![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 32. This is the beginning of the thread.
Posted by 3 Beer Effect on February 6, 2002, at 12:18:54
I always had a problem of abusing ADD psychostimulants such as Ritalin (my favorite), Dexedrine, & Adderall & even Cocaine a few times; So as a service to the wonderful field of psychiatry I thought I would take Provigil for a test drive of its abuse potential to make sure it is safe for my fellow psycho-babblers.
I just got a prescription for Provigil (Modafinil) for Provigil 200 mg/day. Since I had a complementary sample bottle of six extra Provigils I decided to try 600 mg the first day & 400 mg the second day (today). {from tommorrow onward I'll definitely go back to the normal 200 mg dose}. Somewhere I read that it was feared Provigil may have an abuse potential much like the other psychostimulants since it supposedly causes euphoria at doses of 500 mg/day or greater. Currently Provigil is Schedule IV (low potential for abuse) while the other psychostimulants/ADD meds Dexedrine, Adderall, & Ritalin, Focalin, Concerta are Schedule II (high potential for abuse, DEA triplicate prescription required, no refills allowed).
I personally found that Provigil has a low potential for abuse since it lacks the most desirable quality of abusable stimulant drugs- euphoria. Both 600 & 400 mg feel roughly similar to 5-10 mg Dexedrine but without euphoria. Provigil does none cause any of that great 'on top of the world' amphetamine feeling that Dexedrine or even Adderall does.
Unfortunately, at 600 or 400 mg, Provigil is dysphoric & feels exactly like if you took too many No Doz caffeine pills. The most notable dysphoric feeling is a rapid heartbeat that lasts all day long & nausea. Also seems to cause lack of appetite but does increase energy. It does seem to make you optimistic & have anti-depressant qualities-- will definitely get you out of bed in the morning if you have the type of severe depression where you stay in bed all day. So far, seems to be inferior to Ritalin for brain stimulation, but some said Provigil takes up to a month for its full psychostimulant effect.
Doctors take note: A great beneficial use of Provigil would be to counteract the daytime drowsiness/somnolence effect of Remeron. Remeron is supposed to be one of the most powerful antidepressants & if it was taken (at night) in combination with Provigil 200 mg (in the morning) it would be an antidepressant combo almost completely free of side effects! (Remeron has no sexual side effects, Provigil would cancel out both the Remeron daytime sedation & appetite increase).
Doctors now have a stimulant that they can safely prescribe to alcoholics or former alcoholics & perhaps even to former drug addicts who have attention deficit disorder or brain degeneration/atrophy/lesions from alcohol/drug abuse.
Perhaps more importantly, Provigil diversion to the street illegal drug trade will most likely NOT occur. Provigil is NOT water soluble & so cannot be given by a needle (intraveneuosly). There has been some diversion of the other psychostimulants (dexedrine) & surprisingly Ritalin is somewhat popular on the illicit drug market- Ritalin is known as "West Coast" & is often combined with Talwin(Pentazocine) "T's & Rits" or even with Zoloft "Zoomers" & is snorted or injected intraveneously.
Posted by Ritch on February 6, 2002, at 13:16:08
In reply to Provigil- took test drive of abuse potential- none, posted by 3 Beer Effect on February 6, 2002, at 12:18:54
Posted by Rick on February 8, 2002, at 1:30:51
In reply to Provigil- took test drive of abuse potential- none, posted by 3 Beer Effect on February 6, 2002, at 12:18:54
Thought I'd compare notes re your reactions to Provigil. I have not used any of the traditional psychostimulant drugs, although purely from the standpoint of stimulation, I found selegiline (deprenyl) to be in the same league. Of course, selegiline is contra-indicated with many AD's. Plus, unlike Provigil, it added anxiety and kacked many of Provigil's unique benefits. (Selegiline's great for cogniton, memory, and sexual stimulation, though.) And importantly, all of my experience is based on taking Provigil in combo with low-dose Klonopin, or both Klonopin and Serzone.
>Somewhere I read that it was feared Provigil may have an abuse potential much like the other psychostimulants since it supposedly causes euphoria at doses of 500 mg/day or greater.
I undersood the euphoria had been reported at much smaller, traditional doses as well.
>Currently Provigil is Schedule IV (low potential for abuse) while the other psychostimulants/ADD meds Dexedrine, Adderall, & Ritalin, Focalin, Concerta are Schedule II (high potential for abuse, DEA triplicate prescription required, no refills allowed).
There have been very few reports of abuse potential with Provigil. The warning may be based on a 1996 study of rats. Their conclusion hardly sounds too cautionary, though:
"The reinforcing and discriminative stimulus effects of modafinil-required very high doses: modafinil was over 200 times less potent than d-amphetamine and was also less potent than l-ephedrine. These results show that modafinil has some cocaine-like discriminative stimulus effects and, like other abused stimulants, can serve as a reinforcer at high doses."> I personally found that Provigil has a low potential for abuse since it lacks the most desirable quality of abusable stimulant drugs- euphoria. Both 600 & 400 mg feel roughly similar to 5-10 mg Dexedrine but without euphoria. Provigil does none cause any of that great 'on top of the world' amphetamine feeling that Dexedrine or even Adderall does.
I once heard someone suggest that Cephalon *could* have demonstrated the lack of abuse potential in humans, but this would have resulted in too much delay in FDA approval, thus lost revenue.
The first time I took it (200mg), I did have some mild euphoria, but it was short-lived. About half the times that I temporarily bump the dose from 100 mg to 200mg, the mild euphoria briefly returns. But I can easily go cold turkey on Provigil -- have done so several times.
> Unfortunately, at 600 or 400 mg, Provigil is dysphoric & feels exactly like if you took too many No Doz caffeine pills.
But why is there any reason take that much? Provigil certainly doesn't feel like that at typical doses. And even the manufacturer, who wants to sell more product, says that doses over 200 add side effects without an increase in efficacy -- and that's in narcoleptics. Even though I'm taking Klonopin, caffeine definitely makes me more anxiety-prone. Adding a normal dose of Provigil, on the other had, actually makes me *less* anxious.
>The most notable dysphoric feeling is a rapid heartbeat that lasts all day long & nausea.
No nausea here, even up to 200 mg. OK, maybe infrequently some vague, mild, quickly-passing nausea if I take 200 after getting insufficient sleep and then don't eat breakfast. Basically a nonissue for me, although many people tend to be susceptible to drug-induced nausea in general.
It increases my heart rate some, but surprisingly does so without adding anxiety. (Again, this is in tandem with Klonopin...which also raises my resting heart rate a little, BTW.) What shocked me re the vitals is this: I originally added Provigil to my Klonopin/Serzone combo, and -- as expected based on what I had read -- it had absolutely no effect on my blood pressure. But as soon as I stopped Serzone, Provigil had a strong and dose-dependent blood-pressure raising effect. After a few months, I added back the Serzone, and the BP immediately dropped back down to low-normal. Serzone somehow completely eliminates tmy Provigil BP effect. I should point out that my BP tends to be very med/supplement reactive in general.
>Also seems to cause lack of appetite but does increase energy.
No argument with the energy comment. As for appetite effect, I think at least half of the readers here would find that to be a *benefit*. Especially at 200 mg, Provigil is very dieting-supportive, in the sense that I can go without eating and it doesn't bother me.
However...That brings up one of the things I really like about Provigil, namely the fact that I can mentally turn off its effects when I want to. If I feel I've been eating too much, Provigil allows me to easily "order" my appetite to take a hike, and I can even skip a meal without difficulty. But when I decide I *want* to eat a nice big meal, a hearty appetite is right there waiting to be satiated.
For me, one of the best "tell-it-what-to-do" Provigil benefits is that I can be awake and alert when I want to be (which is most of the daytime), yet still catch some daytime zzz's if I choose. I love the fact that I can essentially turn Provigil on and off at will.
>It does seem to make you optimistic & have anti-depressant qualities
Agree, although I've never had major depression..
>will definitely get you out of bed in the morning if you have the type of severe depression where you stay in bed all day.
I don't know about the depression connection, but if anything I find it harder to get out of bed in the morning when I'm taking Provigil. But once I'm finally up, the energy quickly starts coming on.
>So far, seems to be inferior to Ritalin for brain stimulation, but some said Provigil takes up to a month for its full psychostimulant effect.
I noticed an increase in many aspects of cognition, sociability, energy and enthusiasm on day one. That neither improved nor dissipated over time. But I can see how some people might require a greater period of time to recognize full effects. My biggest disappointment with Provigil is that it doesn't have a memory-enhancing effect for me, despite its reputed nootropic effect supported by promising animal studies. Damn! Selegiline did much better in that department, but it made me anxious.
>(Remeron has no sexual side effects, Provigil would cancel out both the Remeron daytime sedation & appetite increase).
I had already thought about this combo. I have little doubt about the anti-sedation effect (it certainly has that effect for me in combo with with Serzone and Klonopin, which might be additively as sedating as Remeron). But I'm particularly curious about your anti-weight-gain theory. Given the magnitude of weight-gain typical for Remeron, I doubt Provigil could completely nullify it, even if Remeron's weight-gain comes from increased appetite. My guess is that Provigil could reduce the amount of weight-gain but not eliminate it. Aga
Is there anyone out there who's tried a Remeron/Provigil combo and can fill us in?
> Perhaps more importantly, Provigil diversion to the street illegal drug trade will most likely NOT occur.
Someone posting from France who claimed to have some kind of relation to the inventors of modafinil (Provigil) and adrafinil said businesspeople there have been "abusing" Provigil staying up all night working. (But in France? I thought it was only in the U.S. that it's customary for people to work themselves to death.) I have to admit that there are times I've stayed up a lot later than I should -- NOT because I wasn't getting sleepy (I NEVER take Provigil after noon), but because I knew Provigil would allow me to be awake and alert the next day even after minimal sleep.
BTW, I think Provigil may have some mild pro-sexual effects.
Rick
Posted by IsoM on February 8, 2002, at 13:20:31
In reply to Re: Provigil- took test drive of abuse potential- none » 3 Beer Effect, posted by Rick on February 8, 2002, at 1:30:51
I really wish I could find more information, studies, case histories, etc on Provigil (modafinil) & Olmifon (adrafinil). In my experience, it doesn't behave like other psychostimulants. Currently, the other available stims all have rapid action effects within an hour or less of dosing. Both Ritalin & Dexedrine affects me like that.
But with adrafinil (& modafinil-Provigil works similar), effects aren't noticed for a week or more, much like standard ADs in time of action. It's actions are different than the other stims, & PET scans confirm this too, showing different areas of the brain with increased metabolic activity. I honestly can't see how a drug that behaves like this could be abused or why anyone would abuse it. The point of abusing a drug for recreational use is to get an immediate high - something that just doesn't happen with modafinil/adrafinil. Manowar (Tim) also takes Provigil & can confirm the slow onset of benefits.
Any abuse of adrafinil with business men in France would be similar to truckers taking Wake-up pills to get more work done - workaholics perhaps, but certainly not for fun.
I hyprothesise that the reason a person can sleep or not when taking Provigil, eat or not too, is because for me, at least, these drugs don't "feel" stimulating. I feel normal instead (but I do have narcolepsy & ADHD - that may account for how I feel with the med). I actually have a slightly better appetite with adrafinil, but then I lose interest in food when depressed & very little tastes good to me then. With adrafinil, my taste seems to return to normal. It doesn't increase energy for me as I'm high-energy (the hyper part of my ADHD) when I'm alert & awake, but adrafinil keeps me from feeling eternally sleepy. I would normally need something externally stimulating to perk me up & when it was finished, I'd again turn sleepy. Adrafinil keeps me perky so the energy part naturally comes into play.
Rick, about the memory boosting power of Provigil - I think that effect takes a little while to work. For me, it's one of the last benefits to come into effect. I sure noticed a huge difference in short-term & working memory. Perhaps if your short-term memory is already good, you may not notice much difference. Give it time though. I'm really surprised you noticed an immediate effect ("day one"). The best study I read on it said it took a while to affect most.
I ran out of adrafinil after the first package, & had to wait another 1 1/2 months for my next batch to come. At least, it doesn't have the horrid withdrawal/discontinuation problems that most ADs have & while I really missed feeling alert & awake, it doesn't have that feeling of tolerance build-up/addiction that other stims can give.
Posted by Rick on February 8, 2002, at 20:10:36
In reply to Re: Provigil- took test drive of abuse potential- none » Rick, posted by IsoM on February 8, 2002, at 13:20:31
Interesting thoughts, IsoM. Some comments and questions:
>I really wish I could find more information, studies, case histories, etc on Provigil (modafinil) & Olmifon (adrafinil).
If you don't mind sharing this, what is your current regimen for adrafinil and any other meds you're taking? Can I correctly infer that your desire for more info on a med you've already used awhile is part of a quest for better treatment response? Or is this more along the lines of general self-education, safety concerns, adraf vs. modaf, back-pocket info, plain curiosity, or ???
>Currently, the other available stims all have rapid action effects within an hour or less of dosing. Both Ritalin & Dexedrine affects me like that.
Even though I only take Provigil in the a.m., it has psychotropic benefit all day long, with the sheer "user-controllable-wakefulness" component winding down a bit as evening approaches. But I can really feel amplified benefits within an hour of dosing, particularly if I didn't allow myself enough sleep the night before. It clearly depends on the person taking it, what disorder(s) you have, and what specific benefits you're seeking. If I were taking it as part of depression treatment, I'd imagine that it might start helping soon, but not immediately. Or perhaps it would have an immediate impact followed by quick poop-up and then a more gradual theraputic ramp-up.
>
> But with adrafinil (& modafinil-Provigil works similar), effects aren't noticed for a week or more, much like standard ADs in time of action. It's actions are different than the other stims, & PET scans confirm this too, showing different areas of the brain with increased metabolic activityI wouldn't be so quick to bucket them together, despite that fact that modafinil is the primary metabolite of adrafinil. Some people on this board who have taken both reported significant variation in how the two different meds make them feel. Adrafinil seems to have the edge among Psyco-Babblers, although I seem to be seeing more and more Provigil proponents like myself.
One thing I think people neglect in assessing whether Provigil served them well is whether it's taken as monotherapy (I have my doubts that this would be effective for my social phobia) or with other meds -- and if so, which ones. I can see Provgil being synergistic with some meds and working against others. Even though Provigil *may* reduce GABA in selected areas of the brain, for me it perfectly complements the Klonopin and Serzone for a more-rounded antianxiety effect. The specific benefits Provigil adds to my SP treament are startlingly tangible and identifiable. BTW, I've never tried Adrafinil.
>Manowar (Tim) also takes Provigil & can confirm the slow onset of benefits.Again, I'm sure it depends on both the person and what effect you're looking for. Recently I've been seeing quite a few reports and formal studies on immediate and strong wakefulness-inducing qualities of Provigil, e.g. with soldiers who need to stay on duty and alert all night. And I also note that Effexor can provide very rapid benefits for GAD, typically one week, while for depression it can take the typical two-four weeks or more for the benfits to really show. Different people -- > diferent theraputic needs -- > different parts of the brain that need to be "jolted" -- > different progression of neurological changes that need to occur -- > different length of onset
> I hyprothesise that the reason a person can sleep or not when taking Provigil, eat or not too, is because for me, at least, these drugs don't "feel" stimulating.
Provigil does feel stimulating to me, but in a gentle, working-in-the-background kind of way. Unlike you, my baseline condition is low-energy. And when I'm less energetic or just plain tired, even Klonopin lets some of my noticeabe somatic symtoms start creeping back, notably vocal tremor, facial rigidity, as well as brain-lock and loss of assertiveness. That's why Provigil adds so much to my treatment. Unlike other stimulating meds I've used it makes me feel "up" and confident without making me feel wired. Provigil helps me build a fortress against the lethargy and apathy that would otherwise make me more vulnerable to "opportunistic anxiety," if you will. I see one of Provigil's main roles as analagous to an immune-system booster that helps your body fight off opportunistic infections that try to make their presence known when your're physically or mentally susceptible. I don't want any "cold sores" of anxiety breaking through. (Guess I've milked THAT analogy for all it's worth!)
>I feel normal instead (but I do have narcolepsy & ADHD - that may account for how I feel with the med). I actually have a slightly better appetite with adrafinil, but then I lose interest in food when depressed & very little tastes good to me then. With adrafinil, my taste seems to return to normal. It doesn't increase energy for me as I'm high-energy (the hyper part of my ADHD) when I'm alert & awake, but adrafinil keeps me from feeling eternally sleepy. I would normally need something externally stimulating to perk me up & when it was finished, I'd again turn sleepy. Adrafinil keeps me perky so the energy part naturally comes into play.
Sounds like adrafinil is right for you.
> Rick, about the memory boosting power of Provigil - I think that effect takes a little while to work. For me, it's one of the last benefits to come into effect. I sure noticed a huge difference in short-term & working memory.Hmmm...as well as Provigil works for me, that last statement makes me think that maybe I *should* give adrafinil a trial run. On the other hand, I would imagine that it's the modafinil metabolite that provides any memory benefit, though. How long did your memory benefit take to surface?
>Perhaps if your short-term memory is already good, you may not notice much difference.
It's not. Not terrible, but hardly good.
>Give it time though.
I read that memory benefits start to appear after a few months. I've been taking Provigil over a year and a half. I'd be skeptical that any drug could really help age or med-caused memory lapse if I hadn't seen tangible benefit from selegiline.
Also, do you think that maybe your own memory problems might have represented a symptom of depression that has improved as you became less depressed -- vs. a direct adrafinil effect? That theory certainly doesn't seem to hold with my social anxiety, though. I don't know if social anxiety causes memory problems, beyond the obvious fact that it's hard to pay attention and consolidate a memory when you're too busy dwelling on how you're being perceived. Anyway, the anxiety's been lifted but my memory's even worse than before. (Ironically, my mentally marvelling -- obsessing -- over how comfortable I now feel during social/business interaction can interfere with listening and digesting. But there's more to it than that, because I forget things that have no social aspect at all)
>I'm really surprised you noticed an immediate effect ("day one"). The best study I read on it said it took a while to affect most.
I'd be interested to see the study you're referring to. Do you have a link or an electronic copy you can paste? I know that the studies of Provigil for AD augmentation in treatment-resistent depression showed very rapid response, often a week, rarely more than two. (If you'd like to see more detail on this, let me know. I've posted some of it here before.)
> I ran out of adrafinil after the first package, & had to wait another 1 1/2 months for my next batch to come. At least, it doesn't have the horrid withdrawal/discontinuation problems that most ADs have & while I really missed feeling alert & awake, it doesn't have that feeling of tolerance build-up/addiction that other stims can give.
Tha's exactly how I've felt during the periods (four or five days max) where I've had to go without Provigil. In fact, the only reason I originally started taking it was to combat the fatigue that was coming from my Serzone+Klonopin combo. But when I unexpectedly found myself becoming more enthusiastic, confident, assertive, alert -- vs. simply wide awake -- I realized I had struck on a super combo for my social phobia.Rick
Posted by IsoM on February 8, 2002, at 21:10:46
In reply to Re: Provigil- took test drive of abuse potential- none » Rick, posted by IsoM on February 8, 2002, at 13:20:31
> > “…If you don't mind sharing this, what is your current regimen for adrafinil and any other meds you're taking? Can I correctly infer that your desire for more info on a med you've already used awhile is part of a quest for better treatment response? Or is this more along the lines of general self-education, safety concerns, adraf vs. modaf, back-pocket info, plain curiosity, or ???”
Thanks for the nice, long post. I appreciate details – makes understanding much clearer. I’d like to know more for both sheer curiousity (I love all science related subjects) & the more knowledge gained, the more accurately I can decide how to make adjustments in meds, if necessary. My 79 year old mother, who’s still active & in relative good health, noticed the difference in me. She still has, at her age, ADD features, organisation & forgetfulness. She wanted to try it too. I checked with other meds she’s on for any interactions & told her to try a minimum dose first to see how it might work. I take her to the doctor for any appointments & will keep a check on her health too.
I take 88 mcg Synthroid, 40 mg Celexa, 10 mg Paxil (I want off it completely but had serious, long-term discontinuation problems when I came off a higher dose – I’m going to try going off it permanently this summer when things are always better for me), & on alternate days, one tablet adrafinil (300 mg) & the next day two tablets. I’m trying to keep it as low as I can & still have it effective. Lower dosage = less likelihood liver problems, I think. I’m willing to be patient & see what longer term effects (over 2-3 months) are without increasing the dosage too rapidly. I think if I had ADD without the hyperactivity part, I’d probably up it more. Maybe a higher dose wouldn’t have an effect on my energy level, just the cognitive part, but I’’ wait. Elizabeth also mentioned piracetam as a memory booster. I’m trying to find good info on it plus user’s experiences.
> > “…Even though I only take Provigil in the a.m., it has psychotropic benefit all day long, with the sheer "user-controllable-wakefulness" component winding down a bit as evening approaches. But I can really feel amplified benefits within an hour of dosing, particularly if I didn't allow myself enough sleep the night before. It clearly depends on the person taking it, what disorder(s) you have, and what specific benefits you're seeking. If I were taking it as part of depression treatment, I'd imagine that it might start helping soon, but not immediately. Or perhaps it would have an immediate impact followed by quick poop-up and then a more gradual theraputic ramp-up.”
Interesting, that you do feel an effect immediately. It doesn’t matter if I take it first thing I wake up or a couple of hours later. Feels the same. When I ran out the first time, it took a couple of days for the benefits to start fading & I could still feel some of the effects a week later but very weak. It might be more noticable for me because of my narcolepsy.
> > “ …I wouldn't be so quick to bucket them together, despite that fact that modafinil is the primary metabolite of adrafinil. Some people on this board who have taken both reported significant variation in how the two different meds make them feel. Adrafinil seems to have the edge among Psyco-Babblers, although I seem to be seeing more and more Provigil proponents like myself.”
That’s one reason I’d like to read more. Does the other active metabolites of adrafinil have extra benefits that modafinil alone doesn’t give? The reason I take adrafinil was the price. I can get someone in France to send it out – much, much cheaper than the oversea nootropic drug companies.
> > “…One thing I think people neglect in assessing whether Provigil served them well is whether it's taken as monotherapy (I have my doubts that this would be effective for my social phobia) or with other meds -- and if so, which ones. I can see Provgil being synergistic with some meds and working against others. Even though Provigil *may* reduce GABA in selected areas of the brain, for me it perfectly complements the Klonopin and Serzone for a more-rounded antianxiety effect. The specific benefits Provigil adds to my SP treament are startlingly tangible and identifiable. BTW, I've never tried Adrafinil.”
I’m not sure how modafinil/adrafinil affects GABA receptors. I find calming affects after a couple of weeks. I feel alert & ahppy but in a very calm, gentle manner not at all like other stims do. I also found it really lifted my mood. I have a bugger of a time in winter even with my other meds but didn’t want to increase them just for winter. I’m finding winter quite tolerable now. I can’t wait to see how I’ll respond when summer comes!
> > “…I see one of Provigil's main roles as analagous to an immune-system booster that helps your body fight off opportunistic infections that try to make their presence known when your're physically or mentally susceptible. I don't want any "cold sores" of anxiety breaking through. (Guess I've milked THAT analogy for all it's worth!)”
I think that’s a good analogy. I read that adrafinil has an over-all effect of boosting brain metabolism.
> > “… How long did your memory benefit take to surface?”
Near the end of my first package, which was about4-5 weeks.
> > “…I read that memory benefits start to appear after a few months. I've been taking Provigil over a year and a half. I'd be skeptical that any drug could really help age or med-caused memory lapse if I hadn't seen tangible benefit from selegiline.”
A year & half? Boy, you’d sure expect the memory improvement to kick in sooner!
> > “… Anyway, the anxiety's been lifted but my memory's even worse than before. (Ironically, my mentally marvelling -- obsessing -- over how comfortable I now feel during social/business interaction can interfere with listening and digesting. But there's more to it than that, because I forget things that have no social aspect at all)”
Could you train yourself to focus better? I know it sounds dumb but when I went back to university, even without stims, I noticed an improvement in concentrating & listening. It sure wasn’t easy but I’d keep dragging my focus back to the subject everytime I caught myself getting distracted. Took a while before it worked but I did notice an improvement.
> > “…I'd be interested to see the study you're referring to. Do you have a link or an electronic copy you can paste?”
This one is strictly on adrafinil: http://www.nevapress.com/cnsdr/full/5/3/193.pdf
One thing I have that may be different from you is I could still nap anytime I wanted to if tired. No way adrafinil could keep me going all night! When I get properly sleepy, I can conk right out. As you state, different people = different reactions, but it still seems to be good for many – the most important factor. :-)
Posted by Ritch on February 9, 2002, at 0:21:21
In reply to Re: Thoughts on Provigil/adrafinil » IsoM, posted by Rick on February 8, 2002, at 20:10:36
> Tha's exactly how I've felt during the periods (four or five days max) where I've had to go without Provigil. In fact, the only reason I originally started taking it was to combat the fatigue that was coming from my Serzone+Klonopin combo. But when I unexpectedly found myself becoming more enthusiastic, confident, assertive, alert -- vs. simply wide awake -- I realized I had struck on a super combo for my social phobia.
>
> Rick
Rick,Just a quick question. Did you ever have any situational panic attacks with your SP? I am curious because I wonder what differentiation might be useful to predict med responses based on whether situational panic happens or not.
Mitch
Posted by Rick on February 9, 2002, at 2:46:51
In reply to Re: Provigil- Adrafinil » IsoM, posted by IsoM on February 8, 2002, at 21:10:46
>I appreciate details – makes understanding much clearer.
That's exactly I feel, too. Although I can understand how some people could prefer brevity.
> I take 88 mcg Synthroid, 40 mg Celexa, 10 mg PaxilAccording to a 2000 in vitro study, the only liver enzyme significantly *inhibited* by modafinil was CYP2C19. This happens to be one of the primary enzymes Celexa needs for elimination. So adrafinil MAY (3 Beer, please note the "MAY") be increasing your blood levels of Celexa. If that's happening, it could be good or bad depending on whether "more Celexa" would be theraputically helpful vs. simply increasing side effects. That's why, when someone takes Provigil to fight AD-induced fatigue or apathy, it MAY not do the trick as effectively with Celexa as with other ADs. But there's a great deal of inter-individual variability, e.g. the interaction would be more significant for someone who has lower base levels of CYP2C19.
(I know this was discussed in a previous thread but I forget by whom. Sorry if I'm rehashing old stuff.)
> Interesting, that you do feel an effect immediately. It doesn’t matter if I take it first thing I wake up or a couple of hours later. Feels the same. When I ran out the first time, it took a couple of days for the benefits to start fading & I could still feel some of the effects a week later but very weak. It might be more noticable for me because of my narcolepsy.
This seems to be evidence that you're probably NOT having an interaction effect. When I've stopped Provigil temporarily, I likewise feel a gadual decline in benefits, but they're usually gone within a few days. (Importantly though, there's still some residual benefit for my social phobia. Provigil-driven confidence, assertiveness, and social immersion have resulted in some lasting improvements in mindset and behavior.)
>That’s one reason I’d like to read more. Does the other active metabolites of adrafinil have extra benefits that modafinil alone doesn’t give?
Yeah, I'd like to know that, too.
>I’m not sure how modafinil/adrafinil affects GABA receptors. I find calming affects after a couple of weeks. I feel alert & ahppy but in a very calm, gentle manner not at all like other stims do. I also found it really lifted my mood. I have a bugger of a time in winter even with my other meds but didn’t want to increase them just for winter. I’m finding winter quite tolerable now. I can’t wait to see how I’ll respond when summer comes!
That's a nice, positive report! Once someone posting here tried to tell that a Klonopin/Provigil couldn't really be helping my social phobia because of that one fuzzy GABA-reduction study in rodents. Well even if the 25% reduction really occured in ME, and occured at a *relevant* area of the brain (and I doubt it would based on what I've read), the only thing that's important is that I'm doing better than ever with what should be a safe combo! (I have complete blood labs, including liver panel, at least once a year just to make sure everything looks OK there.)
> A year & half? Boy, you’d sure expect the memory improvement to kick in sooner!
I thinks at this point I'll have to write off Provigil as a memory boster. But it could very well have that effect for others.
> “… Anyway, the anxiety's been lifted but my memory's even worse than before. (Ironically, my mentally marvelling -- obsessing -- over how comfortable I now feel during social/business interaction can interfere with listening and digesting. But there's more to it than that, because I forget things that have no social aspect at all)”
>
> Could you train yourself to focus better? I know it sounds dumb but when I went back to university, even without stims, I noticed an improvement in concentrating & listening. It sure wasn’t easy but I’d keep dragging my focus back to the subject everytime I caught myself getting distracted. Took a while before it worked but I did notice an improvement.That's not dumb at all, IsoM! Thanks for the idea! I have to keep telling myself, "OK, so it worked! Now get over it and move on. Pay attention!"
> “…I'd be interested to see the study you're referring to. Do you have a link or an electronic copy you can paste?”
>
> This one is strictly on adrafinil: http://www.nevapress.com/cnsdr/full/5/3/193.pdfThanks.
>As you state, different people = different reactions, but it still seems to be good for many – the most important factor. :-)
Yep, whatever works!
(...and is safe and affordable)Rick
Posted by Rick on February 9, 2002, at 3:28:59
In reply to Re: Thoughts on Provigil/adrafinil » Rick, posted by Ritch on February 9, 2002, at 0:21:21
> Just a quick question. Did you ever have any situational panic attacks with your SP? I am curious because I wonder what differentiation might be useful to predict med responses based on whether situational panic happens or not.
That in fact is why I first sought treatment two and a half years ago (wish I had done so MUCH sooner). My SP was getting worse, and several times I was on the *verge* of full-blown panic. E.g, I went into a room to give a presentation in front of a large group of people. And I was actually feeling pretty relaxed about it. But when I stood up and saw all these people crammed into a too-small room staring at me, waiting for me to speak, it felt like it took 100% of the little bit of energy that was left in me just to open my mouth. (The fact that I felt inferior to the first speaker, a co-worker, didn't help either). I had rehearsed and rehearsed, but I couldn't get myself to say more than a few words at a time, and they were coming out very tremulous and in-slow motion. The feeling started spiraling. I felt I couldn't breathe, and thought, "my God, I have to get out of here." For the first time ever I was just on the verge of blurting out some excuse and running away, but I started to calm down a tad just in time.
There were a few other similar incidents (including one when I was on meds -- the WRONG ones, obviously).
Up until that time I would have pounding heart, sweaty palms, lockjaw, tremulous voice...but not feeling were I felt I had to run away and could never show my face again. Ironically, one of my toughest situations would be standing in line at the post office. I'd always feel as if my heart was going to jump out of my chest. Everything was situational for me, even if not truly panic.
Funny, I could easily strike up a conversation with someone in a check out lane, but I'd have the pounding heart/sweating/voice tremor thing when calling information. Speaking in echo-y rooms or vestibules was also one of my most dreaded events. I still sometimes have a few fleeting moments of difficulty with that one, especially if I'm speaking on a phone and others are walking by. Oh, and of course speaking up at meetings or at lunches was a real challenge, so I usually stayed quiet...not great for a career. One-to-one talk wasn't as bad as being the center
of attention, although I would always avoid parties. I'm still not a huge fan of them, but now they don't scare me, and I actually end up having fun and meeting people.As usual I gave a not-so-quick answer to a quick question. But once I started writing about situational symptoms (which are now 90% improved), I just kept going. Kind of a catharsis
Rick
Posted by Ritch on February 9, 2002, at 10:19:29
In reply to Re: Thoughts on Provigil/adrafinil » Ritch, posted by Rick on February 9, 2002, at 3:28:59
> > Just a quick question. Did you ever have any situational panic attacks with your SP? I am curious because I wonder what differentiation might be useful to predict med responses based on whether situational panic happens or not.
>
> That in fact is why I first sought treatment two and a half years ago (wish I had done so MUCH sooner). My SP was getting worse, and several times I was on the *verge* of full-blown panic. E.g, I went into a room to give a presentation in front of a large group of people. And I was actually feeling pretty relaxed about it. But when I stood up and saw all these people crammed into a too-small room staring at me, waiting for me to speak, it felt like it took 100% of the little bit of energy that was left in me just to open my mouth. (The fact that I felt inferior to the first speaker, a co-worker, didn't help either). I had rehearsed and rehearsed, but I couldn't get myself to say more than a few words at a time, and they were coming out very tremulous and in-slow motion. The feeling started spiraling. I felt I couldn't breathe, and thought, "my God, I have to get out of here." For the first time ever I was just on the verge of blurting out some excuse and running away, but I started to calm down a tad just in time.
>
> There were a few other similar incidents (including one when I was on meds -- the WRONG ones, obviously).
>
> Up until that time I would have pounding heart, sweaty palms, lockjaw, tremulous voice...but not feeling were I felt I had to run away and could never show my face again. Ironically, one of my toughest situations would be standing in line at the post office. I'd always feel as if my heart was going to jump out of my chest. Everything was situational for me, even if not truly panic.
> Funny, I could easily strike up a conversation with someone in a check out lane, but I'd have the pounding heart/sweating/voice tremor thing when calling information. Speaking in echo-y rooms or vestibules was also one of my most dreaded events. I still sometimes have a few fleeting moments of difficulty with that one, especially if I'm speaking on a phone and others are walking by. Oh, and of course speaking up at meetings or at lunches was a real challenge, so I usually stayed quiet...not great for a career. One-to-one talk wasn't as bad as being the center
> of attention, although I would always avoid parties. I'm still not a huge fan of them, but now they don't scare me, and I actually end up having fun and meeting people.
>
> As usual I gave a not-so-quick answer to a quick question. But once I started writing about situational symptoms (which are now 90% improved), I just kept going. Kind of a catharsis
>
> RickWow, thanks! I was really concerned that if I tried Provigil it would worsen those type of feelings. You say that it has *helped* with them in ways that conventional pstims might *worsen* them (from what I remember)? When I started Adderall for ADHD, I became very aware of all of this body language, facial expressions, etc., and it intensified it. My pdoc told me that I was tuning in to things that I had never paid attention to and that was what worsened the panic. Thanks for that encouragement.
Mitch
Posted by IsoM on February 9, 2002, at 12:33:43
In reply to Re: Provigil- Adrafinil » IsoM, posted by Rick on February 9, 2002, at 2:46:51
> > "...That's exactly I feel, too. Although I can understand how some people could prefer brevity."
Great! Now that we understand each other, I won't be afraid to (I call) 'blither' on & when I'm looking for info from you, I'll expect lots! :-)
> > "...According to a 2000 in vitro study, the only liver enzyme significantly *inhibited* by modafinil was CYP2C19. This happens to be one of the primary enzymes Celexa needs for elimination. So adrafinil MAY (3 Beer, please note the "MAY") be increasing your blood levels of Celexa. If that's happening, it could be good or bad depending on whether "more Celexa" would be theraputically helpful vs. simply increasing side effects. That's why, when someone takes Provigil to fight AD-induced fatigue or apathy, it MAY not do the trick as effectively with Celexa as with other ADs. But there's a great deal of inter-individual variability, e.g. the interaction would be more significant for someone who has lower base levels of CYP2C19."
I checked for CYP interactions with a drug software program & read the same thing. No side-effects that I've ever noticed with Celexa, but I have a gut-feeling the improvement comes from the adrafinil alone.
> > "...This seems to be evidence that you're probably NOT having an interaction effect. When I've stopped Provigil temporarily, I likewise feel a gadual decline in benefits, but they're usually gone within a few days. (Importantly though, there's still some residual benefit for my social phobia. Provigil-driven confidence, assertiveness, and social immersion have resulted in some lasting improvements in mindset and behavior.)"
I've always believed that even if a person needs to change their thinking patterns due to depression, or in your case, social phobia, that meds make it possible. Trying to do it without meds is like trying to exercise & strengthen a limb that's still broken & hasn't been set.
> > "...That's a nice, positive report! Once someone posting here tried to tell that a Klonopin/Provigil couldn't really be helping my social phobia because of that one fuzzy GABA-reduction study in rodents. Well even if the 25% reduction really occured in ME, and occured at a *relevant* area of the brain (and I doubt it would based on what I've read), the only thing that's important is that I'm doing better than ever with what should be a safe combo! (I have complete blood labs, including liver panel, at least once a year just to make sure everything looks OK there.)"The thing is GABA is an inhibitory neurotransmitter, but that doesn't mean it has a blanket inhibiting effect throughout the brain. Our neurotransmitters have very selective sites that they can either inhibit or excite both at the same time. Brain chemistry is incredibly complicated. To pretend we understand how it works is presumptious beyond compare. All I know is that adrafinil/modafinil 'seems' to increase general brain metabolism. Myabe this is why it has so many postive benefits with such few side-effects?
> > "...I thinks at this point I'll have to write off Provigil as a memory boster. But it could very well have that effect for others."
What a disappointment! Have you looked into piracetam or the other *racetams along with choline supplementation? Elizabeth brought it to my attention. It seems to have an effect on acetylcholine & more so in the hippocampus, associated with memory. Depending on how much my memory is improved with adrafinil, I'd be curious to check into it myself.
The flip side to having a good memory is the case of "S". This poor Russian man *couldn't* forget anything. Every trivial memory was indeligibly imprinted in his memory. It made it impossible for him to have a normal life. He ended up touring, demonstrating his ability to large audiences as a living. He said the only way he could erase a memory was to mentally write it on paper & then to mentally burn the paper. The famous Russian neurologist, Luria, studied him & wrote a book about him. It's been translated into English.
http://www.amazon.com/exec/obidos/ASIN/0674576225/drbobsvirte00-20
Luria was the inspiration for Dr. Oliver Sacks. You've probably heard of him - his books are worth reading.> > "...That's not dumb at all, IsoM! Thanks for the idea! I have to keep telling myself, "OK, so it worked! Now get over it and move on. Pay attention!"
I'm glad you like the idea. It worked very well with me at university when I went back. Perhaps because of ADHD, I can multi-task pretty well. I found that if I (1) listened to the prof carefully, (2) wrote notes at the same time, & (3) colour-coded & underlined in my text books while (4) making references in the margin of my notes to what page of the text the info came from, it really helped. I suppose my hyperfocus at such times also helped along with a real interest in the subjects - I love learning. It's recreation for me.
Tell me what you think of the study on adrafinil that was written. To me, it's the most understandable & intelligent of all the write-ups I've read on it yet.
Posted by Rick on February 10, 2002, at 4:57:49
In reply to Re: Provigil- Adrafinil » Rick, posted by IsoM on February 9, 2002, at 12:33:43
IsoM
Thanks for yet another thoughtful and interesting post with helpful (and insightful) ideas. I have some comments/questions lined up, but I won't have time to post them until later...a few days to a week or even longer. Things are suddenly getting mega-busy at both work and home. Hardly have time to think! But briefly:
-- That story about that poor Rusian guy is wild, and sad. That would be sheer torture. I'm already too focused on trivia as it is!
-- Thanks for the "memory-rejuvenation tips. I'll have to look further into this, although I've seen some discouraging (in terms of efficacy) reports on the "racetams." Funny how all there's an incredible amount of stuff written about memory-boosting supplements and exercise, but it's virtually never about countering *med-induced* memory deficits.
I was intrigued by the recent placebo-controlled study on Bacopa (Medline abstract plus link to full study below.) It suggests pretty impressive stuff about Bacopa's memory boosting benefits. But I've learned the study was sponsored by an Australian distributor of much-higher-potency Bacopa than is available in the U.S. (Although I found a place in Australia that will take online orders. BTW, the people at a New Zealand university who did the study, as well as the distributor, provided friendly and detailed answers to some questions I emailed them.) The fact that it was mfr-sponsored doesn't mean the results are false -- in fact the researcher is the person who freely offered up the fact that the study was distributor-sponsored -- but I do have to wonder if it was completely objectve. Also, I know nothing about the long-term safety.
Rick
Psychopharmacology (Berl) 2001 Aug;156(4):481-4The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects.
Stough C, Lloyd J, Clarke J, Downey LA, Hutchison CW, Rodgers T, Nathan PJ.
Neuropsychology Laboratory, School of Biophysical Science and Electrical Engineering, Victoria, Australia.
RATIONALE: Extracts of Bacopa monniera have been reported to exert cognitive enhancing effects in animals. However, the effects on human cognition are inconclusive. OBJECTIVE: The current study examined the chronic effects of an extract of B. monniera (Keenmind) on cognitive function in healthy human subjects. METHODS: The study was a double-blind placebo-controlled independent-group design in which subjects were randomly allocated to one of two treatment conditions, B. monniera (300 mg) or placebo. Neuropsychological testing was conducted pre-(baseline) and at 5 and 12 weeks post drug administration. RESULTS: B. monniera significantly improved speed of visual information processing measured by the IT task, learning rate and memory consolidation measured by the AVLT (P< 0.05), and state anxiety (P< 0.001) compared to placebo, with maximal effects evident after 12 weeks. CONCLUSIONS: These findings suggest that B. monniera may improve higher order cognitive processes that are critically dependent on the input of information from our environment such as learning and memory.
http://web.iol.cz/lscentrum/brahmi.pdf
Posted by A0102 on February 11, 2002, at 1:30:44
In reply to Provigil- took test drive of abuse potential- none, posted by 3 Beer Effect on February 6, 2002, at 12:18:54
Hi,
I thought some of you might find my experience with Provigil interesting (and maybe a little dull as well). First of all, I have depression (frequently quite severe) and usually find myself having varying degrees of anergia. I have tried Provigil in combination with Celexa, Wellbutrin, Effexor, Desipramine, and all alone. I have tried doses from 200-600mg/day. For me, any dose below 400mg is unnoticeable. Only when I have taken 600mg am I unable to fall asleep. At that dosage, the only other side effects I notice are perhaps a tiny (hardly noticeable) amount of shakiness and increased heart rate. No euphoria, no increased desire to socialize, nothing else at all. I do not think that my response is typical, but I suppose I'm one of the unlucky ones. I have also tried Adderall and Concerta (even in combination with Provigil) and neither of those are particularly stimulating for me either. Don't get me wrong, the Adderall and Concerta don't go unnoticed, they just don't have me bouncing off the walls. The largest effect that I notice with either of those is the increased ability to concentrate (although I have never been diagnosed ADD). No euphoria with those, either. In fact, the only stimulant that has ever had that kind of effect for me is cocaine, which I have only tried on one occasion. Another odd thing with my experience with coke is that it had me euphoric and wide awake for *hours* after only 1.5 lines (taken in one dose). I have stayed away from it ever since because I can see myself becoming quickly addicted. BTW, I've never had an addiction and definitely am not looking to start. Anyway, good luck with Provigil or whatever you pursue and I hope that you can find a medication that helps keep you happy!Adam
Posted by IsoM on February 11, 2002, at 2:24:30
In reply to My experiences with Provigil other stims, posted by A0102 on February 11, 2002, at 1:30:44
No, Adam, your post WAS interesting. That's what I want to hear - individual response to Provigil (or adrafinil). The more people who post their responses, the better able we'll be to judge its over-all effectiveness.
Do you mind me asking how long you took it for & did you take it daily too? You do sound like you have an atypical response to some meds. Caffeine doesn't keep me awake so shows my response to some things is different too. Neither Dexedrine or Ritalin has me bouncing off walls either but they do work. But some days, I could also sleep on Dexedrine though.
Posted by manowar on February 11, 2002, at 12:37:10
In reply to Re: Provigil- took test drive of abuse potential- none » Rick, posted by IsoM on February 8, 2002, at 13:20:31
Hello everyone,
My insurance said it wouldn’t cover Provigil, even though my pdoc (pediatrician who specializes in ADD) said it would be beneficial. Oh well, I don't think I want to fight that battle, because I don't want to lose my insurance (I kinda fudged on the application, or I'd have no insurance at all!). I suppose it'll cost me $150-$300 a month for either the Adrafinil or Provigil. They both seem to have the same effect on me, but I've only taken either one or the other for the past couple months.
Anyhow, if you've read my previous posts, you'll notice how I've raved about the *franil (Modafinil/Adrafinil) drugs.
First a disclaimer of sorts, then two points:
I know a lot of people will disagree with me here, but I think Dr. Daniel Amen of CA is the world's foremost expert on ADD, and SPECT also.
BTW: In one of my earlier posts, I said that Amen was not only a psychiatrist, but a neurologist too. I was wrong, because he is not a neurologist. Of course he is certified in SPECT, which is just an adjunct to his skills as a shrink.
1) I saw Dr. Amen at a conference in Tampa on Saturday, and the question was asked if Provigil could be beneficial for folks with ADD. I was surprised to hear him say that he didn't have much success with the drug. He calls it a ‘soft’ treatment for ADD. (I have the inattentive/deep limbic subtypes of ADD, which basically mimics depression.) My personal pdoc told me that in his experience, many people with the deep limbic subtype of ADD (hard to concentrate, apathy, depressed mood, ect.) had very positive results with *finil drugs.
2) I read some cool info on Provigil this morning:“Modafinil (Provigil) has been approved for treatment of narcolepsy in adults. It is chemically unrelated to methylphenidate or amphetamine. When compared to methylphenidate and amphetamine, it seems less likely to cause irritability and jitteriness. It appears to act on the frontal cortex and is more selective in its area of action than the traditional stimulants. Cephalon will be doing studies to assess the efficacy of Modafinil in children with ADHD. In studies of adults with ADHD, there was a promising study (Taylor and Russo) suggesting that it might be effective for adults with ADHD. However a larger study sponsored by Cephalon indicated that Modafinil was no more effective than placebo.”
That it presumably works in the frontal cortex is probably why it’s so effective for me. When I had my scans done, my frontal cortex looked as if someone from close range had fired a shotgun at my brain, especially on the concentration scan (SPECT scans – thank the good Lord—are just functional images). So if the *finil drugs act on the frontal cortex, that would make perfect sense on how it seems to help me with organizational skills, increase focus, less depression, and better executive functioning altogether.
I had a bad weekend, and felt pretty down, but so far since I started the *finil drugs it seems that I bounce back from my downs very quickly, and I hope I will this time also.
The quote is from a great page on ADD, here’s the link:
http://www.ncpamd.com/NewADD_Meds.htm--Tim
Posted by kregpark@yahoo.com on February 15, 2002, at 4:02:39
In reply to My experiences with Provigil other stims, posted by A0102 on February 11, 2002, at 1:30:44
Ever tried using Eldepryl 5-10mg as a "base" (no pun intended), then adding the Provigil, Wellbutrin, or whatever?
Eldepryl used alone that way synergizes quite potently (dopaminergically) in augmentation.
Ray
> Hi,
> I thought some of you might find my experience with Provigil interesting (and maybe a little dull as well). First of all, I have depression (frequently quite severe) and usually find myself having varying degrees of anergia. I have tried Provigil in combination with Celexa, Wellbutrin, Effexor, Desipramine, and all alone. I have tried doses from 200-600mg/day. For me, any dose below 400mg is unnoticeable. Only when I have taken 600mg am I unable to fall asleep. At that dosage, the only other side effects I notice are perhaps a tiny (hardly noticeable) amount of shakiness and increased heart rate. No euphoria, no increased desire to socialize, nothing else at all. I do not think that my response is typical, but I suppose I'm one of the unlucky ones. I have also tried Adderall and Concerta (even in combination with Provigil) and neither of those are particularly stimulating for me either. Don't get me wrong, the Adderall and Concerta don't go unnoticed, they just don't have me bouncing off the walls. The largest effect that I notice with either of those is the increased ability to concentrate (although I have never been diagnosed ADD). No euphoria with those, either. In fact, the only stimulant that has ever had that kind of effect for me is cocaine, which I have only tried on one occasion. Another odd thing with my experience with coke is that it had me euphoric and wide awake for *hours* after only 1.5 lines (taken in one dose). I have stayed away from it ever since because I can see myself becoming quickly addicted. BTW, I've never had an addiction and definitely am not looking to start. Anyway, good luck with Provigil or whatever you pursue and I hope that you can find a medication that helps keep you happy!
>
> Adam
Posted by manowar on February 22, 2002, at 12:24:33
In reply to Re: My experiences with Provigil other stims » A0102, posted by kregpark@yahoo.com on February 15, 2002, at 4:02:39
Hi Ray,
I'm glad you mentioned the Eldepryl. I'm taking Adrafinil 600-1200 mg a day along with 300 mg a day of Wellbutrin (which I don't think is helping me), and 54 mg of Concerta once every two or three days. The Adrafinil (and Modafinil also) really seems to help my depression. However, even with the Adrafinil, I may do well for several days, then bam! - I'm in the funk again. Anergic, unmotivated, etc...
When I start coming down with the funk, the next morning I add the 54 mg of Concerta to my chemical cocktail, and bam! - I'm out of the funk. I can't take the Concerta on a daily basis, or I'll quickly develop a tolerance (within two or three days).
I was thinking about adding Eldepryl to my diet of drugs. Maybe the MAOI effects of the drug could continue to smooth out my Cyclothymia.
Any suggestions by anyone would be very much appreciated.
Tim
> Ever tried using Eldepryl 5-10mg as a "base" (no pun intended), then adding the Provigil, Wellbutrin, or whatever?
>
> Eldepryl used alone that way synergizes quite potently (dopaminergically) in augmentation.
>
> Ray
>
> http://www.socialfear.com/
>
> > Hi,
> > I thought some of you might find my experience with Provigil interesting (and maybe a little dull as well). First of all, I have depression (frequently quite severe) and usually find myself having varying degrees of anergia. I have tried Provigil in combination with Celexa, Wellbutrin, Effexor, Desipramine, and all alone. I have tried doses from 200-600mg/day. For me, any dose below 400mg is unnoticeable. Only when I have taken 600mg am I unable to fall asleep. At that dosage, the only other side effects I notice are perhaps a tiny (hardly noticeable) amount of shakiness and increased heart rate. No euphoria, no increased desire to socialize, nothing else at all. I do not think that my response is typical, but I suppose I'm one of the unlucky ones. I have also tried Adderall and Concerta (even in combination with Provigil) and neither of those are particularly stimulating for me either. Don't get me wrong, the Adderall and Concerta don't go unnoticed, they just don't have me bouncing off the walls. The largest effect that I notice with either of those is the increased ability to concentrate (although I have never been diagnosed ADD). No euphoria with those, either. In fact, the only stimulant that has ever had that kind of effect for me is cocaine, which I have only tried on one occasion. Another odd thing with my experience with coke is that it had me euphoric and wide awake for *hours* after only 1.5 lines (taken in one dose). I have stayed away from it ever since because I can see myself becoming quickly addicted. BTW, I've never had an addiction and definitely am not looking to start. Anyway, good luck with Provigil or whatever you pursue and I hope that you can find a medication that helps keep you happy!
> >
> > Adam
Posted by Rick on February 22, 2002, at 17:37:14
In reply to Re: My experiences with Provigil other stims » kregpark@yahoo.com, posted by manowar on February 22, 2002, at 12:24:33
Re Ray's idea for Tim, I wonder if MAOI's are safe with Provigil (modafinil) or adrafinil. The manufacturer says the combo hasn't been tested, and I recall reading one rodent study that reported at least indirect serotonergic effect of some sort from Provigil.
One reason I'm curious (besides wanting to see Tim experience the most consisitent benefit) is that, even though my current combo (Klonopin+Provigil+Serzone) works so well for my social phobia, I miss the memory-enhancing effect I seemed to get from Eldepryl/Deprenyl/selegiline. Since taking even a tiny dose with Klonopin added back some anxiety for me, I would try a super-tiny dose. From what I've read, a little bit of selegiline can have some potent and long-lasting effects.
(Of course I'd have to dump the Serzone -- the least important part of my combo -- even though it's only been *speculated* that MAOI+Serzone is dangerous, not actually demonstrated.)
Anyone out there taking/taken Provigil or Adrafinil + an MAOI? Ray, weren't you doing that at one time? Details, please?
Thanks,
Rick----
> Hi Ray,
>
> I'm glad you mentioned the Eldepryl. I'm taking Adrafinil 600-1200 mg a day along with 300 mg a day of Wellbutrin (which I don't think is helping me), and 54 mg of Concerta once every two or three days. The Adrafinil (and Modafinil also) really seems to help my depression. However, even with the Adrafinil, I may do well for several days, then bam! - I'm in the funk again. Anergic, unmotivated, etc...
>
> When I start coming down with the funk, the next morning I add the 54 mg of Concerta to my chemical cocktail, and bam! - I'm out of the funk. I can't take the Concerta on a daily basis, or I'll quickly develop a tolerance (within two or three days).
>
> I was thinking about adding Eldepryl to my diet of drugs. Maybe the MAOI effects of the drug could continue to smooth out my Cyclothymia.
>
> Any suggestions by anyone would be very much appreciated.
>
> Tim
>
> > Ever tried using Eldepryl 5-10mg as a "base" (no pun intended), then adding the Provigil, Wellbutrin, or whatever?
> >
> > Eldepryl used alone that way synergizes quite potently (dopaminergically) in augmentation.
> >
> > Ray
> >
> > http://www.socialfear.com/
> >
> > > Hi,
> > > I thought some of you might find my experience with Provigil interesting (and maybe a little dull as well). First of all, I have depression (frequently quite severe) and usually find myself having varying degrees of anergia. I have tried Provigil in combination with Celexa, Wellbutrin, Effexor, Desipramine, and all alone. I have tried doses from 200-600mg/day. For me, any dose below 400mg is unnoticeable. Only when I have taken 600mg am I unable to fall asleep. At that dosage, the only other side effects I notice are perhaps a tiny (hardly noticeable) amount of shakiness and increased heart rate. No euphoria, no increased desire to socialize, nothing else at all. I do not think that my response is typical, but I suppose I'm one of the unlucky ones. I have also tried Adderall and Concerta (even in combination with Provigil) and neither of those are particularly stimulating for me either. Don't get me wrong, the Adderall and Concerta don't go unnoticed, they just don't have me bouncing off the walls. The largest effect that I notice with either of those is the increased ability to concentrate (although I have never been diagnosed ADD). No euphoria with those, either. In fact, the only stimulant that has ever had that kind of effect for me is cocaine, which I have only tried on one occasion. Another odd thing with my experience with coke is that it had me euphoric and wide awake for *hours* after only 1.5 lines (taken in one dose). I have stayed away from it ever since because I can see myself becoming quickly addicted. BTW, I've never had an addiction and definitely am not looking to start. Anyway, good luck with Provigil or whatever you pursue and I hope that you can find a medication that helps keep you happy!
> > >
> > > Adam
Posted by christophrejmc on February 23, 2002, at 13:38:06
In reply to Re: My experiences with Provigil other stims , posted by Rick on February 22, 2002, at 17:37:14
I've taken Provigil with Nardil and Parnate on an as-needed basis. I believe it's quite safe. I've heard that adrafinil is *not* safe to take with MAOIs... I forget exactly why, though.
-chris
Posted by Rick on February 23, 2002, at 16:03:52
In reply to Re: mod/adrafinil with MAOIs, posted by christophrejmc on February 23, 2002, at 13:38:06
Posted by christophrejmc on February 23, 2002, at 16:09:18
In reply to Thanks. How large is the as-needed dose of Pvig? (nm), posted by Rick on February 23, 2002, at 16:03:52
Posted by Elizabeth on February 23, 2002, at 17:25:58
In reply to Re: mod/adrafinil with MAOIs, posted by christophrejmc on February 23, 2002, at 13:38:06
> I've taken Provigil with Nardil and Parnate on an as-needed basis. I believe it's quite safe. I've heard that adrafinil is *not* safe to take with MAOIs... I forget exactly why, though.
Probably pressor effects. Do you know anything about how adrafinil is different from modafinil?
I tried taking Provigil with Parnate. My blood pressure increased only mildly (not to a dangerous level by anyone's standards), but I felt very wired even at a low dose of Provigil (100 mg).
-e
Posted by Ray on February 25, 2002, at 0:14:49
In reply to Re: My experiences with Provigil other stims , posted by Rick on February 22, 2002, at 17:37:14
For over a year I've taken
Nardil 60mg + Provigil 50-75 + Klonopin 2.5-3.0Higher doses than 100 taken reguarly tend to make me wired too much, insomnia, aggressive, etc.
I tolerate the above well. I sleep an hour less though, and libido is increased (a good side effect).
With Eldepryl, I was thinking in my last post of low dose 5-10mg as base dose. I recall that Parkinson's patients were shown in one study to tolerate Provigil well for daytime sedation, although I don't recall what Parkinson's meds Provigil were added to.
Ray_3888@yahoo.com
http://www.socialfear.com/> Re Ray's idea for Tim, I wonder if MAOI's are safe with Provigil (modafinil) or adrafinil. The manufacturer says the combo hasn't been tested, and I recall reading one rodent study that reported at least indirect serotonergic effect of some sort from Provigil.
>
> One reason I'm curious (besides wanting to see Tim experience the most consisitent benefit) is that, even though my current combo (Klonopin+Provigil+Serzone) works so well for my social phobia, I miss the memory-enhancing effect I seemed to get from Eldepryl/Deprenyl/selegiline. Since taking even a tiny dose with Klonopin added back some anxiety for me, I would try a super-tiny dose. From what I've read, a little bit of selegiline can have some potent and long-lasting effects.
>
> (Of course I'd have to dump the Serzone -- the least important part of my combo -- even though it's only been *speculated* that MAOI+Serzone is dangerous, not actually demonstrated.)
>
> Anyone out there taking/taken Provigil or Adrafinil + an MAOI? Ray, weren't you doing that at one time? Details, please?
>
> Thanks,
> Rick
>
> ----
Posted by shelliR on February 26, 2002, at 9:51:23
In reply to Re: mod-/adrafinil with MAOIs » christophrejmc, posted by Elizabeth on February 23, 2002, at 17:25:58
> > I've taken Provigil with Nardil and Parnate on an as-needed basis. I believe it's quite safe. I've heard that adrafinil is *not* safe to take with MAOIs... I forget exactly why, though.
>
> Probably pressor effects. Do you know anything about how adrafinil is different from modafinil?
>On nardil, I was fine on provigil (prescribed by my pdoc), but she recommended against the combination of nardil with adrafinil. Sure enough, I had my first (and only) hypertensive reaction with that combination. I would be careful if you decide to combine those two drugs.
Shelli
Posted by Elizabeth on February 26, 2002, at 21:04:18
In reply to Re: mod-/adrafinil with MAOIs » Elizabeth, posted by shelliR on February 26, 2002, at 9:51:23
> On nardil, I was fine on provigil (prescribed by my pdoc), but she recommended against the combination of nardil with adrafinil. Sure enough, I had my first (and only) hypertensive reaction with that combination. I would be careful if you decide to combine those two drugs.
I've had lots of mild (i.e., not dangerous)hypertensive episodes, including when I tried taking modafinil while on Parnate. I think this is rather common. Do you know how high your blood pressure got when you took the adrafinil?
Also, does anyone have any idea what pharmacological differences there might be between modafinil and adrafinil? I'm sort of thinking that Shelli's doctor might have recommended extra caution with adrafinil because s/he [the doctor] wasn't very familiar with it (since adrafinil isn't marketed in the U.S.), rather than because of any inherent differences between the drugs.
-e
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