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Re: Emsam + Provigil = Tiredness?

Posted by Jeff81 on May 23, 2007, at 19:43:08

In reply to Re: Emsam + Provigil = Tiredness?, posted by malcolm664 on May 23, 2007, at 13:15:57


> I'm on another MAOI (Parnate) and my doc adamantly refuses to prescribe another stimulant (I've asked him specifically about Provigil) b/c he says that it's dangerous to combine them with MAOIs; he doesn't even want me taking caffeine tabs while on Parnate(and I've been taking about 4-5 200 mg tabs during the day to counteract the Parnate fatigue).
>
> How did you get your doc to prescribe Provigil and and an MAOI at the same time? Have you experienced any serious side effects from the combination of the EMSAM and Provigil. And what, btw, are you taking Provigil for?
>
> Best-
> Malcolm


Hi Malcolm,

I have been on a stimulant (Provigil, Concerta or Adderall XR) for the past couple of years for ADHD and bc I am really tired all the time (from insomnia and sleep apnea). My doctor is on the conservative side. When I started Emsam my doctor made me get off Provigil. In his drug interaction guide, Emsam + Concerta or Adderall was a red flag no-no. Provigil said use with caution due to lack of research. He still did not feel good about giving me. He asked a bunch of other doctors their opinions. He got mixed reviews. He was bugging the parent company of Emsam to discuss this issue with him. Finally he spoke to a high up Doctor that Emsam referred him to and he said it was ok. He did say that it is more likely to have a bad interaction with other MAOI's but it is safer with Emsam. From the research I have done and from what my doctor told me Emsam has a lot less reactions to food and other medications then other MAOI's.

I just started this combo on Saturday, I don’t think Provigil helps me now as much as it did in the past. Today was the best I felt on it so far. I think Kayebaby is right that it is too much on dopamine. I have been taking my blood pressure and it has been ok (it does increase after I take Provigil but it is still a safe #). I will keep you updated on how it works out.

How do you like Parnate? How does it compare to other antidepressants you have taken? Let me know if you have any other questions.

Good Luck,
Jeff


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poster:Jeff81 thread:758942
URL: http://www.dr-bob.org/babble/20070509/msgs/759112.html