Posted by Rick on June 26, 2000, at 12:02:44
In reply to Re: side effect with provigil - CONT'D, posted by Rick on June 26, 2000, at 11:08:15
(Continuing from where the last post aborted...)
While understanding or theorizing about the chemical mechanisms involved is both important and interesting (and I envy your knowledge in that regard), there can be some big missed opportunities (Type II errors, if you will) in the absence of safe and cautious "leaps". Some studies and theories on Povigil's pharmokinetics might lead one to conclude that this would not be a go-to drug for someone with prominent anxiety, especially in tandem with benzos (and for many people including JohnL, that could be true). But to me, that's all secondary to real-life human efficacy and safety. No one REALLY understands how most modern psychotropics exert their beneficial actions, anyways. Take SSRI's, for instance. There is growing belief that serotonin reuptake inhibition or other SSRI properties may be setting off a long chain of secondary, tertiary and "beyond" activities that drive much -- or even most -- of the beneficial effects, especially when used for disorders other than major depression. This could explain why it often takes a long time for theraputic value to show up -- as long as four months for some anxiety disorders like OCD. As you probably know, there is increasing interest and debate as to whether their is validity to the inyuitively accepted need for steady-state blood levels of the "parent" drug, when in fact it could actually be the "last domino" in a comples chain of chemical effects set off by the parent that really benefits the user. Mintaining constant levels of the parent drug may be accomplishing nothing but increased side effects. (Obviously this is largely unexplored territory to-date. Even if right on the money, the clinical impliations of this concept could vary greatly by drug and/or patient. There is a very interesting new article in Medscape about whether steady-state ioavailability should always be sought, although the author cautions that much further research is necessary.)
I started Provigil to counter
poster:Rick
thread:37987
URL: http://www.dr-bob.org/babble/20000619/msgs/38364.html