Posted by Fivefires on August 27, 2007, at 11:28:36
In reply to Provigil inducing depression and social anxiety?, posted by kristeenamarie on August 23, 2007, at 15:31:13
> I am being treated for Bipolar I with Lamictal, Wellbutrin, Abilify, and Adderall XR. The issue lately has been my daytime sleepiness, cloudy mind, and chronic fatigue. This is why I have been taking Adderall, which has worked tremendously well. The only problem is, the XR takes way too long to start working in the morning causing me to lag and get depressed in bed until I feel like getting up finally. Also, in the late afternoon/evening the sleepiness returns and so does my rather resistant depression.
>I have the same problem with anything that is supposed to be *extended release*. Before Effexor-XR came out, I was doing fine on Effexor. When I took Effexor-XR, instead of taking one a day like some people could w/ satisfactory results, I'd 'come down' 6-7hrs later. If I'd taken it @ 9a, I'd have to take another smaller dose at least by @ 5p or so, unless I wanted to feel terribly uncomfortable from 5p till whenever I was ready to go to bed.
I believe it is because I am a fast metabolizer, so 'not enough' and 'not quickly does the not enough' medication, get into your system.
> I told my psych this and he decided that I should try Provigil. I've been taking 100mg/day along with my regular 20mg Adderall XR/day for one week, with the eventual goal (according to my doctor) being switching from Adderall to 200mg Provigil.
>
> In this short period of time I feel like the Provigil has had some positive effects for me, mostly a quicker waking period in the morning. But, I feel like my thoughts are more introspective, sometimes bordering on obsessive, and "inside my head" and as a consequence my social anxiety and discomfort has returned in a big way. Also, in the evenings, I still seem to get depressed, even moreso than before.
>When I first began Provigil, I wasn't comfortable w/ taking 200mg, so took just 100mg, and had similar response as you. I was very uncomfortable and confused. But, when I finally got up the nerve to take 200mg, it worked and I could 'get out of your head'. But, even on the 200mg, I was having like a 'nose dive' around 4p and, of course, my day wasn't over and it wasn't time to sleep yet. It's *extended release* wasn't extended enough for me. I was 'coming down' sts. This med is intended to carry a person through an entire day until h.s., but not this person. I have to take 200mg a.m. and 100mg around 4-5p. Also, sounds like Adderall-XR may be doing the same thing w/ you.
> So, is it unusual for Provigil to induce depression and social anxiety? Or, could it possibly be something else and not this?>
>I was scared to take 200mg in the beginning so chose to take 100mg instead. I felt as you describe, more depressed by the frustration and I'd get a hint of energy, just to be slammed face down on the bed. I mean, in a matter of a couple hours!
I believe this was because it just was not enough to get me, a person who metabolizes fast, (There is then less medication released into your body as well.) to an altered state, a state where I felt some substantial energy. After a 2-3weeks of trying to work w/ it, I took the 200mg. First few days were a little rough, then I was also realizing the 'drop off feeling' disrupting my late afternoon as well. But, chose the latter dosing I mention above I believe
>I don't know what to tell my doctor, if it will even make sense. I know one week is a short period and I should probably wait it out, but honestly it's not something I imagine going away with time.>
>If what happened to me is happening to you, I'm afraid I agree with you not imagining it going away. You could try do as I did, or, as unfortunately, it pooped out altogether for a prior poster, maybe your pdoc will allow one of the others.
The reason I'm being given it is because I'm on a lot of 'downing meds', Valium or Xanax and at least three for chronic pain.
I printed the first post following yours, should Provigil 200mg a.m. and 100mg late afternoon quit serving me well at some point in the future.
You never know, when comparing ourselves to another re: how meds will work, if life circumstance or drug interaction or tolerance (There are so many reasons.) may be reasons a drug poops out. For me, guess will cross bridge when comes.
I don't know much about Adderall-XR. Were you feeling 'a dropping off' during your days on it or did it carry you through an entire day? Maybe you were and this is the reason your doc put you on Provigil?
If you feel like I did, you just wanted to 'flush' the Provigil, but the switch in dosage and dosing times made a lot of difference and now it is helping me.
I'm sorry I don't know enough to say anything about Adderall-XR. Did I already ask you if you had a 'dropping off' on it as well?
I apologize if repeating. Wish we could see a full screen here. Hope you talk w/ doc asap and get some comfort kristeenamarie. I would be interested to hear your decision, if you'd wish to share.
5f
poster:Fivefires
thread:778123
URL: http://www.dr-bob.org/babble/20070824/msgs/779043.html