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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by utopizen on October 14, 2002, at 19:58:11
I'm not a narcoleptic. But my college roommates have told me I sleep more than anyone else they know.
Even if I get a solid 9 hours of sleep, I'll still go through a 1-3 lull that's dreadful to go through.
Is anyone on Provigil? What does it feel like not to be sleepy all the time? I try to take 2 hour naps in the afternoon if I don't have to do anything that day, but finding this time is hard.
I've got anxiety and ADD, but no depression- I can wake up early in the morning when I have to, have a lot of energy, but three hours later I need to collapse into a nap somewhere or else it's dreadful. And so much for Desoxyn (methamphetamine HCL) - it almost makes me sleepy or something!
Adderall is the only thing that appears to keep my fatigue away, but it makes me incredibly anxious. And Klonopin of course knocks me into a nap at .5mg. I feel like I'm in this continium all the time- do you want to be productive and anxious or calm and tired?
And what's up with people with SP using Provigil on this board? How does this work out for those of you who do this? I've seen it listed as part of a cocktail for some, and am curious.
Posted by Seamus2 on October 14, 2002, at 20:44:36
In reply to What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 19:58:11
Have you ever tried curtailing your sleep to 6-7 hours per night for two or three days?
I find that while I *feel* better with more sleep, I'm much more active and productive if I get just the MDR (which for me is 6-7, but I'm 42).
This especially held true when I was on MAOI's, though I'd often have a 45 minute nap in the afternoon.
How's the Desoxsyn holding out? Any noticeable differences between it and Dexedrine?
Are you finding the effective doses equivalent mg per mg?
Posted by utopizen on October 14, 2002, at 21:08:03
In reply to Re: What's Provigil like for off-label use?, posted by Seamus2 on October 14, 2002, at 20:44:36
> Have you ever tried curtailing your sleep to 6-7 hours per night for two or three days?
>
> I find that while I *feel* better with more sleep, I'm much more active and productive if I get just the MDR (which for me is 6-7, but I'm 42).
>
> This especially held true when I was on MAOI's, though I'd often have a 45 minute nap in the afternoon.
>
> How's the Desoxsyn holding out? Any noticeable differences between it and Dexedrine?
>
> Are you finding the effective doses equivalent mg per mg?I've tried the 6-7 hrs route as well... the severity of the lull seems consistent with 6-7 or 9 hours.
Jury's still out on Desoxyn. It is giving me some freaky dermatoses, which any amphetamine is liable to do... but so far this is the first time one has for me. Anyway, I got these black flakes of dead skin on my face. I fanned them off, it was fine, but weird. It may also be responsible for a few whiteheads, but I do have a history of acne coming and going.
I can't up the dose more than 5mg/wk, or I'm liable to get nausea- not pleasant. I'm still on 5mg (I've skipped a few days).
I'm going to add Vitamin E to the mix- heard meth addict on a newsgroup said it kept her face clean back when she was a junkie of the stuff. For some reason junkies tend to have better solutions to pharmaceutical side-effects than boring squares like us...
I'll actually just titirate a bit faster... but definitely not more than 5mg increase per 72 hrs. Doing that should offset potential nasuea.
Hopefully 10mg will work when I get up to it... in the mean time, it just makes me a bit happy now and then, in an odd way... like a fuzzy feeling in the frontal lobes or something. Yeah, more like fuzzy than happy... but good fuzzy. Sort of like when I first drank a Red Bull I suppose. It doesn't seem to keep me "wired" or "awake."
Posted by BrittPark on October 14, 2002, at 21:19:05
In reply to What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 19:58:11
Hi,
I once tried modafinil as an augmentation agent for an antidepressant. For the first 2 week I thought it was the miracle drug of all miracle drugs. My depression melted after the first dose. Unfortunately it didn't last. However it does seem like it might be good at keeping you alert without pushing you over the edge to anxiety. It had a mild feeling not at all amphetamine-like.For what it's worth,
Britt
Posted by viridis on October 15, 2002, at 3:27:02
In reply to What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 19:58:11
It would certainly be worth a try -- Provigil isn't very controlled, and my impression is that free samples are readily available. My pdoc was quite willing to give me samples to try.
I used it for a while (for ADD), and although it didn't help much with that (Adderall is much better for me), it did keep me alert without any substantial increase in anxiety (I was taking Klonopin at the time, though). That's pretty good for me, since I have an anxiety disorder and get really wired if I even drink much caffeine, although amphetamines like Adderall actually have a calming/focusing effect.
I'd ask your doctor if you can try it, although he/she might be wary of mixing a second stimulant with Desoxyn. If you can get a sample, maybe start with a small amount -- the tablets are quite easy to break into smaller pieces. Some people seem to have a great response to it; my pdoc said it was hit-or-miss for ADD, but generally well tolerated and quite safe.
Posted by paulk on October 15, 2002, at 19:04:12
In reply to What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 19:58:11
> I'm not a narcoleptic. But my college roommates
>have told me I sleep more than anyone else they >know.
>
> Even if I get a solid 9 hours of sleep, I'll
>still go through a 1-3 lull that's dreadful to go
>through.This sounds like me.
>
> Is anyone on Provigil?I tried it once - for just a day - made me so sleepy I went to bed and slept for a couple of hours. I would like to try it again sometime and take it at bedtime. (Anyone else had this experience on Modafinil(Provigil)?
> What does it feel like not to be sleepy all the
> time? I try to take 2 hour naps in the afternoon
>if I don't have to do anything that day, but
>finding this time is hard.Feels like being alive
>I've got anxiety and ADD, but no depression- I can
> wake up early in the morning when I have to, have
>a lot of energy, but three hours later I need to
>collapse into a nap somewhere or else it's
>dreadful. And so much for Desoxyn (methamphetamine
> HCL) - it almost makes me sleepy or something!
Sounds like me – do you also have trouble staying on task – get too many iorns in the fire?>
> Adderall is the only thing that appears to keep
>my fatigue away, but it makes me incredibly
>anxious. And Klonopin of course knocks me into a
>nap at .5mg. I feel like I'm in this continium all
> the time- do you want to be productive and
>anxious or calm and tired?
I found that D-amphetamine works MUCH better – there is a difference in that Adderal has the boht L and D isomers of amphetamine. The L isomer is a NE and DA releaser while the D isomer is selective for just dopamine. There is much less anxious feeling on the D isomer for me. methamphetamine (Desoxyn)is the L isomer that hits both NE and DA.How much amphetamine do you take?
>And what's up with people with SP using Provigil
> on this board? How does this work out for those
>of you who do this?I also wish to hear about anyone’s long term use of Modafinil(Provigil).
Also would like to know what doses of D-amphedamine folks with ADD are taking. For me it seems that too low of a dose makes me feel worse instead of better.
Posted by IsoM on October 15, 2002, at 19:20:23
In reply to Sounds like ADD, posted by paulk on October 15, 2002, at 19:04:12
I've used first adrafinil for about 4 months (I forget exactly how long as I didn't see the need to keep track) & then switched to modafinil (Alertec here in Canada & Provigil in the States). I've been on Provigil for 3-5 months.
I have narcolepsy & ADHD. Originally adrafinil kept me awake & it felt wonderful but that wore off after a couple of months. Probably more to do with PEA euphoria effect from finding something that did work. Provigil didn't keep me any more awake than adrafinil did & I could soon sleep as many hours on the Max dose of Provigil as I could without, so I quit it.
Not a good idea. I found that while it didn't do a lick to keep me awake, it was doing marvellous in mood-enhancement & focus (when I was awake). I now take both Provigil & Dexedrine (dextroamphetamine) along with my Celexa & Eltroxin. I know that a higher dose of Dex would help but my doctor is a little reluctant. I'm sure as he gauges the long term effects & how my body handles it, he'll increase it. I need to use my Dex carefully to make it go far enough. I still can take both Dex & Provigil, head stright to bed & sleep for a couple of hours but the overall sleepiness is better & when my mind is engaged, it's much esier to stay awake & alert.
I suspect that too low a dose of Dex may only serve to make you sleepier (it does me) as it will quiet my mind just enough to enable my physical self to drop off to sleep again. Some doctors actually recommend a small amount of stimulant to their patients to take at bed time to help them relax the mental merry-go-round & fall asleep easier.
Posted by Rick on October 15, 2002, at 19:55:51
In reply to What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 19:58:11
> And what's up with people with SP using Provigil on this board? How does this work out for those of you who do this? I've seen it listed as part of a cocktail for some, and am curious.
I may not be adding anything new here if one of the Provigil-containing SP cocktails you already read about was mine, but the skinny is this:
A few years ago an AD was added to my mainstay Klonopin, and I became kinda lethargic and apathetic. My pdoc wanted me to try adding Ritalin, but I fnally convinced him to let me try this new "gentler" psychostimulant I had read about, Provigil. I was surprised to find that it not only handled things nicely in the wakefulness department (without interfering with *desired* sleep), but it also made me feel more enthusiastic and more "forward" with people...more sociable. So while Klonopin handled the basic "people fear", Provigil helped my ingrained introversion and avoidance. It made me more assertive, but without going to extremes or making me feel wired. (I'm talking significant change here, but not a 180 degree flip to extrovert.) So Provigil actually helped *reduce* my anxiety (at least in tandem with Klonopin)...as long as I didn't exceed a 100 mg dose for more than a few days at a time. My pdoc said that based on my experence he's used Provigil to good benefit for anxiety with several other patients.
I'm off it now -- hopefully temporarily -- because drying meds (of which Provigil is one) were doing a number on my throat...creating something akin to chronic sinusitus...feel like I'm choking on phlegm. I'm still doing quite well on Klonopin alone, but hope to add back the Provigil after the mucus invasion subsides (which it's doing). BTW, my pdoc thinks Klonopin should cause more dry mouth than Provigil or Serzone (which works well for me in combo with the other two), but that sure hasn't proven to be true.
Rick
Posted by paulk on October 15, 2002, at 22:24:31
In reply to Re: What's Provigil like for off-label use? » utopizen, posted by Rick on October 15, 2002, at 19:55:51
Klonopin is known to have a serotonergic effect. I don’t know if it ends up pushing down the DA like the SSRI’s do? It might and you may be correcting it with the other meds.
Modafinil(Provigil) gave me a really strange experience. I took it in the morning and an hour later I was nodding off and slept for a few hours. Just the opposite of what I expected. Later I learned it should not have an effect for a week or two.
I’m taking a low dose of Dex right now (15mg/day), but I’m worried about the roller coaster effects. I feel pretty lousy by about 4PM. I’m wondering if the Modafinil might help with that.
My biggest problem when taking the Dex is I fall asleep at night, but then I wake up at 3 or 4 in the morning and can't get back to sleep. Anyone else taking Dex have/had this problem?
Did you ever try Dex by itself? Can you compare the difference taking the combo?
Posted by utopizen on October 16, 2002, at 10:55:17
In reply to Sounds like ADD, posted by paulk on October 15, 2002, at 19:04:12
> Also would like to know what doses of D-amphedamine folks with ADD are taking. For me it seems that too low of a dose makes me feel worse instead of better.
>I stopped Desoxyn yesterday. I tried 10mg at once, and it gave me terrible adbominal pain. Ritalin very benign abdominal pain by comparison. It also didn't change the way I thought AT ALL. It just seemed to make my heart speed up and that was it. 10mg is a decent amount, so I gave up.
I've got Dexedrine, but I stopped that too. A little effect on my brain- I write longer- that seems it- and lots of hypertension. I don't feel like taking a beta-blocker, since Dex doesn't do anything for my head anyway- no more motivation than usual, focus usual, etc.
Ritalin seems to work fine, although it's annoying to feel abdominal pain or stomach pain or whatever it is even after taking it with food. Adderall's fine on an empty stomach, keeps me feeling motivated, wakes me, up, etc. In fact, Adderall's the only thing that fights fatigue for me-- Desoxyn doesn't, although it does taking longer to get my breathing and pulse slow enough to sleep.
Adderall's great, little anxiety, but I appear to be battling that better with Anxiety. Ritalin gives me OCD- how the heck am I suppose to fight off dorky urges to ask questions in class I wouldn't ussually care about?
Anyway, so I wish Desoxyn actually made me think differently, or Dexedrine did... unfortunately neither worked, although it did appear to calm me down.
Posted by utopizen on October 16, 2002, at 11:10:54
In reply to Re: What's Provigil like for off-label use? » utopizen, posted by Rick on October 15, 2002, at 19:55:51
Rick,
it seems every med gives me dry mouth.
Ask your doctor about Salagen (pilocarpine) or Evoxac. For some reason, it's only indicated for treating dry mouth of chemo patients. Maybe the app was never filed, but I think it's weird it hasn't been just approved for dry mouth in general.
My dentist, dermatologist (Accutane, finished now) GP and Psyc doc never heard of it. My GP gives iSalagen to me, but I will switch to Evoxac soon because it lasts longer and my insurance co-pay drops from $25 to $10.
If this doesn't work, try adding Flonaise. Someone just told me it helps post-nasal drip, which you appear to have. It will also help to thin the mucous by drinking 8-10 glasses of water/day.
Your doctor may not prescribe or find it approrpriate to prescribe Salagen or Evoxac. It's not for people with heart problems, since Salagen can do bad things to people with heart conditions. DO NOT try a beta blocker along with this- it's contraindicated. Unless your doctor seems very confident in the combo, don't take a bteta blocker within the same day.
Also, it is essiential to only add a dry mouth drug on top of a good dental regimen. My dentist advised me to pick up Colgate Phosfur, a $16 bottle of flouride rinse. Rinse for 30 seconds every other night before bed.
Also expensive, but worth it, is Biotene toothpaste and mouthwash. Totally need these things. Oh, and floss. I use the electric waterpik thing. And I use the UltraSonex toothbrush (salton.com). But any electric toothbrush will leave you with much less plaque.
good luck!
Posted by Rick on October 16, 2002, at 16:59:54
In reply to treating Dry mouth Rick, posted by utopizen on October 16, 2002, at 11:10:54
Thanks for the great tips, utopizen.
I'll have to look into the Salagen or Evoxac. I don't have heart problems, although sometimes my heart rate is pretty rapid (NOT anxiety-related as far as I can tell).
I do use Biotene -- both the mouthwash and the tootpaste -- on my pdoc's recommendation. My problem would clearly be even worse without them. I'll also try the Colgate product.
I've also been doing the lots-of-water thing, which I know helps a lot of people, but I'm not convinced it helps me. Always good to stay well-hydrated, though, so I'll continue.
I long used Beconase AQ, which is a nasal steroid like Flonase, for allergies. Tried restarting it when the postnasal drip got really bad, but unfortunately it didn't seem to help the PND.
Interesting you should mention the waterpik, because one thing I tried was the Grossan nasal irrigator tip that you attach to a waterpik for pulsing saline solution through the sinuses in order to flush them, remove allergens/irritants, and improve the function of the cilia. I know a few people who absolutely swear by it, but thus far it only seems to help me for about an hour.
Do you -- or anyone reading this -- find that any of the following supplements can cause dry mouth (at the moment I'm taking the first six listed):
Typical multi vitamin-mineral
Vitamin E Gelcap (I doubt that would be drying)
Ester-C
B-12 (NOT sublingual)
Calcium Citrate
Magnesium Citrate
Alpha-Lipoic Acid
Panax Ginseng
Chromiun Polynicotinate ("Chrome Mate")
B Complex
Thanks,
Rick
> Rick,
>
> it seems every med gives me dry mouth.
>
> Ask your doctor about Salagen (pilocarpine) or Evoxac. For some reason, it's only indicated for treating dry mouth of chemo patients. Maybe the app was never filed, but I think it's weird it hasn't been just approved for dry mouth in general.
>
> My dentist, dermatologist (Accutane, finished now) GP and Psyc doc never heard of it. My GP gives iSalagen to me, but I will switch to Evoxac soon because it lasts longer and my insurance co-pay drops from $25 to $10.
>
> If this doesn't work, try adding Flonaise. Someone just told me it helps post-nasal drip, which you appear to have. It will also help to thin the mucous by drinking 8-10 glasses of water/day.
>
> Your doctor may not prescribe or find it approrpriate to prescribe Salagen or Evoxac. It's not for people with heart problems, since Salagen can do bad things to people with heart conditions. DO NOT try a beta blocker along with this- it's contraindicated. Unless your doctor seems very confident in the combo, don't take a bteta blocker within the same day.
>
> Also, it is essiential to only add a dry mouth drug on top of a good dental regimen. My dentist advised me to pick up Colgate Phosfur, a $16 bottle of flouride rinse. Rinse for 30 seconds every other night before bed.
>
> Also expensive, but worth it, is Biotene toothpaste and mouthwash. Totally need these things. Oh, and floss. I use the electric waterpik thing. And I use the UltraSonex toothbrush (salton.com). But any electric toothbrush will leave you with much less plaque.
>
> good luck!
Posted by Rick on October 16, 2002, at 17:14:47
In reply to Sounds like ADD, posted by paulk on October 15, 2002, at 22:24:31
> Modafinil(Provigil) gave me a really strange experience. I took it in the morning and an hour later I was nodding off and slept for a few hours. Just the opposite of what I expected. Later I learned it should not have an effect for a week or two.
When I took my first Provigil (200 mg), I could *really* feel it within 2 hours -- which is not to say it made me feel wired, just very awake and "up." I also had that mild euphoria, which went away within a few days. (In fact, my suspicion is that some people who say the Provigil was great for a few days, but then pooped, don't realize that the mild euphoria is only a side effect -- a transient one.)
Despite my own experience, I've seen plenty of people who reported, like you, that Provigil put them to sleep at first. For some people it does seem to take awhile to start working, and for others it just never starts at all. Seems to be some bigtime YMMV with Provigil.
I wonder if previously stimulant-naive people like myself have a quicker and/or stronger response. Also, the fact that I started it while taking some sedating meds may have made the wakefulness impact even more noticeable?
Rick
Posted by utopizen on October 16, 2002, at 17:33:07
In reply to Re: treating Dry mouth Rick » utopizen, posted by Rick on October 16, 2002, at 16:59:54
I take Vitamin E water soluble caps and B 100 complex.
No dry mouth.
Okay- Salagen kills dry mouth within like 10 minutes. You WILL NOT experience dry mouth if you end up taking it. Evoxac appears similar, like a year newer... but I haven't tried it yet. I'd try Evoxac, since I heard it lasts longer. Salagen I end up popping like 4-5 times a day, even though the bottle says 3x.
Posted by Rick on October 17, 2002, at 1:37:58
In reply to Re: treating Dry mouth Rick, posted by utopizen on October 16, 2002, at 17:33:07
>Evoxac appears similar, like a year newer... but I haven't tried it yet. I'd try Evoxac, since I heard it lasts longer.
I looked up Evoxac on Medline, and the first thing that popped up was something saying it might prove to be a neuroprotective, novel cognitive enhancer. Now I'm even more intrigued.
Thanks again for the ideas.
Rick
Posted by Seamus2 on October 17, 2002, at 21:40:22
In reply to Re: What's Provigil like for off-label use?, posted by utopizen on October 14, 2002, at 21:08:03
Best of luck w/ the titration. I'll eventually ask my doc for some, although at the tiny dose I take I sure hope I can split those 5 mg pills evenly!
Posted by Jo Ann on October 19, 2002, at 2:02:17
In reply to Sounds like ADD, posted by paulk on October 15, 2002, at 22:24:31
I take 20 mg of Dex per day, and for the last 3 or 4 weeks, I wake up halfway through the night, then fall back asleep about half an hour before my alarm goes off. This happened about a year ago when I first started the meds. I am going to the doctor on Monday to see what he thinks.
> Klonopin is known to have a serotonergic effect. I don’t know if it ends up pushing down the DA like the SSRI’s do? It might and you may be correcting it with the other meds.
>
> Modafinil(Provigil) gave me a really strange experience. I took it in the morning and an hour later I was nodding off and slept for a few hours. Just the opposite of what I expected. Later I learned it should not have an effect for a week or two.
>
> I’m taking a low dose of Dex right now (15mg/day), but I’m worried about the roller coaster effects. I feel pretty lousy by about 4PM. I’m wondering if the Modafinil might help with that.
>
> My biggest problem when taking the Dex is I fall asleep at night, but then I wake up at 3 or 4 in the morning and can't get back to sleep. Anyone else taking Dex have/had this problem?
>
>
> Did you ever try Dex by itself? Can you compare the difference taking the combo?
>
Posted by paulk on October 20, 2002, at 18:07:53
In reply to Re: Sounds like ADD, posted by Jo Ann on October 19, 2002, at 2:02:17
Sounds familiar – I’m guessing that during the time that D-amphetamine (Dexidrine) is in my system and releasing dopamine(DA) that it causes the general level of DA to increase. Then as the drug wears off – DA releasing neurons under-release due to partial depletion – causing the crash and sleepiness – as the night goes on the neurons regenerate DA stores and the background level of DA is still elevated enough to wake me up.
I had the problem at a low dose of only 7.5 Mg/day – Today is my first day at 15mg/day and I will see if my sleep is better or worse in the next week. Might be better sleep as the neurons will be more depleted.
Modafinil(Provigil) should only raise the background level of DA. I’m not sure that would give me the benefits in focus and prioritizing that I’m after.
I really want to do an experiment and take tyramine, it is tyrosine that is partly metabolized – I think almost to L-dopa. I find that I crave Cheddar cheese and would eat it all the time except for the high fat content. My hunch is that it acts as a pro-drug for DA (and probably NA also).
Jo Ann wrote on 10/19/02
> I take 20 mg of Dex per day, and for the last 3 or 4 weeks, I wake up halfway through the night, then fall back asleep about half an hour before my alarm goes off. This happened about a year ago when I first started the meds. I am going to the doctor on Monday to see what he thinks.
This is the end of the thread.
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