![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Amberlin on October 28, 2002, at 13:20:44
I have been on this combination (all together) for about two weeks and I am so tired even with the Provigil. I can't understand it as it had been working, and now all of a sudden, I seem to be even MORE tired than before. It's like a terrible drowsiness I cannot ignore.
I'm on the provigil to battle the fatigue that has come with my depression. I had been on Effexor for two years, but because there is an agent in it that when combined with Provigil was increasing my blood pressure, I was switched to Celexa almost four weeks ago.
I can't explain this extreme fatigue now--it hits the same time of day. I'm scared to take a higher dose of Provigil...and I'm thinking that maybe Celexa isn't a good choice.
Lin.
Posted by Halfway on October 28, 2002, at 16:43:05
In reply to Celexa/Provigil/Klonopin, posted by Amberlin on October 28, 2002, at 13:20:44
Lin,
Evidently, Provigil augments most SSRIs nicely...except for Celexa. Check out link below. Among the babblers are some experts on P450 interactions, who can probably explain this better. You may want to consider a different stimulant before giving up on the Celexa. Just a thought...
Jist of article (full link below):
"Statistically significant improvements in energy and concentration as measured by a sub-scale of the Hamilton Depression Scale (HAM-D retardation scale) were seen in patients taking Provigil(r) and various antidepressants including Prozac(r) (fluoxetine HCl), Zoloft(r) (sertraline HCl), or Paxil(r) (paroxetine HCl) but as anticipated, not in patients taking Celexa™, (citalopram HBr), a compound with which Provigil(r) has a known metabolic interaction. Results on the overall Hamilton Depression Scale, which contains elements that are not influenced by fatigue and cognitive function, did not distinguish Provigil(r) from placebo."
http://talkaboutsleep.com/news/Provigil_Depression.htm
Posted by Amberlin on October 28, 2002, at 19:25:05
In reply to Re: Celexa/Provigil/Klonopin » Amberlin, posted by Halfway on October 28, 2002, at 16:43:05
Thanks so much, Halfway. I see my doctor tomorrow and I am going to discuss this with him. Provigil doesn't seem to be agreeing with me. It's odd that I'm taking a stimulant, but yet I am so tired. The cost is also a bit much with not having insurance.
I'm not taking the Provigil tomorrow--because by 2 PM, I am so exhausted I have to leave work to go sleep. It's interfering with my life.
Posted by leslieg on October 30, 2002, at 9:23:57
In reply to Re: Celexa/Provigil/Klonopin, posted by Amberlin on October 28, 2002, at 19:25:05
I'm about to start Lexapro in addition to my Provigil (which I take for narcolepsy). I hope it does better for me ... why I'm writing is to say that Provigil seems to have wide variations in effectivness in different individuals. I, personally, take 200 mg in the am (with a cup of coffee) and then often another 100 in the late afternoon (with another cup of coffee). Without the afternoon dose, I wouldn't be able to make dinner and take care of the kids. But of course, if it doesn't work for you, it doesn't work! I hope you find a good solution.
Leslie
> Thanks so much, Halfway. I see my doctor tomorrow and I am going to discuss this with him. Provigil doesn't seem to be agreeing with me. It's odd that I'm taking a stimulant, but yet I am so tired. The cost is also a bit much with not having insurance.
>
> I'm not taking the Provigil tomorrow--because by 2 PM, I am so exhausted I have to leave work to go sleep. It's interfering with my life.
Posted by Amberlin on October 30, 2002, at 9:33:48
In reply to Re: Celexa/Provigil/Klonopin » Amberlin, posted by leslieg on October 30, 2002, at 9:23:57
Well, the doctor took me off the Celexa and Provigil, and now I am just on Lexapro.
It makes me angry that he isn't concerned about my fatigue, and it's extreme nature.
Posted by leslieg on October 30, 2002, at 9:39:07
In reply to Re: Celexa/Provigil/Klonopin, posted by Amberlin on October 30, 2002, at 9:33:48
One thing I learned when searching for what was wrong with me (discovered after 2 years of looking that I am Narcoleptic) is that the medical world makes a big distinction between "fatigue" and "sleepiness". Of course no one told me until the end of my search. I was *sleepy* but told all my docs I was suffering from fatigue. I honestly don't know how they define fatigue (brain awake but body not?) but it might be very worth your while to investigate which of the two you have and be sure to use the correct term to your docs.
Leslie
> Well, the doctor took me off the Celexa and Provigil, and now I am just on Lexapro.
>
> It makes me angry that he isn't concerned about my fatigue, and it's extreme nature.
Posted by Amberlin on October 30, 2002, at 9:45:47
In reply to Re: Celexa/Provigil/Klonopin » Amberlin, posted by leslieg on October 30, 2002, at 9:39:07
Thanks, Leslie. Thankfully I am getting good health insurance the middle of november that will cover certain pre-existing conditions. I think I want a sleep study done..it could be a sleep disorder. The other concern the doctor had was Chronic Fatigue Syndrome, with the depression being a product of that. For as long as I can remember, I can never get enough sleep. I just hate having to wait two months to see my doctor again...but as soon as I get my insurance, i am switching to a private practice and hopefully will get treated better.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.