Posted by Lorraine on February 13, 2002, at 13:38:28
In reply to Re: Provig DOESN'T Induce Klon/And if Did, No Big Deal » manowar, posted by Rick on February 12, 2002, at 19:20:16
Rick: I have recently started Progivil. I felt the drug on day one. I was on 50 mg. My blood pressure went up and my pdoc told me to scale back to 25 mg, which I have, but I suspect my blood pressure is still high. (150/100). But the drug is good--better energy, more focus without being wired, no hard landings like with amphetamines (even the long lasting ones like Concerta), less depressed mood and more motivation. Pretty compelling reasons to stay on it for someone who has been through about 50 med trials. I am adding the Klonopin (I have used it for a short time before and it helped my anxiety a lot). I am hoping the blood pressure thing resolves itself over time. If not, I'm not sure what the next step should be. I think I would rather try to control the blood pressure than go off the med. Any thoughts would be appreciated.
Lorraine
> Tim, thanks for the kind words. Always good to hear from another Klonipin-head.
>
> I wish I could agree that I *am* "well-versed in psychopharmocology", but to the extent that's true it's limited to the aspects that I've informally researched and thought through -- or experienced.
>
> I know what Clonidine is, but that's about it. But at least I can reply to a few points, and then hopefully someone else who has used your meds or has nore knowledge of them will have some thoughts. (Of the meds you take, I've only used Klonopin, Provigil, and a very short trial of Wellbutrin.)
>
>
> > The Klonipin for me is the cement that holds my psychological walls in place. (I know-extremely lame, but VERY TRUE:)
>
> Not lame at all! A nice, succinct way to explain WHY Klonopin is what I called my "mainstay".
>
> > 1) You said this: “But when I added back the Provigil, the therapeutic enhancement came roaring back.”—Can you detail what the therapeutic enhancement is for you? Could you also let me know how much you’re taking and what your present medicinal cocktail is?
>
> Sure, but remember that this is all in the context of non-depressive social phobia:
> -- Increased energy, concentration, motivation, assertiveness, sociability, and improved ability to handle stress (up to a point). To some extent some of these may result directly from the increased energy. Even before I took any meds, it was clear that my anxiety was worse when I felt fatigued, e.g. because I didn't get a good night's sleep. Of course, the energy provided by a med or other stimulus must not have negative side effects that outweight the energy benefits, e.g. by making me feel too wired.
>
> Current Cocktail: 1 mg Klonopin, 100 mg Provigil, and 300 mg Serzone. All taken first thing in the morning. I sometimes bump up the Provigil to 200 mg. I've been doing the bump-up more frequently lately, because I've been going through an absolutely nuts period at work, leaving the office at 3 a.m., etc. But I find that after more than a few days at 200 mg, I start to get a tad wired.
>
> For the last two months, I experimented with the a Klonopin+Provigil only combo, same dosages. It was a great combo, maybe just a little less effective than the trio. Serzone, as a powerful inhibitor of CYP 3A4, was quite possibly intensifying the effects of the other two meds.
>
> It was a dynamite combination for me, especially back when I was taking 450 mg Serzone, but memory lapses were happening more frequently. I had once been on Klonopin alone for over a year with minimal memory detriment, so I suspected the Serzone.
>
> After a few months with only K+P I did see some attenuation of the memory lapses, but oddly, without Serzone, Provigil started making my blood pressure shoot up. Because of this, and because I was feeling (non-clinically) depressed (including first big bout with insomnia in quite awhile), I started the Serzone again recently. BP's back down, but, (sigh) memory seems worse again at a time I can least afford that. So I might drop the Serzone again, soon. It does concern me that the Provigil raises my BP, which I had never noticed before, since I never took it without Serzone until a few months ago. From all I've seen and heard, that's not a typical Provigil side effect as it can be for amphetamine-based meds. I think my BP has an unusually strong reaction to meds, whether up (Provigil) or down (Serzone).
>
> I wish there were something that could help offset the med-induced memory deficit in what is otherwise an incredible three-med cocktail for my Social Phobia (but, again, Serzone's main benefits for me might be potentiating the K+P, while nullifying the Provigil BP-raising effect).
>
> Ironic that I'd end up talking about Blood Pressure, since I do know that Clonidine's official indication is as a (centrally-acting) antihypertensive. I wonder if your initial morning mental fogginess might have been due to hypotension, given that BP is lower while sleeping, and you are taking a BP medication.
>
> Sorry for rambling a bit at the end.
>
> Rick
poster:Lorraine
thread:93336
URL: http://www.dr-bob.org/babble/20020208/msgs/94001.html