U.S. monograhps are! Maybe that's reflective of the amount of testing that's required before the FDA will approve a drug.
None of the monographs discourage combination benzo/Provigil use. In fact, the U.S. monograph has references to Provigil use with triazolam (no safety issues found) and diazepam. It says that Provigil may increase blood levels of diazepam (and other drugs which share Provigil's elimination mechanisms), thus calling for possible diazepam dosage reduction.
There are no absolute contraindications given at all in the U.S. monograph, except for known hyper-sensitivity to the drug. In terms of worsening of CNS-related disorders, the only problem seen was in one patient with a history of psychosis.
The French and British mongraphs, but not the U.S.'s -- warn against prescribing Provigil to patients with moderate-to-severe hypertension (BTW, it hasn't affected my blood pressure). The European, but not the American, guidelines also say that Provigil should be prescribed to patients with "Major Anxiety" only by a "specialist" (I assume this means a psychiatrist instead of a general practitioner.) I think that's prudent advice, but needn't be an "absolute". General practitioners often seem pretty much in the dark about depression, but they can be even more clueless when it comes to anxiety disordes like Panic, GAD, OCD. and Social Phobia. "Fun Fact": Did you know that in England the first-line medication for GENERALIZED Social Phobia is beta blockers??!!
poster:Rick
thread:36517
URL: http://www.dr-bob.org/babble/20000610/msgs/36882.html