Posted by Eljakeo25 on October 26, 2004, at 10:38:05
I was recently Dx at the Rogers Memorial Hospital in Oconomwoc WI. It is the rated #3 psych hospital. The new Dx was Intermittent Explosive Disorder, along with my major depression and ADHD. My impulsive explosions for example would be yelling at couples displaying public affection threatening suicide to them as a cry out for my lonliness (and I was not even suicidal whatsoever!) I would get some ideations of putting a UNloaded gun to my head in front of a couple (I have been single my whole life) and I would say to them if I did that would be "feel your emotions?, thats what I feel everyday." Well to make a long story short, Adderall helps a lot to reduce this kind of impulsivity as it is both related to both of my disorders, however adderall lasts only like 2 hours and would end up taking 90 mg/day of it! I could sleep just fine. SInce I did not want to become dependent, I took 600 mg of Provigil as there was one report for that it was only at these dosages that is was effective for ADHD. I was out of the adderall and after taking the Provigil, it felt almost like the adderall. A complete 180 degree change in my behavior, I would feel normal (who I really am) offer smiles to people even to couples, and back to my normal friendly disposition. It has now been 8 days on this 600-700 mg of Provigil alond with 30 mg of adderall in the morning and I feel VERY relaxed in front of others, non-depressive, or impulsive, focused, and motivated to study. And of course AWAKE! lol. I could still sleep fine. But here is the problem. The doctor was happy that I found that 600-800 mg of Provigil to be extremely effective for me. However, eventhough 600mg was well tolerated in clinical studies, unfortuneatly my pdoc could only prescribe the maximum recommended daily dose of 400 mg. (which is much less effective), at 100 or 200mg Provigil does nothing. But here is the question, sorry for such a long post, but 400 mg is the maximum recommended dose for narcolepsy. But if used "off label" for ADHD, there is no recommeded dose if you think about it. I think my pdoc is covering his butt incase I have a reaction, eventhough he agrees on my larger dosage. He said I can take 600 mg and get my prescription filled early, but insurace and pharmacies are a pain in the butt sometimes. Now I heard other posts that Provigil "poops" out. And it may very well happen to me. But if it is working, I will continue. Obviously, with the good reaction to control my symptoms on Provigil, it strongly indicates a chemical imbalance in my brain that is causing my disorders. The final problem is just I am running out of meds fast, and I will have to take a "drug holiday" and of course during that break, nothing gets done, and all my symptoms come back. Finally, I think that larger dosages may actually be augmenting my Cymbalta causing a more powerful anti depressant response since both Cymbalta and Provigl (to some degree) works on Noradrenaline) but it's hard to tell for sure. I think your doctor should have the final say over the dose of your medication and not the drug makers, the FDA, or the insurance companies. (athough Provigil is really expensive) And suggestions on how to get the higher dosage prescribed for me if the doctor agrees but can only prescribe 400 mg. Should I see two Psychiatrists? Because, one person e-mailing the Cephlon company who makes provigil will unlikey cause them to raise their daily recommended dosages. Thanks a million for reading. I know this a similar post I had earlier, but you hit the right combination and dosages to treat your problem and cannot even get enough medication, whats the point of psychiatry? But some of the top dosages for the "big boy" psychiatric meds would make plenty of adverse effects for some people. I don't get it.
Treatment for my condition(s) include:
Risperdal 2mg bedtime
Klonopin 1mg BID
Adderall 30 mg morning
Cymbalta 60 mg morning
Provigil 600-800mg.And NO side effects =)
poster:Eljakeo25
thread:407420
URL: http://www.dr-bob.org/babble/20041024/msgs/407420.html