Posted by Rick on July 17, 2000, at 20:00:06
In reply to Re: Adrafinil (Olmifon) - Liver Damage ???, posted by SLS on July 16, 2000, at 9:28:04
> Dear Rick,
>
> I appreciate tremendously your efforts in searching out this information. I may try to call the drug company next week.
>
> I'm not sure, but I think you are the only person who has reported having responded well to Provigil. I know that social anxiety is your major concern, but to what degree had you been depressed? Do you have any impressions about the success rate for treating depression with Provigil from what you have seen? How about adrafinil?
>
> I tried taking Provigil last week. Although I experienced some sort of episodic improvement over the first few days, I did not like the way I felt by the end of the week and discontinued it. I felt more numb than usual and experienced some anxiety along with dull headaches. I hate to discontinue a drug so quickly. I am worried that I have become less likely to "stick it out". It is hard to do so when a drug makes me feel worse instead of better. Within 24 hours after discontinuing the Provigil, I felt more like my usual self.
>
> I really don't know what to do next.
>
>
> - Scott
>
> ---------------------------------
>
> Drug: adrafinil - Olmifon™
>
> Laboratoire L. LAFON
> Siège
> 19, avenue du Pr Cadiot
> 94701 MAISONS-ALFORT
> Tél : 01.49.81.81.00
>Hi, Scott –
First of all, you're welcome. Looking for some info also proved educational for me, helping me hone my net research skills -- including delving into foreign languages!
No, I am not depressed, although I know most longtime social anxiety sufferers have depressive tendencies. I could go into theories as to why I have not had comorbid depression (except perhaps undiagnosed depression during one extended grieving period twelve years ago), but that is not the topic at hand. Even though I wasn’t depressed, Provigil (when added to my Klonopin and Serzone) had me feeling unusually happy (but NOT high!) for the first week. Since then, a mild version of this effect has lingered, but is suppressed when I am stressed or angry (both of which happen a heckuva alot less and with less intensity than before I first sought med-focused treatment of my anxiety a year ago. )
Since I am not a hardcore regular of this site, but just dabble in Babble, I only know snippets about your mental challenges (I know you have some form of severe depression), and treatment history (I know only that you took Cylert in 1998 with an unfortunate hepatic side effect).
One of my first thoughts in response to your post involved that recent study showing great success in using Provigil to induce a theraputic response to AD’s among previous non-responders. The study was of course open and very small, but provocative nonetheless. But – and again I’ve only been reading a sampling of posts – I didn’t see anyone here reporting that they tried one of “afinils” specifically to elicit response from AD’s which had previously failed for reasons other than side effects. (Of course, where the guilty side effect was fatigue, low motivation, etc., that could quite possibly be alleviated by adrafinil or modafinil/Provigil). In particular, I’m talking about the more common AD classes like SSRI’s, SNRI’s, Serzone, Wellbutrin (but often bad for anxiety), Remeron, MAOI’s and Tricyclics. While I can’t tell from the abstract, it’s likely that THESE are the kinds of AD’s Provigil so successfully augmented in the study. Instead, I’m reading in P-B about adrafinil and Provigil being taken (more successfully for the former except for me – although Karen admitted her trial was unintentionally-but-severely compromised) with things like Zyprexa, Amisulpride, and Adderall. And in many (most?) cases, it looks like core alleviation of depression was not even the primary goal.
Now, I assume that at some point you’ve tried and failed to respond adequately or consistently to a number of the typical AD classes. So I was going to suggest that you may want to re-try a failed AD or two with Provigil augmentation. The study abstract certainly never suggested that Provigil would be effective for depression by itself, and so I’d submit that your short-lived, first-day wave of benefit may have been irrelevant to Provigil’s potential for making failed AD’s “work” for you . (Again, I need to add a disclaimer: for all I know, you already are taking one of these “typical” AD’s.) This suggestion was also predicated upon your concerns about potential liver toxicity and med importation. Getting back to what you experienced that first day, it may have been parallel to the unusual happiness I felt the first week...I’ve seen references to “initial euphoria”; my take is that that’s most likely a pleasant, early side-effect that some people experience, rather than a significant indicator of Provigil’s primary benefits.
That said, your other reactions to Provigil, presumably without a first-line AD (numbness, dull headaches, and some anxiety), suggest that the augmentation approach might not payoff. On the other hand, perhaps it might be worth a try with a lower dose of Provigil (100 mg or 50 mg?). I seem to recall that you went up to 200 (perhaps too fast in an effort to maintain that initial day’s benefit?), and that the study participants took between 100 and 200. And you surely know that side effects can take a good four weeks to go away. I always wonder how many people (myself included, in past trials) have let side effects drive them from meds that would have eventually proven very beneficial with side effect remission.If this kind of modified Provigil re-trial doesn’t appeal to you or fails to produce results after giving it a fair shot, I would seriously consider adrafinil if I were you. I say this in particular since adrafinil is widely believed to have subsatntial anti-depressant qualities of its own. It certainly seems to have had that kind of effect for JohnL, quickly and with minimal adverse effects.
If your adrafinil importation concern revolves around chemical integrity of the product, perhaps you could call Laboratoire L Lafon at the number I provided, and attempt to verify the reputation of potential mail-order suppliers of adrafinil. And for added peace of mind, stick to a place that REQUIRES a prescription.
The liver concern is a little more problematic, given your 1998 Cylert reaction. Again, however, you did not mention the magnitude of the toxicity, it’s reversibility, and whether or not you were testing frequently.
I know that were I in your shoes, these answers would make a big difference to what kind of risk I perceived and was willing to take with regard to adrafinil.Hope this helps, or that I’ve at least provided a few thought-starters. My apologizes if the relevance of some of those thoughts are diminished by my limited knowledge of your situation.
Good Luck,
Rick
poster:Rick
thread:40412
URL: http://www.dr-bob.org/babble/20000717/msgs/40786.html