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Re: provigil -modafinil -trial update

Posted by dennison on July 10, 2001, at 20:47:07

In reply to Re: provigil -modafinil -trial update » dennison, posted by Zo on July 10, 2001, at 14:56:11

> Sounds like you might really like Dexedrine SR or Adderall. Ritalin made me sleepy too, it's a lousy med for adults. Neither Dex nor Adderall are hard on the liver like Cylert. Just had a friend get nothing from Provigil who is doing very well on Adderall. You can even combine the two, to hit as many dopamine receptor sites as possibile!
>
> Zo
>
>
> > Hi --Well I'm continuing my follow-up posts on my trial on modafinil (provigil) . After about two weeks I was noticing improvement in my mood and energy and I became very optimistic concerning my prospects on provigil. Unfortunately the mental impairment has become extreme, very difficult to read,spell words follow thoughts etc. So I stopped the provigil and in about 2 days my cognitive abilities were much sharper I was extremely depressed but I could think. I've been on parnate(tranylcypromine) for many years and continue on it and one really large advantage on it has been absolutely no mental impairment. The mental impairment on provigil is very much like that I had on efflexor, the starring in the headlight effect, you look at something but nothing sinks in. Now my question is has anyone had similiar problems on provigil as I would like to give it another try and most likely will but has anyone had problems thinking on it that eventually cleared up. I'm taking the provigil in place of the cylert (pemoline) that I took but cylert is really tough to take frequently caused aches and pains etc. plus especially in morning it would make me very drowsy many times, but it never caused the cognitive problems that provigil has. Might have to go back on cylert I think but I'm not ready to through the provigil out the window yet. It's too bad in this age that patients are left out on their own to analyze their own medication regiments but as many of us know that's the nature of the business (mental health), there is simply no avenue available to reflect how your doing on these medications(psychiatrists) see patient less than 5 minutes every 2 months and other staff will never respond to medication questions. Dr. Bob's psychobabble serves a great service to many many of us, so I take a quick second here to thank him and I'll be waiting to hear from anyone that would like to respond to my provigil debacle!!

Hi Zo (thanks for responding) Dexedrine non-sustained release or adderall (the sustained release) version probably would be a good alternative trial only thing is since I'm taking the maoi parnate(tranylcypromine) the strong contra-indication battle again becomes an issue. Hypertensive-crisis of course the concern there. Of course as I mentioned in my above post indeed cylert-ritalin-dexedrine have all been used with maoi's with good results for refractory depressions or to treat maoi side-effects. Strategy simply requires slow introduction of the c.n.s. agent and careful monitoring of any blood pressure responses. I was given the ritalin and cylert in conjunction with the maoi as I'm very adept at home monitoring of blood pressure. Actually the maoi's get used so infrequently and many times they could be really helpful but doctor's concern about possible food interactions (cheese affect) or possible inadvertent drug interactions (meperidine-demerol) or some type of sympathomimetic drug cause this class of anti-depressants to be under utilized. Just to illustrate the point I'm the only client at this clinic in over 20 yrs. that has been allowed to take a maoi!!! I still haven't fully given up on the provigil yet but it doesn't seem that I'm going to continue on it but I have to experiment(adjust) dosages around of cytomel or time scheduling of dosages to see if I can improve my response!!!! Would have been really nice if the provigil had just flat out worked but as we know trial and error is extremely common.


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poster:dennison thread:69431
URL: http://www.dr-bob.org/babble/20010708/msgs/69658.html