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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by wildflower on April 29, 2005, at 0:42:56
This has been discussed in various posts but I'm curious about Provigil. Suposedly it's prescribed to keep you awake and alert. In my case, I take 200 in the morning and 100 around noon and I'm still ready to sleep on my keyboard. Any ideas? Here's my cocktail:
Wellbutrin XL 300
Cymbalta 120 mg
Lamictal 100 mg
Provigil 250 mg
Klonopin for sleepIs there something that may be counteracting provigil and preventing me from being awake and alert?
I do go to bed at various times each night but not enough to throw off my internal clock.
Posted by JKL on April 29, 2005, at 6:33:58
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
Provigil, in contrast to what it was supposed to do, made me extremely tired and sluggish.
I have also noticed over the years that when I take meds to boost dopamine function, I get a nice activating effect at lower doses, but get a tired exhausted effect at higher doses. For me, a little dopamine boost is helpful, but if I overdo it then it works just the opposite. Too little dopamine...bad. Too much dopamine...bad.
With the exception of klonopin, all the meds you are taking have either direct or indirect effects on boosting dopamine. Maybe you are experiencing sluggishness from provigil like I did, or maybe there is just too much dopamine stuff going on.
Just my thoughts based on my own experiences. I could be way off. Just something to think about. If nothing else, I wanted to let you know that provigil made me very very tired, to where my legs felt like they were 100 pounds each.
> This has been discussed in various posts but I'm curious about Provigil. Suposedly it's prescribed to keep you awake and alert. In my case, I take 200 in the morning and 100 around noon and I'm still ready to sleep on my keyboard. Any ideas? Here's my cocktail:
>
> Wellbutrin XL 300
> Cymbalta 120 mg
> Lamictal 100 mg
> Provigil 250 mg
> Klonopin for sleep
>
> Is there something that may be counteracting provigil and preventing me from being awake and alert?
>
> I do go to bed at various times each night but not enough to throw off my internal clock.
Posted by banga on April 29, 2005, at 10:08:04
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
> This has been discussed in various posts but I'm curious about Provigil. Suposedly it's prescribed to keep you awake and alert. In my case, I take 200 in the morning and 100 around noon and I'm still ready to sleep on my keyboard. Any ideas?
I don't know--Provigil did little for me when I took some samples....
also, what I hear is that it can be very helpful for a short while, then lose effectiveness (good ol' poop-out) That's one reason why I have been hesitant in trying (although main problem is that insurance won't cover it)--I didn't want to experience great benefit, only to have it disappear a few weeks later....Maybe you can test out which it is: poop-out vs too much dopamine activation--by taking the med doses all at once.
If it helps a tiny bit or there is barely change, maybe it's poop-out; conversely, if you feel more tired, maybe it's too much dopamine as was suggested.
Posted by Wildflower on April 29, 2005, at 11:48:44
In reply to Re: Way too tired - need med assessment, posted by JKL on April 29, 2005, at 6:33:58
> Maybe you are experiencing sluggishness from provigil like I did, or maybe there is just too much dopamine stuff going on.
I was way too tired before the provigil. My pdoc thought that the provigil would help.
> Just my thoughts based on my own experiences. I could be way off. Just something to think about. If nothing else, I wanted to let you know that provigil made me very very tired, to where my legs felt like they were 100 pounds each.Thanks. I appreciate your input!
>
Posted by Wildflower on April 29, 2005, at 11:50:48
In reply to Re: Way too tired - need med assessment » wildflower, posted by banga on April 29, 2005, at 10:08:04
> Maybe you can test out which it is: poop-out vs too much dopamine activation--by taking the med doses all at once. If it helps a tiny bit or there is barely change, maybe it's poop-out; conversely, if you feel more tired, maybe it's too much dopamine as was suggested.
I take all the meds except Klonopin at the same time already. I take an extra dose of provigil around lunch if I'm tired. Maybe it is the dopamine.
Posted by banga on April 29, 2005, at 12:05:53
In reply to Re: Way too tired - need med assessment » banga, posted by Wildflower on April 29, 2005, at 11:50:48
> I take all the meds except Klonopin at the same time already. I take an extra dose of provigil around lunch if I'm tired. Maybe it is the dopamine.
>
Hi!
I meant take the extral Provigil at the same time as the first dose--all at once and see...Good luck!
Banga
Posted by Phillipa on April 29, 2005, at 19:06:18
In reply to Re: Way too tired - need med assessment » Wildflower, posted by banga on April 29, 2005, at 12:05:53
Since all the meds do seem to have a stimulant effect, the only one that sedates if klonopin. I know when I took it it made me feel stupid. Are you anxious? Do you sleep okay? Maybe you don't need the klonopin. Just my thought. Fondly, Phillipa
Posted by paul_d_234 on April 29, 2005, at 20:44:45
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
Someone told me that Wellbutrin prevents Cymbalta from being "metobolized" which means it accumulates / becomes more potent the more Wellbutrin you add. Cymbalta at high doses can make you tired, letharic, and unmotivated. Either try cutting back some of the cymbalta - or taking it 12 hours after the Welbutrin for a few days and see what happens.
> This has been discussed in various posts but I'm curious about Provigil. Suposedly it's prescribed to keep you awake and alert. In my case, I take 200 in the morning and 100 around noon and I'm still ready to sleep on my keyboard. Any ideas? Here's my cocktail:
>
> Wellbutrin XL 300
> Cymbalta 120 mg
> Lamictal 100 mg
> Provigil 250 mg
> Klonopin for sleep
>
> Is there something that may be counteracting provigil and preventing me from being awake and alert?
>
> I do go to bed at various times each night but not enough to throw off my internal clock.
Posted by Ktemene on April 30, 2005, at 20:10:18
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
Klonopin has a really long half-life. If you are using it just for sleep, and not for anxiety, then you might be better off using a benzo (or some other sleep medication) with a shorter half-life.
> This has been discussed in various posts but I'm curious about Provigil. Suposedly it's prescribed to keep you awake and alert. In my case, I take 200 in the morning and 100 around noon and I'm still ready to sleep on my keyboard. Any ideas? Here's my cocktail:
>
> Wellbutrin XL 300
> Cymbalta 120 mg
> Lamictal 100 mg
> Provigil 250 mg
> Klonopin for sleep
>
> Is there something that may be counteracting provigil and preventing me from being awake and alert?
>
> I do go to bed at various times each night but not enough to throw off my internal clock.
Posted by BJM on May 1, 2005, at 8:21:47
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
My guess would be the Klonopin is making you too tired. Definetly does it to me. And I think there is definetly something to the less is more theory for Provigil. If I take it all at one large dose I'm exhausted. Really bizarre. But maybe that is a good thing since it is sooooo expensive and insurance companies are being really difficult about paying for it anymore.
Posted by wildflower on May 2, 2005, at 12:37:44
In reply to Way too tired - need med assessment, posted by wildflower on April 29, 2005, at 0:42:56
Could this be the cause? I've just noticed that I haven't been drinking any liquids lately. You'd think with all of the "activating" meds, this wouldn't be a factor.
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