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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by saturn on May 7, 2006, at 22:27:48
I'm interested in any thoughts or experiences regarding a Tenex/Provigil combo for ADHD in terms of effectiveness/synergy and side effects/problems. (There have been reports of suddent death when combining ritalin and clonidine--though I realize this combo is not the same thing).
Beyond reducing blood pressure, does Tenex have any effect on heart rate or contractility?
I'm thinking perhaps Tenex could counter some of the bodily stimulation caused by provigil, and at the same time provide a bit of a sedating/calming balance to the mental stimulation of provigil. Or you could look at as provigil offsetting the sedative qualities of Tenex.
Just a thought experiment, for what it's worth.
Posted by saturn on May 7, 2006, at 22:53:26
In reply to tenex and provigil, posted by saturn on May 7, 2006, at 22:27:48
Isn't Provigil's main mechanism of peripheral activation by central activation of sympathetic nerves in the PNS (increased CNS NE activating the sympathetic nervous system, especially activating the adrenal glands to release epinephrine into the blood)?
So might tenex reduce this downflow of epinephrine from the adrenal glands and other sympathetic fibers?
Not really sure. Need some help.
Posted by alone ranger on May 8, 2006, at 17:46:00
In reply to tenex and provigil, posted by saturn on May 7, 2006, at 22:27:48
Sorry. Tenex has no effect on contractility or direct effect on heart rate.
> I'm interested in any thoughts or experiences regarding a Tenex/Provigil combo for ADHD in terms of effectiveness/synergy and side effects/problems. (There have been reports of suddent death when combining ritalin and clonidine--though I realize this combo is not the same thing).
>
> Beyond reducing blood pressure, does Tenex have any effect on heart rate or contractility?
>
> I'm thinking perhaps Tenex could counter some of the bodily stimulation caused by provigil, and at the same time provide a bit of a sedating/calming balance to the mental stimulation of provigil. Or you could look at as provigil offsetting the sedative qualities of Tenex.
>
> Just a thought experiment, for what it's worth.
Posted by alone ranger on May 8, 2006, at 17:49:28
In reply to Re: tenex and provigil, posted by saturn on May 7, 2006, at 22:53:26
Tenex wouldn't do too much to offset the activating effects of prvigil. Have you explored any alternatives?
> Isn't Provigil's main mechanism of peripheral activation by central activation of sympathetic nerves in the PNS (increased CNS NE activating the sympathetic nervous system, especially activating the adrenal glands to release epinephrine into the blood)?
>
> So might tenex reduce this downflow of epinephrine from the adrenal glands and other sympathetic fibers?
>
> Not really sure. Need some help.
Posted by saturn on May 8, 2006, at 18:01:18
In reply to Re: tenex and provigil, posted by alone ranger on May 8, 2006, at 17:49:28
> Tenex wouldn't do too much to offset the activating effects of prvigil. Have you explored any alternatives?
maybe coreg.
Posted by alone ranger on May 8, 2006, at 18:20:08
In reply to Re: tenex and provigil » alone ranger, posted by saturn on May 8, 2006, at 18:01:18
Saturn,
My bad. I didn't explain too well. I meant an alernative to provigil. The beta blockers really won't have much effect at diminishing the activating effects necause of the mode of action of provigil. You would think it would be with the sympathetic nervous system.> > Tenex wouldn't do too much to offset the activating effects of prvigil. Have you explored any alternatives?
>
> maybe coreg.
Posted by alone ranger on May 8, 2006, at 18:38:13
In reply to tenex and provigil, posted by saturn on May 7, 2006, at 22:27:48
Saturn,
There's evidence that Minipress will help you.Central alpha 1-adrenergic stimulation in relation to the behaviour stimulating effect of modafinil; studies with experimental animals
by
Duteil J, Rambert FA, Pessonnier J,
Hermant JF, Gombert R, Assous E
Centre de Recherches du Laboratoire L. Lafon,
Maisons-Alfort, France.
Eur J Pharmacol 1990 May 3; 180(1):49-58ABSTRACT
Single administration of the new drug modafinil was followed by an increase in locomotor activity in mice and in nocturnal activity in monkeys. Stereotyped behaviour in mice and rats, and potentiation of amphetamine-induced stereotyped behaviour were not observed; however, at the highest dose used, a slight potentiation of apomorphine-induced stereotyped behaviour was observed in rats. The modafinil-induced increase in locomotor activity in mice was prevented by the centrally acting alpha 1-adrenoceptor antagonists, prazosin and phenoxybenzamine, and by reserpine but not by the mixed dopamine D-1/D-2 antagonist, haloperidol, the dopamine D-2 antagonist, sulpiride, the peripherally acting alpha 1-adrenoceptor antagonist, phentolamine, the alpha 2-adrenoceptor antagonist, yohimbine, the beta-adrenoceptor antagonist, propranolol, or by the catecholamine synthesis inhibitor, alpha-methyl-p-tyrosine. Likewise, the modafinil-induced increase in nocturnal activity in monkeys was prevented by prazosin. Interestingly, modafinil did not produce obvious peripheral sympathetic effects in mice and rats (no salivation, no contraction of the pilomotor muscles, slight mydriasis only at high doses). Therefore, modafinil appears to produce a strong stimulating effect in rodents and in primates. These effects could be linked to modulation (stimulation) of central alpha 1-adrenoceptors unaccompanied by peripheral sympathetic effects, which is unexpected.
Posted by saturn on May 8, 2006, at 18:40:41
In reply to Re: tenex and provigil, posted by alone ranger on May 8, 2006, at 18:20:08
>
> Saturn,
> My bad. I didn't explain too well. I meant an alernative to provigil. The beta blockers really won't have much effect at diminishing the activating effects necause of the mode of action of provigil. You would think it would be with the sympathetic nervous system.No problem. I probably wasn't clear as possible either.
Strattera didn't work and made me depressed.
I can't tolerate stimulants or anything like wellbutrin. TCA's and MAOI's are not options either. I've looked into tenex, lamictal, neurontin, aricept, namenda but none of them look promising for inattention.So beta blockers or a mixed alpha/beta blocker like coreg won't prevent my heart from going crazy on provigil?
Posted by saturn on May 8, 2006, at 20:52:51
In reply to Re: tenex and provigil, posted by alone ranger on May 8, 2006, at 18:38:13
> Saturn,
> There's evidence that Minipress will help you.
>
>
>
> Central alpha 1-adrenergic stimulation in relation to the behaviour stimulating effect of modafinil; studies with experimental animals
> by
> Duteil J, Rambert FA, Pessonnier J,
> Hermant JF, Gombert R, Assous E
> Centre de Recherches du Laboratoire L. Lafon,
> Maisons-Alfort, France.
> Eur J Pharmacol 1990 May 3; 180(1):49-58
>
> ABSTRACT
> Single administration of the new drug modafinil was followed by an increase in locomotor activity in mice and in nocturnal activity in monkeys. Stereotyped behaviour in mice and rats, and potentiation of amphetamine-induced stereotyped behaviour were not observed; however, at the highest dose used, a slight potentiation of apomorphine-induced stereotyped behaviour was observed in rats. The modafinil-induced increase in locomotor activity in mice was prevented by the centrally acting alpha 1-adrenoceptor antagonists, prazosin and phenoxybenzamine, and by reserpine but not by the mixed dopamine D-1/D-2 antagonist, haloperidol, the dopamine D-2 antagonist, sulpiride, the peripherally acting alpha 1-adrenoceptor antagonist, phentolamine, the alpha 2-adrenoceptor antagonist, yohimbine, the beta-adrenoceptor antagonist, propranolol, or by the catecholamine synthesis inhibitor, alpha-methyl-p-tyrosine. Likewise, the modafinil-induced increase in nocturnal activity in monkeys was prevented by prazosin. Interestingly, modafinil did not produce obvious peripheral sympathetic effects in mice and rats (no salivation, no contraction of the pilomotor muscles, slight mydriasis only at high doses). Therefore, modafinil appears to produce a strong stimulating effect in rodents and in primates. These effects could be linked to modulation (stimulation) of central alpha 1-adrenoceptors unaccompanied by peripheral sympathetic effects, which is unexpected.
Thanks!
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