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Dr. Bob is Robert Hsiung, MD,
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Posted by Jerrympls on May 12, 2002, at 2:43:51
In reply to provigil jitters, posted by zoe on May 2, 2002, at 8:55:42
> i started provigil 200 mg a day, added on to wellbutrin 200 mg 2x/day for depression/mixed social anxiety. the first few days were great, but yesterday i got the extreme jitters, spaciness, yuck. i stopped taking it for the past couple of days. i can barely eat. does this go away? has anyone had a good effect from this drug?
I tried Provigil starting at 100mg and eventutally moving up to 400mg. I was also taking it with Desipramine - while not exactly like Wellbutrin - you could say some general similarities. (However, Wellbutrin gave me terribly anxiety and panic). Provigil, at first, gave me some nominal energy - not speedy - just "gotta run some errands" type of energy. That lasted about a week. It boosted my mood only slightly and then tapered off--even with the dose increase. Then, it basically just kinda make me feel awake - just awake -nothing more, nothing less. Stopped it after a couple months. No withdrawl.
No real benefits. Perhaps it works for some people?
Posted by Lorraine on May 12, 2002, at 11:50:24
In reply to Re: provigil jitters » zoe, posted by Jerrympls on May 12, 2002, at 2:43:51
I take 25 mg a day to keep me alert and awake, some mood elevation, without the wired feeling. If it is making you jittery for more than the first week, you might try cutting your dose until you find one that works for you or you might find that even with cutting the dose it doesn't work for you.
Lorraine
Posted by Krazy Kat on May 12, 2002, at 12:13:41
In reply to Re: provigil jitters » zoe, posted by Jerrympls on May 12, 2002, at 2:43:51
For some reason Provigil makes me anxious and a little irritable at even a low dose of 100 mg. Also, my heart raced some and I'd strange mini-panic attacks. It did keep me awake, though. I never tried it below 100 mg...
Ritalin works better for me.
- kk
Posted by Emme on May 13, 2002, at 7:36:02
In reply to provigil jitters, posted by zoe on May 2, 2002, at 8:55:42
Hi Folks,
I tried provigil a while back at 25 and then 50 mg. I felt positively manic several hours aftr taking it, and then profoundly exhausted in the evening from the overstimulation. So I dropped it like a hot potato. I'm having a lot of fatigue lately and have been feeling depressed. My doctor recommended giving it another shot at a smaller dosage. Today I'm trying a "flea size" dose of 12.5, yes 12.5 mg. Or at least that's what I think I ended up with after doing surgery on the table with a pill splitter. We'll see what happens. I've got plenty of klonopin on hand in case it makes me too wired. (I'm also taking Lamictal and neurontin.)
Emme
Posted by zoe on May 13, 2002, at 8:54:39
In reply to Re: provigil -trying it out, posted by Emme on May 13, 2002, at 7:36:02
Thanks to all for your responses. This has got to be one of the best places to get real hands-on infor about what works for people and what does not.
My psychiatrist is a great guy, but most of the ideas for where to go med-wise seem to come from me. I'm from the US, and provigil is covered by my insurance, so I'm still trying to stay on any meds i can get that are payed for rather than going the overseas route.I know it sounds bizarre, but almost 2 weeks later those spacey feelings are still there, although they are slowly lessening. So maybe adrafanil would be a better answer, but I'm not ready tothrow in the towel yet on the provigil, esp if i could possibly cut the tabs in fourths and save some money as well.
i have to say, though, that i continue tohave hope for this drug, i certainly likeed the reduced appetite and increased energy.
Posted by Ritch on May 13, 2002, at 9:39:16
In reply to Re: provigil -trying it out, posted by Emme on May 13, 2002, at 7:36:02
> Hi Folks,
>
> I tried provigil a while back at 25 and then 50 mg. I felt positively manic several hours aftr taking it, and then profoundly exhausted in the evening from the overstimulation. So I dropped it like a hot potato. I'm having a lot of fatigue lately and have been feeling depressed. My doctor recommended giving it another shot at a smaller dosage. Today I'm trying a "flea size" dose of 12.5, yes 12.5 mg. Or at least that's what I think I ended up with after doing surgery on the table with a pill splitter. We'll see what happens. I've got plenty of klonopin on hand in case it makes me too wired. (I'm also taking Lamictal and neurontin.)
>
> Emme
Emme,Interesting that your doctor wants to retry at an even smaller dosage, despite that experience. Let us know the result. I know the stuff is $$$$ as all getout, *so* if I could just take 1/8 of a $3-5 pill every AM I wouldn't mind forking out the cash. But, the main thing I like about it is once/day dosing, and no CII hassles with the pharmacy and my pdoc. It is supposed to be a DA reuptake inhibitor. Also, Zoloft inhibits reuptake of DA a tad (and I responded particularly well to Zoloft-motivationwise), but it just shreds my guts to pieces, so I am wondering if a tiny nugget of Provigil combined with the tiny nugget of Celexa I take (every other day) might work out quite well.
good luck,
Mitch
Posted by Iago Camboa on May 13, 2002, at 12:55:00
In reply to Re: Your provigil jitters, posted by SLS on May 11, 2002, at 7:00:06
Hi.
The more I read about the varied reactions to Provigil and the more I'm convinced that the two drugs, namely adrafinil and modafinil/Provigil are completely different drugs. Who would have guessed so after having looked at their formulae (only differing by a 'trifling' OH)? Worse still, the latter being a metabolite of the former...
So your reasoning seems to me both very sound and one worthy of further inquiry... And I'm afraid I will only take rest after I will have tried that substance (modafinil/Provigil) on myself...
Iago
> If you look back a year or so, you will find posts regarding adrafinil by JohnL, who is doing extremely well with it. At one point, he tried crossing over to modafinil (Provigil) - twice. Both times, he immediately experienced uncomfortable anxiety, spaciness, and jitters along with a persistant headache. I don't recall at what dosage he started Provigil, so I guess it can't be excluded that his experience was due to his taking too much. He probably started at 200mg. He characterized the two drugs as feeling completely different.
>
> Adrafinil is converted to modafinil in the body, but I am not sure to what extent. If the percentage is small enough, perhaps the steady-state levels of modafinil in the body equate to a dosage of something like 50mg. I really don't know, but if this is the case, I imagine it's possible that adrafinil is doing most of the good stuff while leaving too little modafinil to do the negative stuff. Again, it is possible that he started modafinil at too high a dosage.
>
>
> - Scott
Posted by IsoM on May 13, 2002, at 14:35:47
In reply to Your provigil jitters » zoe, posted by Iago Camboa on May 11, 2002, at 3:54:39
Today, nestled in the mailbox, was my order of adrafinil! I started dancing about the room (despite my pulled rib muscles), singing to my cats. That made them all excited & happy & they danced about me too. If the neighbours could see me, they'd be convinced I was crazy. Wait... they already know that but think I'm harmless. :-)
Ohhh, I missed that calm, relaxed alertness. With my narcolepsy & the sore ribs, every time I'd sit on the sofa to read or watch TV, I'd be horizontal & asleep in a short while. My poor brain has only felt half-awake this last month or so. I needed a search feature for my brain, but then it would've probably wandered off & fallen asleep too. But my cranky gene was working full-time. Just about bit the head off of some of the managers at work for their stupidity.
OHHH! I'm SOOO happy that it finally came. Hope the effects kick in a little faster than they did before.
Posted by Emme on May 14, 2002, at 7:34:41
In reply to Re: provigil -trying it out » Emme, posted by Ritch on May 13, 2002, at 9:39:16
Hi Ritch,
> Interesting that your doctor wants to retry at an even smaller dosage, despite that experience.
Well, the dose makes the poison. I think sometimes people ditch a drug without first dropping the dose way down to see if that helps. Some folks here (like you ) only need a crumb of Celexa. I never went over 4 mg when trying Celexa.
Anyway, I guess she figured that if 50 mg Provigil made me too high, then some small fraction of that might just perk me up a bit. Easy enough to try I guess. Also, I'm on a different combination than I was last time I tried it. Day one was okay. I'll keep you posted.
I think we need a new term for taking flea sized doses....how about...micropharmacy. :) And if it's several drugs....polymicropharmacy!
> I know the stuff is $$$$ as all getout, *so* if I could just take 1/8 of a $3-5 pill every AM I wouldn't mind forking out the cash.
Ooh, your insurance doesn't cover it?
> I am wondering if a tiny nugget of Provigil combined with the tiny nugget of Celexa I take (every other day) might work out quite well.
I'd recommend giving it a try. See how low you can drop it and still get enough benefit.
Okay, now I could use some advice here from the Provigil folks. How long does it take Provigil to clear out of your system? One day? Two? Is the half life short? What I'd like to do is a "controlled" study on myself and try Provigil for, say three days, then not use it for 3 days or so. Is that long enough? I want to home in on exactly what effect Provigil has on me. The more detailed info I can provide my doctor the better.
Thanks,
Emme
Posted by Ritch on May 14, 2002, at 9:20:40
In reply to Re: provigil -trying it out » Ritch, posted by Emme on May 14, 2002, at 7:34:41
Posted by Iago Camboa on May 14, 2002, at 12:38:39
In reply to Finally Got My ADRAFINIL!!!! » Iago Camboa, posted by IsoM on May 13, 2002, at 14:35:47
Hi Iso,
And I'm SOOO happy that your package arrived in good conditions! If your suppliers are the same as mine they are very reliable people, only a little slow, so one has to remember to place the next order in time.
I can only say 'How I understand your excitement and your joy!'. I've been reading your 'old' posts on the adrafinil and I feel like reading myself, so similar are our responses to that remarkable drug. (Only you describe things better and more accurately than I can do...).
And now that your nightmare of 'half-awakeness' is approaching its end, enjoy every single day the bliss of living fully this only life we all happen to be allowed to live only once!All the very best,
Iago
Posted by Chloe on May 14, 2002, at 21:06:37
In reply to Polymicropharmacy! I like that..thanks (nm) » Emme, posted by Ritch on May 14, 2002, at 9:20:40
Emme,
Glad to hear an update about your meds...
I was thinking for all us microdosers, we should get an analytical balance.I think a jagged, crumble of a pill or whatever I find when I lift the pill splitter, is quite impercise. If I could take so many grams of a crushed pill/day, that I measured out on my balance, then I would be assured of proper microdosing LOL! Gee, I am sounding like a drug dealer...Isn't that what they use to weigh out the goods? Same thing, I guess, sort of.
Anyway, hope the smaller chip of provigil trial is a success.
Take care,
Chloe
Posted by IsoM on May 15, 2002, at 1:01:42
In reply to Re: Finally Got My ADRAFINIL!!!! » IsoM, posted by Iago Camboa on May 14, 2002, at 12:38:39
Posted by Emme on May 16, 2002, at 7:04:49
In reply to Re: provigil -trying it out, posted by Emme on May 13, 2002, at 7:36:02
Hi folks,
Well, it's the morning of day 4 on micropharmacy of Provigil (12.5 mg).
Day 1 was fine. More energy, less depressed, more engaged, with the "gotta run some errands" type energy someone mentioned above.
Day 2 not so bad, but feeling a little bit wired and irritable in the afternoon, but not bad. Overall mood improvement. The stuff seems to hit maximum punch for me in the aftenoon, which is a good 7 hours after taking it in the morning.
Day 3. Yesterday. Felt wired in the afternoon and find it difficult to prioritize, select a task, and focus on it. Not impossible, but difficult. I was exhausted by the end of the day and feel asleep as soon as I got home from work. I think my body was exhausted from the 3 days of being "perked up" by the provigil.
Day 4. Today. Still morning. Let's see what happens. I like the mood improvement, but I'm not sure this is going to work out unless it gets to be a little less stimulating.
Emme
Posted by Ritch on May 16, 2002, at 9:03:34
In reply to low dose Provigil update, posted by Emme on May 16, 2002, at 7:04:49
> Hi folks,
>
> Well, it's the morning of day 4 on micropharmacy of Provigil (12.5 mg).
>
> Day 1 was fine. More energy, less depressed, more engaged, with the "gotta run some errands" type energy someone mentioned above.
>
> Day 2 not so bad, but feeling a little bit wired and irritable in the afternoon, but not bad. Overall mood improvement. The stuff seems to hit maximum punch for me in the aftenoon, which is a good 7 hours after taking it in the morning.
>
> Day 3. Yesterday. Felt wired in the afternoon and find it difficult to prioritize, select a task, and focus on it. Not impossible, but difficult. I was exhausted by the end of the day and feel asleep as soon as I got home from work. I think my body was exhausted from the 3 days of being "perked up" by the provigil.
>
> Day 4. Today. Still morning. Let's see what happens. I like the mood improvement, but I'm not sure this is going to work out unless it gets to be a little less stimulating.
>
> Emme
Hi Emme,Thanks for keeping us posted. Do you also respond this way to a lot of antidepressants (esp. Wellbutrin, SSRI's)? I am hyperresponsive to all of them as well. I can't seem to tolerate a higher dosage of *anything*. Hmmm.. "maximum punch in the afternoon", I like the sound of that a whole lot! ..And you appear to sleep OK. However, on day three you mention having difficulty prioritizing-that doesn't sound so great-sounds like residual anxiety unfortunately. Sounds a lot like Wellbutrin to me (uggh). I wouldn't say "uggh" about the WB that much, except it makes very grouchy, and stimulants don't do that.
Mitch
Posted by krazy kat on May 17, 2002, at 10:34:13
In reply to low dose Provigil update, posted by Emme on May 16, 2002, at 7:04:49
Emme:
Really helpful to me to see this post. I have tried Provigil and am on Ritalin now - there's a thread on the last archived page.
I'm experienceing something similar right now on Ritalin. Will be trying Concerta soon.
- kk
Posted by Emme on May 17, 2002, at 16:00:33
In reply to Re: low dose Provigil update » Emme, posted by Ritch on May 16, 2002, at 9:03:34
Hi Mitch,
> Do you also respond this way to a lot of
> antidepressants (esp. Wellbutrin, SSRI's)?I seem to need low doses of many things. Wellbutrin made me too wired over 150 mg and it had to be used with something sedating like Serzone. Zoloft - too wired at low end therapeutic range. Paxil okay at 10 mg - more = too sleepy. Just like you I guess.
> Hmmm.. "maximum punch in the afternoon", I like > the sound of that a whole lot!
If only it were a good punch. MOrning was better, more normal. The afternoon punch is a bit much.
> difficulty prioritizing-that doesn't sound so
> great-sounds like residual anxiety unfortunately.Or a shortened attention span due to overstimulation.
I'm taking a few days off the Provigil to see how I feel and then if I go back to being too lethargic, I'm going to see if I can shave the provigil down to a puny 6.25 mg. Or some crumb like that.
There are things I like about this drug, but it may end up just being too energizing for me. Maybe it'll end up being something I reserve a crumb of for times when my energy shifts cycles into low gear. Dunno. I'm definitely into exploring teensy doses of things now. I mean my doctor knows enough to try me out at low doses, but I'm thinking that on some things we could have tried still lower. I'll keep you posted.
cheers,
Emme
Posted by Emme on May 17, 2002, at 16:09:12
In reply to Re: low dose Provigil update » Emme, posted by krazy kat on May 17, 2002, at 10:34:13
Hi kk,
Glad my experiment is helping others. How would you compare Provigil and Ritalin? (Or was that covered in the thread you mention?)
I tried Ritalin and it made me too buzzed. But them maybe I just didn't shave it down small enough. ;) Maybe Chloe's right - we should all get analytical balances! I can just imagine being in my kitchen with a balance weighing out my crushed medicine. :)
Good luck with the Concerta. Let us know how it goes.
Emme
> Emme:
>
> Really helpful to me to see this post. I have tried Provigil and am on Ritalin now - there's a thread on the last archived page.
>
> I'm experienceing something similar right now on Ritalin. Will be trying Concerta soon.
>
> - kk
Posted by Ritch on May 17, 2002, at 22:20:30
In reply to Re: low dose Provigil update » Ritch, posted by Emme on May 17, 2002, at 16:00:33
> Hi Mitch,
>
> > Do you also respond this way to a lot of
> > antidepressants (esp. Wellbutrin, SSRI's)?
>
> I seem to need low doses of many things. Wellbutrin made me too wired over 150 mg and it had to be used with something sedating like Serzone. Zoloft - too wired at low end therapeutic range. Paxil okay at 10 mg - more = too sleepy. Just like you I guess.
Hey, you are doing pretty well! The MAX of Wellbutrin I could stand was 150mg/day and that in the absolute middle of a major depression and only for a few days. Paxil at 4mg per day gave me EPS (choking feelings-tongue zaps, etc.), Zoloft-diarrhea/restless legs, Prozac-nightime hallucinations, Luvox-laughing spells, Celexa-choking feelings-tongue zaps, acid reflux (but not as bad as Paxil). Serzone was OK-except that I was dreadfully confused and couldn't see straight (on 50mg/day). Effexor made me itchy, dream vividly, and made me hostile and hypomanic WITH diarrhea and elevated heart rate and blood pressure. IF I didn't get anxious on stimulants, they would be the best meds I had ever taken for seasonal recurrent major depression-most efficacious undoubtedly-with few side effects except for the anxiety. I think I will wind up back on nortripytline or imipramine this time around (TCA's). Unless..long shot....pdoc will go for Concerta.
>
> > Hmmm.. "maximum punch in the afternoon", I like > the sound of that a whole lot!
>
> If only it were a good punch. MOrning was better, more normal. The afternoon punch is a bit much.
That *still* sounds good to me. Mid-late daytime I get the most profound fatigue, I am constantly yawning at work.
>
> > difficulty prioritizing-that doesn't sound so
> > great-sounds like residual anxiety unfortunately.
>
> Or a shortened attention span due to overstimulation.
That is what I got with Wellbutrin. I was too buzzed up and I couldn't focus. Interestingly, methylphenidate or Adderall didn't mess that up (despite the fact that it made me more anxious).>
> I'm taking a few days off the Provigil to see how I feel and then if I go back to being too lethargic, I'm going to see if I can shave the provigil down to a puny 6.25 mg. Or some crumb like that.
>
> There are things I like about this drug, but it may end up just being too energizing for me. Maybe it'll end up being something I reserve a crumb of for times when my energy shifts cycles into low gear. Dunno. I'm definitely into exploring teensy doses of things now. I mean my doctor knows enough to try me out at low doses, but I'm thinking that on some things we could have tried still lower. I'll keep you posted.
>
> cheers,
> EmmeHave a good weekend, I will be away from the computer for a few days, so see ya later,
Mitch
Posted by Zo on May 18, 2002, at 3:51:43
In reply to low dose Provigil update, posted by Emme on May 16, 2002, at 7:04:49
Posted by BLPBart on May 19, 2002, at 4:27:48
In reply to Re: Dex and Provigil a * sweet * combo 4 me (nm), posted by Zo on May 18, 2002, at 3:51:43
Could you elaborate on your combo? I currently take 40 mg/day dexedrine SR along with wellbutrin SR 300 mg/day and sometimes still drag through a day.
Posted by Emme on May 20, 2002, at 10:18:12
In reply to low dose Provigil update, posted by Emme on May 16, 2002, at 7:04:49
Hi Folks,
Update on the experiment. After 4 days of 12.5 mg I was starting to feel worn down. I was exhausted in the evenings - I think from the stimulation of the drug. My doctor said to try half of that (okay now I really will need an analytical balance soon!). I decided to take a few days off just to see how I'd do. The last few days have been okay. I have had acceptable energy and I'm not depressed. But I'm also not undergoing any stressful challenges at the moment that might make me feel more depressed. And I'm task-focused on a trip with friends this weekend. So I'm staying off it for the time being. But if I start to get lethargic and depressed again, I'll try the 6.25 mg. I at least know that the stuff can boost my mood and make me want to interact with people more as well as keep me awake. Maybe the ultra low dose would be the right amount.
Emme
Posted by Emme on May 20, 2002, at 10:28:31
In reply to Re: low dose Provigil update » Emme, posted by Ritch on May 17, 2002, at 22:20:30
>
> Hey, you are doing pretty well! The MAX of Wellbutrin I could stand was 150mg/day and that in the absolute middle of a major depression and only for a few days. Paxil at 4mg per day gave me EPS (choking feelings-tongue zaps, etc.), Zoloft-diarrhea/restless legs, Prozac-nightime hallucinations, Luvox-laughing spells, Celexa-choking feelings-tongue zaps, acid reflux (but not as bad as Paxil). Serzone was OK-except that I was dreadfully confused and couldn't see straight (on 50mg/day).You're right. Compared to what you've experienced I have done pretty well with some of these. You really have had a dreadful time.
> Effexor made me itchy, dream vividly, and made me hostile and hypomanic WITH diarrhea and elevated heart rate and blood pressure.
Effexor was bad news for me, though not as bad as for you. It bumped my heart rate up a lot, which is when we experimented with atenolol. Ditched the Effexor, with the usual discontinuation miseries. But we found that a low dose of atenolol took the edge off my anxiety and I have no side effects from it.
> IF I didn't get anxious on stimulants, they would be the best meds I had ever taken for seasonal recurrent major depression-most efficacious undoubtedly-with few side effects except for the anxiety. I think I will wind up back on nortripytline or imipramine this time around (TCA's).
Do the TCA's give you less trouble than the SSRI's and other antidepressants?
> Unless..long shot....pdoc will go for Concerta.
Is concerta supposed to make you less jittery than ritalin and dexedrine?
> > If only it were a good punch. MOrning was better, more normal. The afternoon punch is a bit much.
> That *still* sounds good to me. Mid-late daytime I get the most profound fatigue, I am constantly yawning at work.Huh, well maybe that would time out nicely for you.
Good luck with the search for the right stimulant-type drug. Have you mentioned how good ole caffeine works for you? I can't tolerate much, but a dash of it (a third of a cup of coke) has been known to keep me from falling asleep in seminars. :)Emme
Posted by Emme on May 20, 2002, at 10:31:49
In reply to Re: low dose Provigil update » krazy kat, posted by Emme on May 17, 2002, at 16:09:12
Hi folks,
Okay, this may be a dumb question, but it sounds like SAM-e is energizing. Could it be used in lieu of provigil or ritalin or whatever? What's the half life of the stuff? I do like the fact that the usual stimulants leave you pretty quickly, so if you're too buzzed on it, you don't have to suffer too long.Thanks,
Emme
Posted by Ritch on May 21, 2002, at 20:57:51
In reply to Re: low dose Provigil update » Ritch, posted by Emme on May 20, 2002, at 10:28:31
> > IF I didn't get anxious on stimulants, they would be the best meds I had ever taken for seasonal recurrent major depression-most efficacious undoubtedly-with few side effects except for the anxiety. I think I will wind up back on nortripytline or imipramine this time around (TCA's).
>
> Do the TCA's give you less trouble than the SSRI's and other antidepressants?Hi, Emme. The most "effective" SSRI that I have taken is fluoxetine. The most "effective" TCA I have taken (esp. for ADHD) is probably desipramine. But I can't really tolerate SSRI's or TCA's. So, my troubles are not efficacy really, it is intolerable side-effects that are sometimes as bad as being depressed or having ADHD symptoms.
>
> > Unless..long shot....pdoc will go for Concerta.
>
> Is concerta supposed to make you less jittery than ritalin and dexedrine?Concerta *is* Ritalin (methylphenidate). It is just a very technical (and pricey) way to make a sustained release methylphenidate that you can take once in the morning.
>
> > > If only it were a good punch. MOrning was better, more normal. The afternoon punch is a bit much.
>
> > That *still* sounds good to me. Mid-late daytime I get the most profound fatigue, I am constantly yawning at work.
>
> Huh, well maybe that would time out nicely for you.
> Good luck with the search for the right stimulant-type drug. Have you mentioned how good ole caffeine works for you? I can't tolerate much, but a dash of it (a third of a cup of coke) has been known to keep me from falling asleep in seminars. :)
>
> EmmeCaffeine works OK. It just upsets my stomach and causes heartburn. It lasts about three hours. I can yawn at work and look at my watch and sure enough about three hours since my last cup.
Oh, I saw your SAMe question below. I have been taking it off and on and it does seem to be energizing, but not really *focusing*. I just feel kind of jumpy, but I don't feel any benefit with concentration (not as good as coffee, i.e.).
Mitch
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