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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Thrud on August 19, 2002, at 4:11:13
Hi all.
I notice that quite a few people here have tried or are on Adrafinil or Modafinil (Provigil).
Probably most of you on these medications have tried SSRIs or other antidepressants as well.
In terms of raw, antidepressant power how do they compare? Is someone with severe depression likely to succeed with Adrafinil or Modafinil montherapy?
Thanks.
Thrud
Posted by IsoM on August 19, 2002, at 12:38:06
In reply to Adrafinil, Modafinil vs Antidepressants, posted by Thrud on August 19, 2002, at 4:11:13
Basic answer to your question, no. Both seem to have AD properties, & modafinil for me is great as an addition but does not have sufficient strength to used alone unless one’s depression is quite mild, or if the depression results from difficulties coping with the problems that modafinil helps (e.g. narcolepsy, ADD). Even though I have both, I still find I need an AD too, in my case, Celexa. My opinion is that both modafinil & adrafinil have potential for helping those suffering with lack of motivation & apathy.
Posted by johnj on August 19, 2002, at 20:29:09
In reply to Re: Adrafinil, Modafinil vs Antidepressants » Thrud, posted by IsoM on August 19, 2002, at 12:38:06
HI,
You might remember we corresponded in the past about Japan and I noticed you said you take Celexa. Due to my TCA messing up my excercise and making me feel like crap my pdoc has been talking about Celexa/lexapro. I am a little scared of ssri's due to the poop out effect that they can have, but I am desperate to try some thing that will hopefully give me some freedom to help myself. Have you ever taken a TCA? I tried remeron and it was a no go...too much sponge brain. Thanks
johnj
Posted by IsoM on August 20, 2002, at 1:58:25
In reply to Celexa question » IsoM, posted by johnj on August 19, 2002, at 20:29:09
Hi John, & yes, I remember you. Thanks for mentioning Japan - it helped trigger my memory. I used a combo of imipramine & amoxepine successfully for about 3-4 years. When SSRIs came out, I happily switched. I never could lose the severe constipation & dry mouth associated with TCAs. I remember that desimpramine & one other TCA (that I forget the name of) did nothing for me. So it appears that even with TCAs, some will work & others not for some people.
I like Celexa personally - a longer half-life than Paxil & Luvox so no problems if I'm late with a dose or miss one day (which I rarely do). Celexa worked very quickly for me unlike other SSRIs, but when the improvement seemed to drop, the dose was raised to 40 mg & I haven't had a poop-out yet in over 2 1/2 years of it. I don't tend to suffer poop-out from meds though when they do work, so it may not be applicable to you.
Posted by awake at last on August 20, 2002, at 9:54:19
In reply to Adrafinil, Modafinil vs Antidepressants, posted by Thrud on August 19, 2002, at 4:11:13
I don't think that could be answered with a simple yes or no. I think it is dependant upon what is the cause of the depression (which is often very difficult to determine). For me the SSRI's did nothing. Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
I do believe there is a place in the world of depression for Modafinil. I do believe that it can overcome some of the negative side-effects that can be caused by anti-depressants.I would not be surprised if it is not approved by the FDA for ADD and Depression in the next couple of years.
**************************************************
> Hi all.
>
> I notice that quite a few people here have tried or are on Adrafinil or Modafinil (Provigil).
>
> Probably most of you on these medications have tried SSRIs or other antidepressants as well.
>
> In terms of raw, antidepressant power how do they compare? Is someone with severe depression likely to succeed with Adrafinil or Modafinil montherapy?
>
> Thanks.
>
> Thrud
>
Posted by Rick on August 20, 2002, at 15:09:33
In reply to Re: Adrafinil, Modafinil vs Antidepressants » Thrud, posted by awake at last on August 20, 2002, at 9:54:19
I understand that in France adrafinil is indicated as an antidepressant for elderly people (perhaps because it is thought that a stimulant effect would be especially helpful for much of that population??)
Off topic...but awhile back there was talk about memory effects (both positive and negative, varying by person) of adrafinil/modafinil and other meds.
I'm still at 1 mg Klonopin, have been off Serzone for several months, and cut my modafinil (Provigil) from 100 mg to 50 mg a few weeks ago. It's too early to tell for sure, but I think since cutting the Provigil (which still helps me a lot a 50 mg, surprisingly), my memory may have improved some. OTOH, I've been away from this board a few months, and for the life of me could not remember IsoM's posting name without checking, even though she's one of my favorite contributors and we've had several exchanges on this board. Does that indicate memory problems, or is it normal for a late-forties-something?
> I don't think that could be answered with a simple yes or no. I think it is dependant upon what is the cause of the depression (which is often very difficult to determine). For me the SSRI's did nothing. Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
> I do believe there is a place in the world of depression for Modafinil. I do believe that it can overcome some of the negative side-effects that can be caused by anti-depressants.
>
> I would not be surprised if it is not approved by the FDA for ADD and Depression in the next couple of years.
>
> **************************************************
>
>
>
>
>
>
> > Hi all.
> >
> > I notice that quite a few people here have tried or are on Adrafinil or Modafinil (Provigil).
> >
> > Probably most of you on these medications have tried SSRIs or other antidepressants as well.
> >
> > In terms of raw, antidepressant power how do they compare? Is someone with severe depression likely to succeed with Adrafinil or Modafinil montherapy?
> >
> > Thanks.
> >
> > Thrud
> >
>
>
Posted by Thrud on August 21, 2002, at 5:17:38
In reply to Re: Adrafinil, Modafinil vs Antidepressants » Thrud, posted by awake at last on August 20, 2002, at 9:54:19
>Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
Your symptoms are intruiging: I also have low testosterone (from hypopituitarism) and narcolepsy symptoms (lumped in as severe fatigue/sleepiness associated with depression). Nothing out of whack with blood sugar though.
A lot of people with ADD use Adrafinil or Modafinil. What are the symptoms of ADD? I cannot focus or concentrate properly when depressed/fatigued: does this mean I may have ADD? How can a diagnosis be made?
Thanks.Thrud
Posted by Thrud on August 21, 2002, at 5:23:20
In reply to Re: Adrafinil, Modafinil vs Antidep + Memory/IsoM » awake at last, posted by Rick on August 20, 2002, at 15:09:33
> I'm still at 1 mg Klonopin, have been off Serzone for several months, and cut my modafinil (Provigil) from 100 mg to 50 mg a few weeks ago. It's too early to tell for sure, but I think since cutting the Provigil (which still helps me a lot a 50 mg, surprisingly), my memory may have improved some. OTOH, I've been away from this board a few months, and for the life of me could not remember IsoM's posting name without checking, even though she's one of my favorite contributors and we've had several exchanges on this board. Does that indicate memory problems, or is it normal for a late-forties-something?
>You take a stimulant + benzo combo. Is the Klonopin to counteract anxiety caused by Provigil?
Regardless of any memory 'problems', your intelligence and fluency definitely remain intact.
Thrud
Posted by Rick on August 21, 2002, at 12:18:48
In reply to Re: Adrafinil, Modafinil vs Antidep + Memory/IsoM » Rick, posted by Thrud on August 21, 2002, at 5:23:20
> You take a stimulant + benzo combo. Is the Klonopin to counteract anxiety caused by Provigil?
>Regardless of any memory 'problems', your intelligence and fluency definitely remain intact.Nope. The Provigil was added about a year after I started Klonopin. The short version of the story is that I was adding Serzone at that point and the idea was to offset med-induced fatigue and possibly add motivation/cognitive protection as well. To my surprise the Provigil not only *didn't* make me more anxious, but instead *helped* my social phobia by making me more outgoing and sociable (as long as I keep the dose at a max of 100mg on most days.)
Unfortunately, the purported memory benefits are nowhere in evidence.But thanks for the vote of confidence on the cognitive/memory front!
Rick
Posted by Jerrympls on August 22, 2002, at 23:40:42
In reply to Re: Adrafinil, Modafinil vs Antidepressants » awake at last, posted by Thrud on August 21, 2002, at 5:17:38
> >Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
>How - may I ask - did you eventually find out yoru depression was caused from low testosterone - among others? Was it a stab in the dark - did you doc just order a whole bunch of tests or ....? I'm also interested in how you are doing now - are you using Androgel or some other testosterone replacement? If so, has it helped?
Thanks- sorry so many questions.
Posted by awake at last on August 23, 2002, at 11:42:41
In reply to Re: Adrafinil, Modafinil vs Antidepressants » awake at last, posted by Thrud on August 21, 2002, at 5:17:38
The symptoms of ADD and Narcolepsy are very similar, except not all ADD's experience the fatigue to the degree that Narcoleptics do. Lack of the ability to focus or concentrate is classic of both. Taking Provigil has really helped me in that respect.
Both ADD and Narcolepsy are treated with stimulants like Ritalin - fortunately Provigil is now out for narcoleptics - which is not a narcotic, and it is currently being tested for use in ADD.
There are easy test to determine ADD, and a MSLT is used to determine Narcolepsy.
Here's a site that might give you some info.************************************************
> >Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
>
> Your symptoms are intruiging: I also have low testosterone (from hypopituitarism) and narcolepsy symptoms (lumped in as severe fatigue/sleepiness associated with depression). Nothing out of whack with blood sugar though.
>
> A lot of people with ADD use Adrafinil or Modafinil. What are the symptoms of ADD? I cannot focus or concentrate properly when depressed/fatigued: does this mean I may have ADD? How can a diagnosis be made?
> Thanks.
>
> Thrud
>
Posted by awake at last on August 23, 2002, at 17:02:37
In reply to Re: Adrafinil, Modafinil vs Antidepressants » Thrud, posted by Jerrympls on August 22, 2002, at 23:40:42
I hate to admit - but I actually discoverd it by luck from watching an interview on the Oprah Winfrey show - she had Chritina Ferrare on discussing her book "Okay, so I don't have a headache..".
Christina was discussing how she was always tired, depressed, no libido, major sugar cravings, etc....she was discribing me to a tee. I got her book and read it - then called my GYN and had the test run - yep that was part of it. Fortunately for me all it took to get my testosterone level back in line was to quit taking my BC Pills. There are creams, patches etc. that can be used for women. For men there are shots.To be honest, I have basically diagnosed myself over the years by continually researching my symptoms and talking to my doctor about having them tested. As I continue to research to determine how all of this has happened to me, I linked all my symptoms to Fibromyalgia.
I went to my Internist yesterday and he agrees that I have an autoimmune disorder...they are testing to rule out Lupus, etc., but they believe I am correct, it's Fibromyalgia (I'll know for sure on Monday)...which in turn is what has caused my hypoglycemia and Narcolepsy. Unfortunately - there's no cure for it either....but maybe I can slow it down or stop it from causing further damage.
Oh - The only med I take is Provigil....I stick with my hypoglycemia diet and I am strict about keeping my sleep/wake schedule the same 7 days a week. I feel better than I have in years. I will continue my search for complete recovery to assure I stay that way for the rest of my life!
Awake at last
************************************************
> > >Provigil was a lifesaver (but only after my incorrect diagnosis of depression was put to the side and my true illnesses were found - hypoglycemia, low testosterone and Narcolepsy).
> >
>
> How - may I ask - did you eventually find out yoru depression was caused from low testosterone - among others? Was it a stab in the dark - did you doc just order a whole bunch of tests or ....? I'm also interested in how you are doing now - are you using Androgel or some other testosterone replacement? If so, has it helped?
>
> Thanks- sorry so many questions.
>
This is the end of the thread.
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