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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Dinah on December 30, 2005, at 12:30:17
Are there any signs to tell when you're getting dependent on Provigil? I used to take it on an as needed basis, but under stress lately as needed became daily, and sometimes more than once a day if I'm to stay awake and functional.
I don't have quite enough to last me until my next appointment with my neurologist, so I've been trying to skip days. And that just isn't working. At all.
What should I look for to tell me if I'm getting dependent on Provigil? What would it feel like if I miss a dose?
Posted by zeugma on December 30, 2005, at 13:39:45
In reply to Provigil dependence, posted by Dinah on December 30, 2005, at 12:30:17
I was told by the clinician at the sleep clinic that Provigil would be more effective if I skipped a day every now and then. I found that the opposite was true; the day after I skipped i would still feel significant drowsiness.
Missing a dose (as I did today): increased need for caffeine; drowsiness. If I were in a high stress environment, I would begin to feel extremely overstimulated (though this may be a specifically ADHD issue), and then I begin to shut down, cognitively and perceptually, because I can't really deal with the flood of information (this again is an ADHD issue).
If I miss the afternoon dose, it becomes very difficult to stay awake past 6 pm. This is my baseline, assuming a wakeup time in the am.
-z
Posted by tecknohed on December 31, 2005, at 0:27:51
In reply to Provigil dependence, posted by Dinah on December 30, 2005, at 12:30:17
Hi Dinah.
I too take Provigil. I do not find it causes tolerence once you give it a chance to settle & find a comfortable dose.
BUT, the way you are taking it CAN and probably WILL 'feel' like it's creating a tolerence.
It seems common that when people start taking Provigil (myself included), its wake-promoting/stimulant properties become apparent very quickly (and is perhaps why you find it good for as-needed use). This may last for about a week during which you 'may' appear to need more for the same effect. It will (often) then seem to diminish almost completely. But from mine, and other's experiences, this isn't the complete theraputic effect of Provigil (though maybe a good indication that its worth sticking with).
It's main effect seems to take a while longer to come on. Once the initial effect wears off, you should start to feel another effect by the end of 3rd week but it may vary.
Rather than being so activating (I even found it gave a nice 'buzz' at first), it's wake promoting effect gets stronger, focus improves and overall mental alertness is increased but as a much more steadier and robust effect. Physical energy is rarely increased at this point. Then its a case of just finding the right dose, usually 100 - 400mg/day. None of this is always exactly the same for everyone of course, but I think its about right for a lot/majority of people.Hope this all makes some sense?
teck
Posted by Dinah on December 31, 2005, at 11:14:56
In reply to Re: Provigil dependence, posted by zeugma on December 30, 2005, at 13:39:45
I was prescribed it for (supposed) narcolepsy. I don't think I agree with my neurologist about that one, and the sleep studies didn't support the diagnosis. But I do tend toward overwhelming sleepiness when I'm upset.
I think your experiences with drowsiness tally with mine.
I ought to talk with someone, but my neurologist is so gung ho on the narcolepsy diagnosis that it's hard to talk to him. And I'm not sure my psychiatrist approves of the provigil, saying something about long term effects on norepinephrine and anxiety.
Posted by Dinah on December 31, 2005, at 11:20:54
In reply to Re: Provigil dependence » Dinah, posted by tecknohed on December 31, 2005, at 0:27:51
It makes sense, and it may be why my neurologist prescribed 2 100 mg tablets a day. I haven't been terribly compliant, since one tablet when I feel sleepy as needed was working for so long. I figured why take more? I never found it particularly activating. I just didn't fall asleep (usually).
But maybe I'm supposed to be on the higher regular dose for the reason you suggested.
Hmmm... It's something to consider.
I tend to be sort of a medication minimalist. I don't even like to take the health related medications, because I'm afraid of the long term effects of taking a handful of medications everyday might be. So much new information comes up everyday on these drugs, that it makes me worry. I try to get by on the bare minimum I need to function.
Posted by tecknohed on December 31, 2005, at 15:47:39
In reply to Re: Provigil dependence » tecknohed, posted by Dinah on December 31, 2005, at 11:20:54
> It makes sense, and it may be why my neurologist prescribed 2 100 mg tablets a day. I haven't been terribly compliant, since one tablet when I feel sleepy as needed was working for so long. I figured why take more? I never found it particularly activating. I just didn't fall asleep (usually).
>
> But maybe I'm supposed to be on the higher regular dose for the reason you suggested.
>
> Hmmm... It's something to consider.
>
> I tend to be sort of a medication minimalist. I don't even like to take the health related medications, because I'm afraid of the long term effects of taking a handful of medications everyday might be. So much new information comes up everyday on these drugs, that it makes me worry. I try to get by on the bare minimum I need to function.
I completely understand, and you've good reason to be that way, taking as little as possible and only when completely neccessary.
What I can definitely say for sure though, is that even at my dose of 500mg per day, I find it an incredibly CLEAN drug with NO side effects now (any initial side effects like insomnia, nervousness or headache should diminish fairly quickly).I would really urge you to consider giving it a 'proper' shot. That means, regular doses at regular times, every day. And should you find it does poop out/build tolerence, just sit back and try to be patient and do not increase the prescribed dose. I think you'll be positively suprised with the results.
Good luck with whatever you decide.
And Happy New Year!
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