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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by shellie on July 5, 2000, at 22:34:06
Provigil augmentation trial officially over (unless I turn out to have a virus or something). I have never been so tired (not sleepy) in my life. My whole body. Figured out only a few days ago that it's got to be provigil. First thought it was pms. Anyway, since January, I have failed in trying to augment nardil with
(1) sam-e--caused agitated depression;
(2) lamictal--weight gain; helped depression though
(3) aricept--made me feel strange and sick
(4) naltrexon--made me feel confused (only 1 day trial)
(5) provigil-nine day trial; last few days depression lifted, but who cares if I'm too tired to do anything.Just my luck. I take a stimulant and it makes me tired.
My pdoc is reading info on adrafinal. That may be next.shellie (Hope everybody else is having better luck.) Karen B.-- how are you doing on adrafinal?
Posted by KarenB on July 5, 2000, at 22:51:59
In reply to Provigal trial a failure; question to karen b., posted by shellie on July 5, 2000, at 22:34:06
>> Karen B.-- how are you doing on adrafinal?
Much better than Provigil. Really - but this is only day 4. I'll keep you informed. I had terrible, TERRIBLE PMS during my trial with Provigil so I did not give it a fair trial but I did have excessive sleepiness on it, which IS really weird for a narcolepsy drug isn't it? Adrafinil is subtle but it feels much better already. At least no gnarrrrly side effects so far:) Usually, if something is not right for me, it makes me feel sleepy or crazy, very early on in therapy. This is doing neither--could be a good sign.
Don't give up!!
Karen
Posted by JohnL on July 6, 2000, at 4:42:43
In reply to Provigal trial a failure; question to karen b., posted by shellie on July 5, 2000, at 22:34:06
So sorry Shellie. However, there is a silver lining. You are one step closer to finding the right medication. Hang in there.
Just so you know, I've tried both Provigil and Adrafinil. Though they are supposedly similar, I found them to be completely different and not related in any way. So hopefully if you try it, it won't be like Provigil.
JohnL
Posted by SLS on July 6, 2000, at 7:24:56
In reply to Re: Provigal trial a failure; question to karen b., posted by JohnL on July 6, 2000, at 4:42:43
I was going to post a question this morning to ask how people who have taken both Provigil and adrafinil would compare them. I am sitting here with a prescription for Provigil in my pocket, but my gut is telling me not to fill it. Based upon what I see written here, I am inclined to try adrafinil. I need something. It's getting harder for me to read and post things, let alone live well and function. I feel a rant coming on. I think I'll "stuff" it for now, though.
It is such a difficult decision to commit oneself to the inconvenience and seemingly tenuous nature of relying on a drug that must be procured from foreign sources. If adrafinil were available in the U.S. (where I live), the decision would be a no-brainer. I would love to here of people who have had the type of great success with Provigil as is described for adrafinil. So far, I have only seen one person describe such a positive experience with Provigil.
Is there anyone who would like to comment?
JohnL - I have been taking sulpiride for two weeks at 50mg per day. I raised the dosage to 100mg per day as of yesterday, but have not at this point felt anything terribly encouraging. I am having trouble remembering, but were you taking amisulpride together with adrafinil at some point? Are you still taking it? How would you describe your experience with amisulpride?
Thank you all for participating here.
- Scott
Posted by shellie on July 6, 2000, at 9:54:59
In reply to Re: Provigal trial a failure - JohnL et al., posted by SLS on July 6, 2000, at 7:24:56
> > I was going to post a question this morning to ask how people who have taken both Provigil and adrafinil would compare them. I am sitting here with a prescription for Provigil in my pocket, but my gut is telling me not to fill it. Based upon what I see written here, I am inclined to try adrafinil. I need something. It's getting harder for me to read and post things, let alone live well and function. I feel a rant coming on. I think I'll "stuff" it for now, though.
>
> It is such a difficult decision to commit oneself to the inconvenience and seemingly tenuous nature of relying on a drug that must be procured from foreign sources. If adrafinil were available in the U.S. (where I live), the decision would be a no-brainer. I would love to here of people who have had the type of great success with Provigil as is described for adrafinil. So far, I have only seen one person describe such a positive experience with Provigil.
>
> - ScottHi Scott. Rick had really good luck with provigil, so it seems worth trying, especially since you already have the prescription. When I actually asked the question on the board-- who had had success with adrafinal, only JohnL. had already had really positive results. A few others, were thinking of taking it, or had just started it, but I was surprised that JohnL (at that time) was the only person who has unequivically said yes, because there had been so many postings about it. Most of the postings on the board about adrafinil so far have just been interest and questions. So besides Karen B. who I quess is on her fifth day, and one other person --I'm trying to remember who--who was inconclusive yet, I think we're looking at a N of 1 each, of success of provigial and adrafinil. shellie
Posted by SadSuzie on July 6, 2000, at 10:11:45
In reply to Re: Provigal trial a failure; question to karen b., posted by JohnL on July 6, 2000, at 4:42:43
Hi John,
I am anxiously awaiting my arrival of Adrafinil and hope that my experience is as positive as yours. May I ask what dosage you started out on, how long it took to see results, and if you are taking any other meds?
I know you have stated these answers several times on this site, but my memory isn't all that great right now.Thanks,
ss
> So sorry Shellie. However, there is a silver lining. You are one step closer to finding the right medication. Hang in there.
>
> Just so you know, I've tried both Provigil and Adrafinil. Though they are supposedly similar, I found them to be completely different and not related in any way. So hopefully if you try it, it won't be like Provigil.
> JohnL
Posted by shellie on July 6, 2000, at 11:22:58
In reply to Re: Provigal trial a failure; question to karen b., posted by SadSuzie on July 6, 2000, at 10:11:45
> > So sorry Shellie. However, there is a silver lining. You are one step closer to finding the right medication. Hang in there.
> >
> > Just so you know, I've tried both Provigil and Adrafinil. Though they are supposedly similar, I found them to be completely different and not related in any way. So hopefully if you try it, it won't be like Provigil.
> > JohnL
JohnL. Just got a message from my pdoc (unfortunately I was outside). She has some concern about mixing Adrafinil with an MAOI, although she had no concern about mixing the provigil. So they really are, apparently, not all that similar--it would not be surprising that you reacted quite differently to the two. She is also worried about possible liver problems.This is not a very conservative doctor; plus she is an excellent doctor, so I am anxious to talk to her. She said she'll call back to "discuss with me the risks", so I don't think she's eliminating the choice, although I will ask her if she has a preference for me to try something else first.
This also speaks to the importance of talking to your pdoc first, if you are mixing meds on your own. shellie
Posted by SLS on July 6, 2000, at 16:18:10
In reply to Re: adrafinil-JohnL and everyone » SadSuzie, posted by shellie on July 6, 2000, at 11:22:58
Hi Shellie.
Thank you so much for your reply above. I haven't flushed the prescription down the toilet yet.
> JohnL. Just got a message from my pdoc (unfortunately I was outside). She has some concern about mixing Adrafinil with an MAOI, although she had no concern about mixing the provigil. So they really are, apparently, not all that similar--it would not be surprising that you reacted quite differently to the two. She is also worried about possible liver problems.
If the MAO inhibitor is Nardil, perhaps she is concerned about the added stress this drug would place upon the liver. Parnate would not be a concern in this regard.
- Scott
Posted by shellie on July 6, 2000, at 19:16:48
In reply to Re: adrafinil-JohnL and everyone » shellie, posted by SLS on July 6, 2000, at 16:18:10
> If the MAO inhibitor is Nardil, perhaps she is concerned about the added stress this drug would place upon the liver. Parnate would not be a concern in this regard.
> - Scott
Hi Scott. I think my pdoc was not comfortable with adrafinil because it is a stimulant with both dopamine and seratonine release--giving the possiblity of both the dangerous high blood pressure rise, and also the general lowering of blood pressure. She also said there was a higher incidence of liver disfunction with this medication in general. The later doesn't bother me because I would just get liver function tests. But so far I am ambivelent about risking the blood pressure thing. And I think she's reluctant to recommend a combination that she's never seen before and that doesn't look good chemically to her.I would love to see more information about its use in France, i.e., how long it's been used, how often, and if ever with MAOIs. I haven't totally counted it out for the future, because I have eaten everything on the no list for maois in the last twenty years and was even given demerol during a hospital procedure with no bad effects, so I sort of think I don't get the high blood pressure thing. I have had it really dip--when I took serzone and nardil, I felt like I was high, and very airy and light, because my blood pressure was so low. But I also was getting too dizzy.
Second day off provigal, I am definitely more depressed and still tired. She said she thought it would take about three days to get out of my system. I am feeling very disappointed about the provigal side effect for me, and also the fact that she doesn't want me to go on adrafinil. (I am also worried about the tiredness--what if I have chronic fatigue syndrome or something. But she thinks it was probably the provigil.)
Next for me is ridalin with nardil, which is also a bit risky, but my pdoc is more comfortable because she has used them together before.
Good luck in what you decide. I'd recommend again that you try the provigil first, because you have the prescription and it presents the lesser risk. Let me know what you decide. Maybe you could get a second opinion from another pdoc. shellie
Posted by Ant-Rock on July 7, 2000, at 12:16:29
In reply to Re: adrafinil » SLS, posted by shellie on July 6, 2000, at 19:16:48
>
>
> > If the MAO inhibitor is Nardil, perhaps she is concerned about the added stress this drug would place upon the liver. Parnate would not be a concern in this regard.
>
> > - Scott
>
>
> Hi Scott. I think my pdoc was not comfortable with adrafinil because it is a stimulant with both dopamine and seratonine release--giving the possiblity of both the dangerous high blood pressure rise, and also the general lowering of blood pressure. She also said there was a higher incidence of liver disfunction with this medication in general. The later doesn't bother me because I would just get liver function tests. But so far I am ambivelent about risking the blood pressure thing. And I think she's reluctant to recommend a combination that she's never seen before and that doesn't look good chemically to her.
>
> I would love to see more information about its use in France, i.e., how long it's been used, how often, and if ever with MAOIs. I haven't totally counted it out for the future, because I have eaten everything on the no list for maois in the last twenty years and was even given demerol during a hospital procedure with no bad effects, so I sort of think I don't get the high blood pressure thing. I have had it really dip--when I took serzone and nardil, I felt like I was high, and very airy and light, because my blood pressure was so low. But I also was getting too dizzy.
>
> Second day off provigal, I am definitely more depressed and still tired. She said she thought it would take about three days to get out of my system. I am feeling very disappointed about the provigal side effect for me, and also the fact that she doesn't want me to go on adrafinil. (I am also worried about the tiredness--what if I have chronic fatigue syndrome or something. But she thinks it was probably the provigil.)
>
> Next for me is ridalin with nardil, which is also a bit risky, but my pdoc is more comfortable because she has used them together before.
>
> Good luck in what you decide. I'd recommend again that you try the provigil first, because you have the prescription and it presents the lesser risk. Let me know what you decide. Maybe you could get a second opinion from another pdoc. shellieShellie,
Your Dr told you adrafanil has seratonin releasing qualities? Are you sure she wasn't referring to Anafranil? I was under the impression nobody knows how adrafanil works, only theories.
I was concerned about your post because I am combining Parnate with adrafanil with my Dr's approval, but he's leaving it up to me regarding the safety issues regarding non US meds.
Sincrely,Anthony
Posted by shellie on July 7, 2000, at 13:11:35
In reply to Re: adrafinil » shellie, posted by Ant-Rock on July 7, 2000, at 12:16:29
Shellie,
> Your Dr told you adrafanil has seratonin releasing qualities? Are you sure she wasn't referring to Anafranil? I was under the impression nobody knows how adrafanil works, only theories.
> I was concerned about your post because I am combining Parnate with adrafanil with my Dr's approval, but he's leaving it up to me regarding the safety issues regarding non US meds.
> Sincrely,
>
> Anthony
Hi Anthony. You are the other person who I forgot was taking adrafinil. My apologies. There are alot of new names for me, and I looked for your post, but couldn't find it in this large maze of posts.Unfortunately, my pdoc has the medication name right. I faxed her the English translation that Adam was so kind to post. Under mechanisms of action it says:
1. principal
stimulant, central nervous system alpha-I adrenergic agonist. Causes release of serotonin and dopamine at high doses.Then later under dosage and administration it says: Usual dose in 600 to 1200 a day.
I don't see where it defines high doses, so it may above 600; I don't know.You've been on it for a while, right? And no problem so far? Maybe you're fine at the dose you're taking it. I would write to the manufacturer and ask some questions. Actually, I would probably call the company who sent you the adrafinil first and ask them to look into it for you--since they must have a direct link to the manufacturer, or at least ask them how you would proceed to get more information.
I'm going to try ridalin with nardil, but if it's not successful, I may try really digging into any info about adrafinil--like what is a "high dose". So far, do you feel an improvement? Are you feeling any side effects? shellie
Posted by SLS on July 7, 2000, at 15:25:26
In reply to Re: adrafinil » shellie, posted by Ant-Rock on July 7, 2000, at 12:16:29
> Your Dr told you adrafanil has seratonin releasing qualities? Are you sure she wasn't referring to Anafranil? I was under the impression nobody knows how adrafanil works, only theories.
> I was concerned about your post because I am combining Parnate with adrafanil with my Dr's approval, but he's leaving it up to me regarding the safety issues regarding non US meds.
Dear Anthony,Have you already begun the combination treatment?
What have you experienced so far? Improvement? Side effects?
Why did you decide not to try Provigil?
If I recall, you had decided to do this several weeks ago. Did your doctor ask you to sign some sort of waiver?
As far as mechanisms of action are concerned, I only know a little bit about modafinil. The number of citations appearing on Medline regarding adrafinil is quite small, and I haven't tried surfing the Web yet. I would interested to know what you come up with.
Thanks.
- Scott
Posted by Ant-Rock on July 7, 2000, at 15:49:08
In reply to Re: adrafinil » Ant-Rock, posted by shellie on July 7, 2000, at 13:11:35
>
>
>
> Shellie,
> > Your Dr told you adrafanil has seratonin releasing qualities? Are you sure she wasn't referring to Anafranil? I was under the impression nobody knows how adrafanil works, only theories.
> > I was concerned about your post because I am combining Parnate with adrafanil with my Dr's approval, but he's leaving it up to me regarding the safety issues regarding non US meds.
> > Sincrely,
> >
> > Anthony
>
>
> Hi Anthony. You are the other person who I forgot was taking adrafinil. My apologies. There are alot of new names for me, and I looked for your post, but couldn't find it in this large maze of posts.
>
> Unfortunately, my pdoc has the medication name right. I faxed her the English translation that Adam was so kind to post. Under mechanisms of action it says:
> 1. principal
> stimulant, central nervous system alpha-I adrenergic agonist. Causes release of serotonin and dopamine at high doses.
>
> Then later under dosage and administration it says: Usual dose in 600 to 1200 a day.
> I don't see where it defines high doses, so it may above 600; I don't know.
>
> You've been on it for a while, right? And no problem so far? Maybe you're fine at the dose you're taking it. I would write to the manufacturer and ask some questions. Actually, I would probably call the company who sent you the adrafinil first and ask them to look into it for you--since they must have a direct link to the manufacturer, or at least ask them how you would proceed to get more information.
>
> I'm going to try ridalin with nardil, but if it's not successful, I may try really digging into any info about adrafinil--like what is a "high dose". So far, do you feel an improvement? Are you feeling any side effects? shellieThank you for those suggestions Shellie, I really appreciate them. Unfortunately, just as I started to increase the Adrafanil from 150 to 300mg/day, I came down with pneumonia (the week of the 4th, no less.) So I cut back down to 150mg/day until I feel better. At this low dosage I have no side effects, but I am eagerly awaiting to see how it works at 300mg for a couple of weeks.
Good luck with the Ritalin/Nardil trial, this combo has been known to be very effective for some people(Dr Bobs Tips section). Please keep posting on how things turn out, and I will do the same. Hang in there, Shellie.
Sincerely,
Anthony
Posted by SLS on July 7, 2000, at 15:58:00
In reply to Re: adrafinil » SLS, posted by shellie on July 6, 2000, at 19:16:48
Thanks you for everything. I hope I can rely on you in the future for such valuable input.
:-)
I wouldn't be too concerned about the Nardil + Ritalin combo. Adding stimulants to MAOIs is no longer considered a high-risk treatment. You'll find some reassurance of this if you can peruse through Dr. Bob's tips and find the section regarding this combination. There was a section regarding combinations of MAOIs and stimulants, but I'm having trouble finding it for you. Personally, I have taken a combination of Parnate + desipramine + Ritalin. It didn't work, but I'm still here.
See ya'
Love,
Scott
Posted by Ant-Rock on July 7, 2000, at 18:54:05
In reply to Re: adrafinil » Ant-Rock, posted by SLS on July 7, 2000, at 15:25:26
> Dear Anthony,
>
> Have you already begun the combination treatment?
>
> What have you experienced so far? Improvement? Side effects?
>
> Why did you decide not to try Provigil?
>
> If I recall, you had decided to do this several weeks ago. Did your doctor ask you to sign some sort of waiver?
>
> As far as mechanisms of action are concerned, I only know a little bit about modafinil. The number of citations appearing on Medline regarding adrafinil is quite small, and I haven't tried surfing the Web yet. I would interested to know what you come up with.
>
> Thanks.
>
>
> - ScottHi again Scott, I hope things are going ok for you. In my response to Shellie above, I state why I haven't been able to give adrafanil a fair chance yet. Next week I hope to take the dose up to 300mgs and give that some time. My Psychiatrist is very open to me trying almost anything, probably because he's as desperate to get me well as I am. I didn't have to sign a waiver. He never heard of amisulpride or adrafanil, so I guess he trusts my judgement when it comes to meds he knows nothing about. I've been with him over five years.
About provigil,
If adrafanil doesn't work out, I may consider Provigil as an augmentor. My main reason for trying adrafanil 1st is due to JohnL's experience and how it helped his anhedonia/apathy, a big problem for me.
Anyway,
It's always great to hear from you Scott and I hope things are moving in the right direction for you, you certainly deserve it.
Sincerely,
Anthony
This is the end of the thread.
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