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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by alesta on September 28, 2004, at 12:21:01
Hello,:)
I was wondering..does provigil in any way magnify the effects of klonopin, or vice versa? I’m considering this combination for social anxiety and would like to know if a dose adjustment will be necessary when combining the two.
Thank you!!
Amy:)
Posted by steve12 on September 28, 2004, at 15:11:39
In reply to klono provigil-any magnification when combining?, posted by alesta on September 28, 2004, at 12:21:01
Amy,
Don't know about that -- but I can tell you that I recently tried Provigil and felt absolutely *nothing* at 400 mgs. It seems like the most overrated med out there and now they're trying to get an indication for ADHD?
But perhaps you're experience will differ. Let me know :)
> Hello,:)
>
> I was wondering..does provigil in any way magnify the effects of klonopin, or vice versa? I’m considering this combination for social anxiety and would like to know if a dose adjustment will be necessary when combining the two.
>
> Thank you!!
>
> Amy:)
>
>
Posted by zeugma on September 28, 2004, at 17:04:00
In reply to Re: klono provigil-any magnification when combini » alesta, posted by steve12 on September 28, 2004, at 15:11:39
hi amy, glad you're back- was it really only a week ?:)
klon and provigil do not magnify each other to the best of my knowledge. in fact Provigil speeds the metabolism of klonopin, resulting in faster clearance and diminished effect. On the other hand, Provigil is not one of the meds that heightened anxiety for me, and it may have had some kind of anxiolytic effect. You have to try it and see. I loved the cognitive effects of provigil, but it had too much in the way of strange side effects for me to continue with. It was a more effective stimulant than Ritalin is, but I have to use what I can tolerate.
And you won't find a more effective pure anxiolytic than Klonopin.
-z
Posted by steve12 on September 28, 2004, at 20:18:16
In reply to Re: klono provigil-any magnification when combini, posted by zeugma on September 28, 2004, at 17:04:00
I agree that Klonopin is the best bezo -- and has a lower risk of dependence. Steve
> hi amy, glad you're back- was it really only a week ?:)
>
> klon and provigil do not magnify each other to the best of my knowledge. in fact Provigil speeds the metabolism of klonopin, resulting in faster clearance and diminished effect. On the other hand, Provigil is not one of the meds that heightened anxiety for me, and it may have had some kind of anxiolytic effect. You have to try it and see. I loved the cognitive effects of provigil, but it had too much in the way of strange side effects for me to continue with. It was a more effective stimulant than Ritalin is, but I have to use what I can tolerate.
>
> And you won't find a more effective pure anxiolytic than Klonopin.
>
> -z
Posted by alesta on September 29, 2004, at 4:10:33
In reply to Re: klono provigil-any magnification when combini, posted by zeugma on September 28, 2004, at 17:04:00
> hi amy, glad you're back- was it really only a week ?:)
hi zeugma! i missed you! i know..it did seem longer than a week...:) at least someone noticed i was gone.:) hope you're doing well, my friend.
> klon and provigil do not magnify each other to the best of my knowledge. in fact Provigil speeds the metabolism of klonopin, resulting in faster clearance and diminished effect. On the other hand, Provigil is not one of the meds that heightened anxiety for me, and it may have had some kind of anxiolytic effect. You have to try it and see.thanks for the *great* info! i will make whatever adjustments are necessary after combining..at least now i know what to expect..
<I loved the cognitive effects of provigil, but it had too much in the way of strange side effects for me to continue with.
really? what kind of side effects? :)
> And you won't find a more effective pure anxiolytic than Klonopin.
i'll second that one! thank god for klonopin's existence!
amy :0)
Posted by alesta on September 29, 2004, at 4:16:57
In reply to Re: klono provigil-any magnification when combini » alesta, posted by steve12 on September 28, 2004, at 15:11:39
> Amy,
>
> Don't know about that -- but I can tell you that I recently tried Provigil and felt absolutely *nothing* at 400 mgs.really? i've heard a lot of good things about prov..but, i suppose, as in your case, YMMV.
<It seems like the most overrated med out there and now they're trying to get an indication for ADHD?
i do think other drugs, such as dexedrine, are definitely more effective for ADHD (which i don't have..i'm adding it to help w/ social anxiety).
> But perhaps you're experience will differ. Let me know :)
let's hope so! i will let you know how it goes.
take care!:)
amy
Posted by alesta on September 29, 2004, at 4:57:50
In reply to Re: klono provigil-any magnification when combini » steve12, posted by alesta on September 29, 2004, at 4:16:57
> i do think other drugs, such as dexedrine, are definitely more effective for ADHD.i wanted to add something to my comment above..gotta cover my a#$, here..i don't know why i only mentioned dexedrine..ritalin is also very effective (and *maybe* less toxic than the amphetamines..it is in studies using *extremely*, high doses, anyway..but this may not matter at normal doses! so maybe i shouldn't have even brought that up). ritalin seems, in general, just a little less effective than dexedrine.
and, concerning provigil..it can help for adhd; i've heard varying things about it. YMMV--it seems to be a hit or miss for ADHD. it can work great, or poorly, depending on who you talk to. if it did work, it would be the way to go, as it is safer cardiowise.
i'm not sure why i went on that tangent...i feel the need to clarifying everything to the max on this board..:)
amy:)
Posted by Waki on September 29, 2004, at 20:20:50
In reply to Re: klono provigil-any magnification when combini, posted by zeugma on September 28, 2004, at 17:04:00
Hi alesta,
The only thing you may want to watch is to make sure the provigil does not cancle out the klon.
personally klon sedates me, and then the provigil wakes me back up. however i quit taking klon.
good luck!
Posted by alesta on September 29, 2004, at 23:11:13
In reply to Re: klono provigil-any magnification when combini, posted by Waki on September 29, 2004, at 20:20:50
> Hi alesta,
>
>
> personally klon sedates me, and then the provigil wakes me back up. however i quit taking klon.
>
> good luck!hi, wak! thanks! the provigil wakes you up but without producing anxiety like the stimulants do..that's one thing that's so great about it (among many).
> The only thing you may want to watch is to make sure the provigil does not cancle out the klon.
i definitely will, and will increase my klon dose if necessary..good to hear from you, man! :)take care, buddy,:)
amy
Posted by zeugma on September 30, 2004, at 20:10:20
In reply to Re: klono provigil-any magnification when combini » zeugma, posted by alesta on September 29, 2004, at 4:10:33
hi again amy.
really? what kind of side effects? :)>>
sorry it's taken so long to get back to ya. The side effects were bizarre. My bdy felt feverish, while my brain felt cold, if you could imagine that. I sweated violently. The glands in my neck were swollen, so much so that it actually hurt to turn my neck. And I felt 'ill' all the time, queasy, with a lot of GI tract pain. I spent a lot of time thinking about going to a GP, or just buying a thermometer :) I figured the effects would dissipate after d/c'ing the Prov, and they did.
now, after all that, try to imagine this: I had REDUCED anxiety, improved concentration, markedly more energy (though I still displayed the activity level more typical of a sloth than of any other mammalian species), was running several miles a day, had an increased appetite and gained weight (the bane of stims for me has always been anorexia, which Ritalin causes, although I may be getting past that thanks to nortriptyline). And my handwriting improved! Well, you wouldn't appreciate that one, as you've never seen my handwriting ;)
btw I am giving Strattera another try at a low dose. Wish me luck- I may need it!
-z
Posted by Rick on October 1, 2004, at 2:53:32
In reply to Re: klono provigil-any magnification when combini » Waki, posted by alesta on September 29, 2004, at 23:11:13
> hi, wak! thanks! the provigil wakes you up but without producing anxiety like the stimulants do..that's one thing that's so great about it (among many).
I agree completely. Been on 1 mg/day Klonopin + 100mg/day Provigil, for 4 years now for severe, non-depressive generalized social phobia. Once in awhile 100 mg Provigil doesn't seem to do the trick wakefulness-wise, but that's very much the exception to the rule for me.
> > The only thing you may want to watch is to make sure the provigil does not cancle out the klon.
>
> i definitely will, and will increase my klon dose if necessary..good to hear from you, man! :)
>I've had no need to increase my Klonopin dose when I added Provigil. A few posts above, it was suggested that Provigil induces Klonopin metabolism, i.e. lowers Klonopin blood levels. But, unless there's been some recent new evidence, I don't believe it works that way.
Animal research shows that Provigil can indeed speed up metabolism of drugs that are substrates of liver enzyme CYP3A4 *and also have significant first-pass metaolism in the gut* (e.g., Halcion). While Klonopin is indeed a substrate of CYP3A4, it doesn't undergo first-pass metabolism, and thus would not have a metabolic interaction with Provigil.
As always, YMMV.
Rick
Posted by pseudonym on October 1, 2004, at 11:14:23
In reply to Re: klono provigil-any magnification when combini » alesta, posted by Rick on October 1, 2004, at 2:53:32
Rick, I have always had a strong interest in your posts, for selfish reasons, your symptoms mirror mine. How has the regimen been treating you? Do you known that is has defeated the social anxiety disorder in its entirety?
Posted by alesta on October 1, 2004, at 13:23:58
In reply to Re: klono provigil-any magnification when combini » alesta, posted by zeugma on September 30, 2004, at 20:10:20
hi zeugy,
those are some side effects! dag! that's quite a reaction..i wish you the utmost of luck with the strattera!
> now, after all that, try to imagine this: I had REDUCED anxiety, improved concentration, markedly more energy (though I still displayed the activity level more typical of a sloth than of any other mammalian species),
now that really did make me laugh out loud! hilarious!:0)
i tell ya, this prov sounds like the cat's meow to me..i'm so excited! oh, to have energy..i can't imagine it right now..i've had to drag myself through the day for so long..look out world!! (but, guess i have to actually take the meds first..:))
*good luck with the strattera!!!!*
lator, buddy,
amy:)
Posted by alesta on October 1, 2004, at 13:28:52
In reply to Re: klono provigil-any magnification when combini » alesta, posted by Rick on October 1, 2004, at 2:53:32
hi rick!
so good to see you! (remember, you're a celebrity.:)) glad you came back...again! this combo really sounds like the bomb..all my research (tons of it) has come back to this..if i'd have just taken your word for it, i could've saved myself a lot of time!:)i plan to take .5 mg once a day (in the morning) and 100 mg provigil (and maybe 200 mg later on if i need to). one lady i read about took this dose of klonopin in the morning and was doing great, no side effects (she wasn't taking the provigil with it, though). i am very med sensitive so i know .5 will work for me (or maybe even lower..i doubt it, though..)
wow, thanks for the great info!:) i really appreciate it!!
take care,:)
amy
Posted by Rick on October 1, 2004, at 13:36:35
In reply to Re: klono provigil-any magnification when combini, posted by pseudonym on October 1, 2004, at 11:14:23
> Rick, I have always had a strong interest in your posts, for selfish reasons, your symptoms mirror mine. How has the regimen been treating you? Do you known that is has defeated the social anxiety disorder in its entirety?
pseudonym -
The Klonopin+Provigil combo still works great for me. The Klonopin removes the fear of people I suffered for so many years and the Provigil provides additional assertiveness as well as enthusiasm and and sociability. At the risk of oversimplification, I'd say that I average about 85-90% relief of my SP symptoms, with the most distressing symptoms showing the greatest improvement. That's not "entirety", but I'll take it! (I'm open to seeking out add-on meds for that extra 10-15%, but I doubt anything could replace what the Klonopin, in particular, accomplishes.)
I occasionally have some breakthrough anxiety, especially in specific kinds of situations, but it happens infrequently and when it does it is now mild and fast-resolving, instead of debilitating.
Where I still am somewhat lacking is in terms of motivation to *seek out* social situations. And there is still some avoidance there. But there's definitely more to this than residual Social Phobia, especially the motivation angle. I'll be the first to admit that, while I feel I have accomplished plenty in life -- and I'm proud of it -- I often have a tendency towards procrastination, complacency and even laziness. I can get really psyched and perform well when I am thrust into something, but I am generally not a self-starter, and I don't think any drug is going to change that. (Note that I didn't say it isn't changeable to some degree, only that a legal *drug* isn't likely to change it.) Also, having had a strong relationship for many years, I don't *need* to be a party animal. But I *should* try to be involved more socially and make more friends. If this sounds like it's contradicting my statement about improved sociability, it's not. For instance, pre-2000 I would have been far less likely to walk around and strike up conversations with people at work -- and if I did, I would be hugely less comfortable and assertive than I am now, would have often been halting and nervous, and would have tried to end the conversations quickly. Also, now when I am at a personal or professional social event, I can interact freely and can actually *enjoy* the social interaction -- which is a huge change from before. While Klonopin alone removed my fear of speaking up in a crowd, with the combo I will speak up spontaneously rather than only when it's expected or necessary. In fact, sometimes I become very talkative, which is quite a difference from the pre-combo days. (And no, I don't mean "manic" by any stretch.) But, like many non-phobic individuals -- especially as they get older -- I still look forward to time alone at home or with loved ones.
Sorry for telling you more than you ever wanted to know. But again the short answer is that after nearly five years my regimen is still a godsend in terms of erasing my debilitating and pervasive Social Fear, and is working as well as ever (and far, far better than the many med trials that preceeded it). I have only two possible side effects: sporadic adverse short term memory effects with the Klonopin, and dry mouth/throat from the Provigil. (I'm only talking about negative side effects. I was pleased to find several unexpected, beneficial side effects from each med as well.)
Rick
Posted by Rick on October 1, 2004, at 13:43:46
In reply to Re: klono provigil-any magnification when combini, posted by pseudonym on October 1, 2004, at 11:14:23
Clarification: When I said earlier in this thread that I've been taking Klonopin four years, that was incorrect. It's actually been five years, as per my reponse to you. Maybe that's one of those sporadic memory effects I referred to :)
Posted by Rick on October 1, 2004, at 13:48:43
In reply to Re: klono provigil-any magnification when combini » Rick, posted by alesta on October 1, 2004, at 13:28:52
amy -
You're quite welcome, and good luck! My bet is that you'll find the combo to be extremely beneficial.
Rick
This is the end of the thread.
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