Shown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by shellie on June 21, 2000, at 10:17:22
I have had a loss of appetite with provigil (which is okay), but I also feel some nausea, which is not okay. I've been taking it about 5 or 6 days now. First, has anyone else experienced this? Second, if you have, has it gone away over time? Thanks. Shellie
Posted by KarenB on June 21, 2000, at 14:03:42
In reply to side effect with provigil, posted by shellie on June 21, 2000, at 10:17:22
> I have had a loss of appetite with provigil (which is okay), but I also feel some nausea, which is not okay. I've been taking it about 5 or 6 days now. First, has anyone else experienced this? Second, if you have, has it gone away over time? Thanks. Shellie
Shellie,
Other than the nausea you report, is it improving your energy? Mood? Motivation?
Very curious...I am hoping to give it a try, as well.
karen
Posted by shellie on June 21, 2000, at 15:39:15
In reply to Re: How's the provigil? » shellie, posted by KarenB on June 21, 2000, at 14:03:42
> > I have had a loss of appetite with provigil (which is okay), but I also feel some nausea, which is not okay. I've been taking it about 5 or 6 days now. First, has anyone else experienced this? Second, if you have, has it gone away over time? Thanks. Shellie
>
> Shellie,
>
> Other than the nausea you report, is it improving your energy? Mood? Motivation?
>
> Very curious...I am hoping to give it a try, as well.
>
> karenHi Karen. I'm really confused about what's going on with me now. First I thought I was sick in my stomach (having nothing to do with the provigil), now I am thinking it does have to do with the provigil. So I am feeling mostly nausea, and for the last two days, bad depression. I think the depression is related to feeling so physically ill for almost a week. It is hard for me to have any motivation when I feel so sick. The only think I can say for sure is that the provigil has increased my energy--well, actually made me less tired. In a way, that is bad right now--because I feel so bad, I'd like just to get in bed and fall asleep, but I'm not tired! I am not going to take it for a few days to see if my body goes hack to normal, then I might try it again.
Everyone has different reactions to different drugs. Why not try it? Have you tried adrafinil, or did you want to start with the one which has fda approval? I'll let you know what happens with the provigil after I figure it out! My therapist is looking into adrafinil--she'd prefer I stay with provigil because there is more information about it. shellie
Posted by KarenB on June 21, 2000, at 18:33:18
In reply to provigil » KarenB, posted by shellie on June 21, 2000, at 15:39:15
Shellie,
I hope to try Provigil following my appt. tomorrow. In the meantime, I put in an order today for Adrafinil, so I can compare the two. I'll let you know how that turns out. I may add amisulpride or Sulpiride if they alone don't do the job.
Keep us informed, OK?
Karen
Posted by Rick on June 22, 2000, at 16:09:56
In reply to side effect with provigil, posted by shellie on June 21, 2000, at 10:17:22
> I have had a loss of appetite with provigil
(which is okay), but I also feel some nausea,
which is not okay. I've been taking it about 5 or
6 days now. First, has anyone else experienced
this? Second, if you have, has it gone away over
time? Thanks. ShellieI had very mild nauesa the first few days. But
then, this is one side effect that doesn't seem
to hit me as hard as it hits many people. (And
I'm talking about many different meds that can
casue nausea,not just Provigil -- e.g., Celexa,
Serzone). As with AD's that cause nausea, my
readings suggest that among *most* people who
experience nausea with Provigil, it eventually
goes away or becomes very mild. The nausea can
disappear pretty suddenly at some point, or it can
be a gradual improvement over two-four weeks.A couple more thoughts:
-- If you're not already doing so, take the
Provigil after a meal. This could certainly help
reduce nausea. Taking it after a meal delays
absorption by about an hour, but does not reduce
the amount or duration of beneficial effects in
any way.-- I assume you started low...certainly no higher
than 100 mg. If you did start at 100, then maybe
you should cut back to 50, or even 25. Then,
building up slowly to your optimal theraputic dose
(usually 200, but 100 might work) could reduce
nausea and any other side effects as your body
gradually acclimates to the Provigil.Finally remember that while some wakefulness
should be apparent very soon, other beneficial
effects can take longer -- e.g. Provigil's
antidepressant and mood-brightening effects
usually take 5-10 days at a theraputic dose. I'm
not sure I buy into this one, but a "good drug"
guide says memory-enhancement kicks in after about three months. (Cephalon IS currently testing
Provigil for use in Alzheimer's and ADHD.)Hope this helps,
RickP.S. If you or Karen do end up with Adrafinil
instead of Provigil, be
Posted by shellie on June 22, 2000, at 19:08:37
In reply to Re: side effect with provigil, posted by Rick on June 22, 2000, at 16:09:56
> >
>
> I had very mild nauesa the first few days. But
> then, this is one side effect that doesn't seem
> to hit me as hard as it hits many people. (And
> I'm talking about many different meds that can
> casue nausea,not just Provigil -- e.g., Celexa,
> Serzone). As with AD's that cause nausea, my
> readings suggest that among *most* people who
> experience nausea with Provigil, it eventually
> goes away or becomes very mild. The nausea can
> disappear pretty suddenly at some point, or it can
> be a gradual improvement over two-four weeks.
>
> A couple more thoughts:
>
> -- If you're not already doing so, take the
> Provigil after a meal. This could certainly help
> reduce nausea. Taking it after a meal delays
> absorption by about an hour, but does not reduce
> the amount or duration of beneficial effects in
> any way.
>
> -- I assume you started low...certainly no higher
> than 100 mg. If you did start at 100, then maybe
> you should cut back to 50, or even 25. Then,
> building up slowly to your optimal theraputic dose
> (usually 200, but 100 might work) could reduce
> nausea and any other side effects as your body
> gradually acclimates to the Provigil.
>
> Finally remember that while some wakefulness
> should be apparent very soon, other beneficial
> effects can take longer -- e.g. Provigil's
> antidepressant and mood-brightening effects
> usually take 5-10 days at a theraputic dose. I'm
> not sure I buy into this one, but a "good drug"
> guide says memory-enhancement kicks in after about three months. (Cephalon IS currently testing
> Provigil for use in Alzheimer's and ADHD.)
>
> Hope this helps,
> Rick
>
> P.S. If you or Karen do end up with Adrafinil
> instead of Provigil, beThanks Rick, for the feedback. I think I will stay off of it for a couple of days and then try again, slower and more conscious of trying it after meals. By the way, your p.s. about adrafinin to Karen and I was truncated, be.....? shellie
Posted by KarenB on June 23, 2000, at 0:31:20
In reply to Re: side effect with provigil, posted by Rick on June 22, 2000, at 16:09:56
> P.S. If you or Karen do end up with Adrafinil
> instead of Provigil, beI'm hanging on the edge of my seat, Rick. Be...what?????
I've ordered Adrafinil already, to compare the two later. I start Provigil tomorrow.
Karen
Posted by Rick on June 23, 2000, at 2:14:12
In reply to Re: provigil » Rick, posted by KarenB on June 23, 2000, at 0:31:20
> > P.S. If you or Karen do end up with Adrafinil
> > instead of Provigil, be
>
> I'm hanging on the edge of my seat, Rick.
Be...what?????
>
> I've ordered Adrafinil already, to compare the
two later. I start Provigil tomorrow.
>
> KarenSorry shellie and Karen, I wasn't trying to build
suspense! Apparently my truncated-post curse has
returned.What I was trying to say, before I was so "rudely"
interrupted: If you end up with Adrafinil instead
of Provigil, be sure to take the required
QUARTERLY liver function tests to rule out the
sometimes-seen hepatic toxicity. Provigil doesn't
require this, although yearly liver tests (or
better yet semi-annual) are wise when taking any
of the many psychotropics that are eliminated via
the CYP 450 enzyme system.
Posted by SLS on June 25, 2000, at 8:16:34
In reply to Re: side effect with provigil, posted by Rick on June 22, 2000, at 16:09:56
> Finally remember that while some wakefulness
should be apparent very soon, other beneficial
effects can take longer -- e.g. Provigil's
antidepressant and mood-brightening effects
usually take 5-10 days at a theraputic dose. I'm
not sure I buy into this one, but a "good drug"
guide says memory-enhancement kicks in after about three months. (Cephalon IS currently testing
Provigil for use in Alzheimer's and ADHD.)
Hi Rick.Have you ever tried adrafinil?
Did you suffer from severe depression, or were social anxiety and panic attacks your primary sufferings?
How long did it take for you to begin to see improvements with Provigil?
Thanks for your input.
- Scott
Posted by Rick on June 26, 2000, at 10:57:43
In reply to Re: side effect with provigil » Rick, posted by SLS on June 25, 2000, at 8:16:34
> > Finally remember that while some wakefulness
> should be apparent very soon, other beneficial
> effects can take longer -- e.g. Provigil's
> antidepressant and mood-brightening effects
> usually take 5-10 days at a theraputic dose. I'm
> not sure I buy into this one, but a "good drug"
> guide says memory-enhancement kicks in after about three months. (Cephalon IS currently testing
> Provigil for use in Alzheimer's and ADHD.)
>
>
> Hi Rick.
>
> Have you ever tried adrafinil?
>
> Did you suffer from severe depression, or were social anxiety and panic attacks your primary sufferings?
>
> How long did it take for you to begin to see improvements with Provigil?
>
> Thanks for your input.
>
>
> - Scott
Scott -Sometimes I give brief replies to brief questions. Other times I give long replies to brief questions. I think this one will fill into the latter category.
I've never had major depression (except possibly undiagnosed after my mother died unexpectedly eleven years ago). My problems are severe social anxiety in many -- but not all -- settings, and obsessive/compulsive tendencies (not officially diagnosed, and much milder and less bothersome than the social anxiety). I haven't been diagnosed with panic, although a debilitating performmance-anxiety-driven panic or near-panic situation is what finally prompted me to seek the professional help I had been considering for awhile.
I've never tried adrafinil. I've been greatly improved in the eight or nine months since starting daily "low-ish" dose Klonopin, but have tried other meds lately in an attempt to "go for the gold" (and POSSIBLY taper off the Klonopin completely or near-completely in the future). So I can't tell you whether Provigil (modafinil) ALONE would have helped me, but I know that within a day of adding it to Serzone & Klonopin I was feeling more alert and awake WITHOUT added anxiety, and within ten days or so it had begun filling in the gaps SO nicely a
Posted by Rick on June 26, 2000, at 11:08:15
In reply to Re: side effect with provigil, posted by Rick on June 26, 2000, at 10:57:43
(My aborted-post curse has returned. Continuing..)
I've never tried adrafinil. I've been greatly improved in the eight or nine months since starting daily "low-ish" dose Klonopin, but have tried other meds lately in an attempt to "go for the gold" (and POSSIBLY taper off the Klonopin completely or near-completely in the future). So I can't tell you whether Provigil (modafinil) ALONE would have helped me, but I know that within a day of adding it to Serzone & Klonopin I was feeling more alert and awake WITHOUT added anxiety, and within ten days or so it had begun filling in the gaps SO nicely and adding a wonderful dimension to my treatment.Something rather telling about Provigil's contribution: A few weeks ago I decided it might be wise to stop taking this gentle stimulant and mood-brightener before getting my gallbladder removed. Going from 200mg of Provigil to zero overnight presented no withdrawal-type problems whatsoever (for ME, anyways). I was still doing pretty darn well on just the Klonopin and Serzone, but a few days after adding back the Provigil, MAN can I feel the difference! I feel GREAT!!
It's not quite this simple, but here's a metaphor for how I see things coming together:
The Klonopin and Serzone relax me so that I can get myself to step into the sea of social interaction. When I add the Provigil, not only do I get into the water and stay afloat, but I feel so much more confident, motivated, and energized that I take off and SWIM! By NO means have I become a "party animal", but for the first time in my life I find myself actually SEEKING OUT some social interaction instead of fearing and avoiding it.While understanding or theorizing about the chemical mechanisms involved is both important and interesting (and I envy your knowledge in that regard), there can be some big missed opportunities (Type II errors, if you will) in the absence of safe and cautious "leaps". Some studies and theories on Povigil's pharmokinetics would lead one to expect
Posted by Rick on June 26, 2000, at 12:02:44
In reply to Re: side effect with provigil - CONT'D, posted by Rick on June 26, 2000, at 11:08:15
(Continuing from where the last post aborted...)
While understanding or theorizing about the chemical mechanisms involved is both important and interesting (and I envy your knowledge in that regard), there can be some big missed opportunities (Type II errors, if you will) in the absence of safe and cautious "leaps". Some studies and theories on Povigil's pharmokinetics might lead one to conclude that this would not be a go-to drug for someone with prominent anxiety, especially in tandem with benzos (and for many people including JohnL, that could be true). But to me, that's all secondary to real-life human efficacy and safety. No one REALLY understands how most modern psychotropics exert their beneficial actions, anyways. Take SSRI's, for instance. There is growing belief that serotonin reuptake inhibition or other SSRI properties may be setting off a long chain of secondary, tertiary and "beyond" activities that drive much -- or even most -- of the beneficial effects, especially when used for disorders other than major depression. This could explain why it often takes a long time for theraputic value to show up -- as long as four months for some anxiety disorders like OCD. As you probably know, there is increasing interest and debate as to whether their is validity to the inyuitively accepted need for steady-state blood levels of the "parent" drug, when in fact it could actually be the "last domino" in a comples chain of chemical effects set off by the parent that really benefits the user. Mintaining constant levels of the parent drug may be accomplishing nothing but increased side effects. (Obviously this is largely unexplored territory to-date. Even if right on the money, the clinical impliations of this concept could vary greatly by drug and/or patient. There is a very interesting new article in Medscape about whether steady-state ioavailability should always be sought, although the author cautions that much further research is necessary.)
I started Provigil to counter
Posted by Rick on June 26, 2000, at 12:07:30
In reply to Re: side effect with provigil - CONT'D #2, posted by Rick on June 26, 2000, at 12:02:44
Continuing from where the previous poet aborted. HOPEFULLY this will get us to the end!)
I started Provigil to counteract undesired laziness and occasional fatigue effects that may have been worsened by the known-for-sedation Serzone, especially as my body tried to get used to it. I never would have expected how much improvement (way beyond pre-meds levels) that I got from Provigil for these problems, and I feared it would help my social anxiety little -- or even make it worse. And I certainly never expected so much mood-lifting (natural feeling -- not manic, overly euphoric, or high) -- especially since I was not depressed. Boy, were my fears and expectations (thankfully) wrong! Provigil actually *helped* ALL of the above without insomnia or any other significant side effects. And my sexual interest, sensation, and performnce are now conistently at all-time highs, another unexpected bonus. Again, I must point out that my responses to Provigil MAY have been different in the absence of one or both of the other meds I had been taking.
Anyways, I don't even care whether it's a *placebo* effect (I think I heard my wallet squeal when I typed that sentence)! For me, for whatever reason, Provigil really helps. As long as it continues to help and appears safe, let me at it!
Good luck to you,
Rick
Posted by Rick on June 26, 2000, at 14:28:34
In reply to Re: side effect with provigil - CONT'D #4, posted by Rick on June 26, 2000, at 12:07:30
No more here...subject line said it all. I just didn't want the jump from "CONT'D #2" to "CONT'D #4" to lead Scott or anyone else to conclude that part of my multi-post response didn't go through. The last post was the final one, but just mis-titled. Between my apparent system problems, Dr-Bob's frustrating server problems, and repeated cutting-and-pasting, I'm surprised there weren't even more slip-ups!
Since no one else to be having this aborted-post problem, I'll have to figure out how to fix my system.
Posted by KarenB on June 26, 2000, at 22:44:41
In reply to CORRECTION: TITLE OF LAST POST S/B CONT'D #3 , posted by Rick on June 26, 2000, at 14:28:34
Rick,
I'm so glad you gave your long response to a short question.
I just started Provigil three days ago and what you had to say was really encouraging. I woukdn't get within a mile of another SSRI or the like (Serzone), but I think the addition of a small dose of Klonopin doesn't sound like an altogether bad idea.
Karen
Posted by shellie on June 26, 2000, at 23:54:30
In reply to Re: Thanks, Rick..., posted by KarenB on June 26, 2000, at 22:44:41
Karen, how's the provigil trial so far? What dose did you start with? Also, are you using it as an adjunct to an antidepressant, or alone. You may have told me, I forget. I started again today with just 50 mg. Last time I started with 200 for two days, then went up 400, so that was probably too fast. shellie
Posted by Rick on June 27, 2000, at 1:13:37
In reply to Re: Thanks, Rick..., posted by shellie on June 26, 2000, at 23:54:30
Karen - You're quite welcome!
I hope both of you have the opportunity to keep everyone up-to-date with your progress, including both benefits (yes!) and possible side effects (hiss!). Even though I won't be able to visit this site more than a few times over the next couple weeks, I'll be looking for any reactons from you, pro or con. And if I have any unexpected change in my own positive reaction to Provigil, I'll report back.
Finally if one of you eventually ends up switching to adrafinil, I and many other Psycho-Babble readers would be interested in hearing how it compares to Provigil in your situation.Shellie, with regard to the side effects, I've got my fingers crossed that the slow-build approach will keep the nausea at bay. I don't know all of the details of your situation, but I'm kind of surprised you would have gone as high as 400 mg. at all, let alone so quickly. I don't know...maybe a high dose can be helpful for ADD. But at least for the label indication of narcolepsy, studies suggested that increasing the dose above 200 mg. usually just added to side effects while providing only a spotty enhancements in efficacy. Of couse, YMMV.
Incidentally, Karen, I'm not trying to push the Serzone (indeed, I think the Klonopin is still more important in treating my Social Phobia), but note that I am sticking with a pretty low dose -- 300 mg/day. As you know, Serzone is not an SSRI, although it is close kin in some ways. I had far fewer side effects from 300 mg Serzone than from 20 mg Celexa (most vividly in terms of sexual drive and function). But I do know that many people can't stand it, especially at more-typical doses of 400-600. I do have one friend who is taking 400 mg Serzone with zero side effects, although she seems virtually immune to all med side effects except nasal congestion!
Rick
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