![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Rick on January 24, 2002, at 21:15:19
Until recently, I only took Provigil soley in combo with Serzone and Klonopin. And my blood pressure was fine...if anything, it dropped a bit. That didn't surprise me, because one advantage of Provigil over traditional stims was supposed to be that it didn't raise BP or heart rate.
That combo is fantastic for my social phobia, but I've been going without Serzone for awhile to see if I can ditch the annoying memory lapses. (I know Klonopin can be amnesic, but I'm on a low dose and had little in the way of memory problems when I was taking Klonopin alone.)
While I've had only modest deterioration in teatment effectiveness, I've been surprised to find that without the Serzone, Provigil clearly raises my BP and heart rate, and also results in much more variation than before. Whereas I'd have a typical 105-120/65-80 in late afternoon, it now routinely gets as high as 150/100. And this is at a relatively low 100 mg. of Provigil. When I've tried 200 mg, which again never affected my BP while I was also taking Serzone, I've gone as high as 160/105.
First-thing-in-the-morning readings are still pretty good. And I know that a person's BP typically rises until about 2 pm, but mine just keeps rising into the evening, and it's too much of a rise.
Any ideas or similar experiences? I'd surmise my reaction probably isn't typical; my BP tends to be very med sensitive in both directions (although Klonopin has no effect). Maybe it's just that the Serzone was lowering it a lot, offsetting a Provigil-induced rise...i.e., maybe I would be hypotensive on Klonopin and Serzone alone. Or was some sort of interaction involved? (Serzone's a powerful inhibitor of liver enzyme CYP3A4, which Provigil uses for clearance, but I don't see how that could attenuate Provigil's BP effect.)
Posted by Ray on January 25, 2002, at 14:50:05
In reply to Provigil/modafinil raising blood pressure????, posted by Rick on January 24, 2002, at 21:15:19
Hi Rick
(my name says Ray is the old KregPark could not stand that name anymore!)
Actually I believe I have similar effect to you with BP.
> Until recently, I only took Provigil soley in combo with Serzone and Klonopin. And my blood pressure was fine...if anything, it dropped a bit. That didn't surprise me, because one advantage of Provigil over traditional stims was supposed to be that it didn't raise BP or heart rate.
In my opinion that is mostly due to Serzone and the hypotension it usually causes. Serzone is a spin off of the older trazodone which is so dizzying it is often intolerable.> That combo is fantastic for my social phobia, but I've been going without Serzone for awhile to see if I can ditch the annoying memory lapses. (I know Klonopin can be amnesic, but I'm on a low dose and had little in the way of memory problems when I was taking Klonopin alone.)
>
> While I've had only modest deterioration in teatment effectiveness, I've been surprised to find that without the Serzone, Provigil clearly raises my BP and heart rate, and also results in much more variation than before. Whereas I'd have a typical 105-120/65-80 in late afternoon, it now routinely gets as high as 150/100. And this is at a relatively low 100 mg. of Provigil. When I've tried 200 mg, which again never affected my BP while I was also taking Serzone, I've gone as high as 160/105.
>
> First-thing-in-the-morning readings are still pretty good. And I know that a person's BP typically rises until about 2 pm, but mine just keeps rising into the evening, and it's too much of a rise.
Traditional stimulants may be hypotensive or hypertensive. Also the up/down effect is signficant so BP may bounce high/low/high/low etc. Provigil does appear to be selective serotonin agonist, and (won't repeat history) - debatably selective dopamine and/or ne boosting also.
I'm not certain but I think serotonin syndrome also leads to high blood pressure.
>
> Any ideas or similar experiences? I'd surmise my reaction probably isn't typical; my BP tends to be very med sensitive in both directions (although Klonopin has no effect). Maybe it's just that the Serzone was lowering it a lot, offsetting a Provigil-induced rise...i.e., maybe I would be hypotensive on Klonopin and Serzone alone. Or was some sort of interaction involved? (Serzone's a powerful inhibitor of liver enzyme CYP3A4, which Provigil uses for clearance, but I don't see how that could attenuate Provigil's BP effect.)
Serzone known to interact negatively with a number of mood stabilzers, Prozac, probably others.As you know I add Provigil to Nardil 60 + Klonopin 2.5
Not long after adding Provigil a year ago, I tried dropping Nardil. Was more stimulating without Nardil. Quite effective I think but hair loss immediately. Was a bit agitated too, and as usual did not have time to give trial due to "back to work".I wonder how Klonopin effects Provigil? Perhaps no Klonopin would render Provigil *less* stimulating...
Oh well better get off computer!!
Posted by Rick on January 26, 2002, at 1:01:58
In reply to Re: Provigil/modafinil raising blood pressure???? » Rick, posted by Ray on January 25, 2002, at 14:50:05
Ray -
You're taking your Provigil with Nardil, right? Does that offset the rise in BP you get from Provigil? Nardil lowered my BP bigtime, although I don't know if that effect would have continued had I taken it for more than a month.
Also, do you find that 75 mg Provigil provides as much benefit as 100 mg? I tried 50 mg and the BP didn't rise as much, but Provigil's benefits seemed decidedly diminished. Maybe 75 mg would be worth trying.
Thanks,
Rick> Hi Rick
>
> (my name says Ray is the old KregPark could not stand that name anymore!)
>
> Actually I believe I have similar effect to you with BP.
>
>
> > Until recently, I only took Provigil soley in combo with Serzone and Klonopin. And my blood pressure was fine...if anything, it dropped a bit. That didn't surprise me, because one advantage of Provigil over traditional stims was supposed to be that it didn't raise BP or heart rate.
> In my opinion that is mostly due to Serzone and the hypotension it usually causes. Serzone is a spin off of the older trazodone which is so dizzying it is often intolerable.
>
> > That combo is fantastic for my social phobia, but I've been going without Serzone for awhile to see if I can ditch the annoying memory lapses. (I know Klonopin can be amnesic, but I'm on a low dose and had little in the way of memory problems when I was taking Klonopin alone.)
> >
> > While I've had only modest deterioration in teatment effectiveness, I've been surprised to find that without the Serzone, Provigil clearly raises my BP and heart rate, and also results in much more variation than before. Whereas I'd have a typical 105-120/65-80 in late afternoon, it now routinely gets as high as 150/100. And this is at a relatively low 100 mg. of Provigil. When I've tried 200 mg, which again never affected my BP while I was also taking Serzone, I've gone as high as 160/105.
> >
> > First-thing-in-the-morning readings are still pretty good. And I know that a person's BP typically rises until about 2 pm, but mine just keeps rising into the evening, and it's too much of a rise.
> Traditional stimulants may be hypotensive or hypertensive. Also the up/down effect is signficant so BP may bounce high/low/high/low etc. Provigil does appear to be selective serotonin agonist, and (won't repeat history) - debatably selective dopamine and/or ne boosting also.
> I'm not certain but I think serotonin syndrome also leads to high blood pressure.
> >
> > Any ideas or similar experiences? I'd surmise my reaction probably isn't typical; my BP tends to be very med sensitive in both directions (although Klonopin has no effect). Maybe it's just that the Serzone was lowering it a lot, offsetting a Provigil-induced rise...i.e., maybe I would be hypotensive on Klonopin and Serzone alone. Or was some sort of interaction involved? (Serzone's a powerful inhibitor of liver enzyme CYP3A4, which Provigil uses for clearance, but I don't see how that could attenuate Provigil's BP effect.)
> Serzone known to interact negatively with a number of mood stabilzers, Prozac, probably others.
>
> As you know I add Provigil to Nardil 60 + Klonopin 2.5
> Not long after adding Provigil a year ago, I tried dropping Nardil. Was more stimulating without Nardil. Quite effective I think but hair loss immediately. Was a bit agitated too, and as usual did not have time to give trial due to "back to work".
>
> I wonder how Klonopin effects Provigil? Perhaps no Klonopin would render Provigil *less* stimulating...
>
> Oh well better get off computer!!
>
> Ray
> http://www.socialfear.com/
Posted by Rick on January 26, 2002, at 1:15:18
In reply to Re: Provigil/modafinil raising blood pressure???? » Ray, posted by Rick on January 26, 2002, at 1:01:58
The OOPS is because I didn't notice until just after I posted a reply that you had made some more comments near the bottom. (The continuation of the single-carats threw me off.)
> > I wonder how Klonopin effects Provigil? Perhaps no Klonopin would render Provigil *less* stimulating...
I actually tried this to see if it was somehow the *combo* of the two, minus Serzone, that was raising my BP. Interesting theory, but didn't seem to be the case. On Provigil alone, I felt really wired, more anxious, and my BP was even a little higher than with the combo. Of course, it was only a three-quarters day trial, but I have a feeling this was telling the "true story". And I don't think it was Klonopin withdrawal, because I've gone nearly 48 hours without it in the past with no physical distress.
I wonder how solo adrafinil would feel compared to that? Or amisulpride? (I still won't take anything that I have to order from overseas due to concerns over consistent delivery, consistent availability, consistent quality, and legality.)
Rick
Posted by kregpark@yahoo.com on January 29, 2002, at 3:09:21
In reply to Re: Provigil/modafinil raising blood pressure???? » Ray, posted by Rick on January 26, 2002, at 1:01:58
Hi Rick, lost my ray name somehow.
> Ray -
>
> You're taking your Provigil with Nardil, right?yep
Does that offset the rise in BP you get from Provigil?
haven't measured but based I know that Nardil lowers it some and my sense is it lowers when Provigil in there also.
Nardil lowered my BP bigtime, although I don't know if that effect would have continued had I taken it for more than a month.
I occasionally got dizzy a few seconds during first few months. Went away totally at 90mg. I don't know the relationship of that to actual blood pressure though, if BP is lower at first.
>
> Also, do you find that 75 mg Provigil provides as much benefit as 100 mg? I tried 50 mg and the BP didn't rise as much, but Provigil's benefits seemed decidedly diminished. Maybe 75 mg would be worth trying.> I do ok between between 50-100, but 100 every single day might be a bit much. Also I vary Klonopin. 3k with 50p, 2.75k,75p, and 2.5k, 100p. The former is more relaxing, probably a bit more social with that. The latter is more energizing physically and mentally, but if sustained I may get a bit too hyper.
ray/kregpark
>
>
>
> > Hi Rick
> >
> > (my name says Ray is the old KregPark could not stand that name anymore!)
> >
> > Actually I believe I have similar effect to you with BP.
> >
> >
> > > Until recently, I only took Provigil soley in combo with Serzone and Klonopin. And my blood pressure was fine...if anything, it dropped a bit. That didn't surprise me, because one advantage of Provigil over traditional stims was supposed to be that it didn't raise BP or heart rate.
> > In my opinion that is mostly due to Serzone and the hypotension it usually causes. Serzone is a spin off of the older trazodone which is so dizzying it is often intolerable.
> >
> > > That combo is fantastic for my social phobia, but I've been going without Serzone for awhile to see if I can ditch the annoying memory lapses. (I know Klonopin can be amnesic, but I'm on a low dose and had little in the way of memory problems when I was taking Klonopin alone.)
> > >
> > > While I've had only modest deterioration in teatment effectiveness, I've been surprised to find that without the Serzone, Provigil clearly raises my BP and heart rate, and also results in much more variation than before. Whereas I'd have a typical 105-120/65-80 in late afternoon, it now routinely gets as high as 150/100. And this is at a relatively low 100 mg. of Provigil. When I've tried 200 mg, which again never affected my BP while I was also taking Serzone, I've gone as high as 160/105.
> > >
> > > First-thing-in-the-morning readings are still pretty good. And I know that a person's BP typically rises until about 2 pm, but mine just keeps rising into the evening, and it's too much of a rise.
> > Traditional stimulants may be hypotensive or hypertensive. Also the up/down effect is signficant so BP may bounce high/low/high/low etc. Provigil does appear to be selective serotonin agonist, and (won't repeat history) - debatably selective dopamine and/or ne boosting also.
> > I'm not certain but I think serotonin syndrome also leads to high blood pressure.
> > >
> > > Any ideas or similar experiences? I'd surmise my reaction probably isn't typical; my BP tends to be very med sensitive in both directions (although Klonopin has no effect). Maybe it's just that the Serzone was lowering it a lot, offsetting a Provigil-induced rise...i.e., maybe I would be hypotensive on Klonopin and Serzone alone. Or was some sort of interaction involved? (Serzone's a powerful inhibitor of liver enzyme CYP3A4, which Provigil uses for clearance, but I don't see how that could attenuate Provigil's BP effect.)
> > Serzone known to interact negatively with a number of mood stabilzers, Prozac, probably others.
> >
> > As you know I add Provigil to Nardil 60 + Klonopin 2.5
> > Not long after adding Provigil a year ago, I tried dropping Nardil. Was more stimulating without Nardil. Quite effective I think but hair loss immediately. Was a bit agitated too, and as usual did not have time to give trial due to "back to work".
> >
> > I wonder how Klonopin effects Provigil? Perhaps no Klonopin would render Provigil *less* stimulating...
> >
> > Oh well better get off computer!!
> >
> > Ray
> > http://www.socialfear.com/
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.