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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Phillipa on January 14, 2007, at 12:35:12
Seems that a lot of people are going on providgil and liking it. Can someone in English simple English explain how this med works? Is it good with anxiety? Love and Thanks Phillipa
Posted by Jimmyboy on January 14, 2007, at 13:20:46
In reply to Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 12:35:12
Hey.. yeah we did post about the same thing at the same time : )
Provigil is stimulating,, but not as intense as traditional stimulants like Ritalin, Adderal, etc.
i still get jittery and anxious on it though, and its damn expensive w/out insurance and supposedly expensive with insurance.
But it definitely clears some of the fog in my head and lets me thikn alittle clearer if the anxiety isn't too high.
Posted by ronaldo on January 14, 2007, at 15:59:11
In reply to Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 12:35:12
> Seems that a lot of people are going on providgil and liking it. Can someone in English simple English explain how this med works? Is it good with anxiety? Love and Thanks Phillipa
Provigil is a memory improving and mood brightening psychostimulant. It enhances wakefulness but it is different to the amphetamines, Ritalin, or cocaine. It is less likely to cause jitteriness, anxiety. It is unlike traditional stimulants. It feels smoother and cleaner than amphetamines. It may even reduce anxiety. Provigil or modafinil has a half life of 12-15 hours. Bear this in mind when planning your dosage schedule.
Provigil, according to research, is safe and well tolerated. A euphoric response is unlikely.
Provigil is useful for the treatment of narcolepsy, or uncontrollable attacks of daytime sleepiness.
Also useful in treating Alzheimer's disease, depression, ADHD,cognitive impairment in Schizophrenia, age related memory decline etc etc
Provigil was reportedly used by Allied combat soldiers in both Gulf Wars.
All the above is a rough summary of the maker's article at
which is also written in plain English or thereabouts.
Posted by laima on January 14, 2007, at 15:59:29
In reply to Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 12:35:12
My doctor explained that it "specifically targets wakefulness receptors", whatever that means. And that other stimulants hit some other places too. I agree though, a higher dose can feel a bit "stimulating".
Posted by Phillipa on January 14, 2007, at 18:55:58
In reply to Re: Can Someone Explain Providgil So many Different Re, posted by laima on January 14, 2007, at 15:59:29
So if anxiety is making you depressed yes or not you would take it? Love Phillipa
Posted by laima on January 15, 2007, at 0:06:13
In reply to Re: Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 18:55:58
It's not really an antidepressent, it's officially approved for narcolepsy and shift work. A lot of people are using it for daytime sleepiness, which of course, is anti-depressing.
Posted by blueberry1 on January 15, 2007, at 5:02:23
In reply to Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 12:35:12
> Seems that a lot of people are going on providgil and liking it. Can someone in English simple English explain how this med works? Is it good with anxiety? Love and Thanks Phillipa
Yeah, at remedyfind I was surprised to see how many people like it. Just a few didn't. In the antidepressant category it is actually rated #1. Of all the antidepresants out there, that took me by surprise.
How does it work? Like most drugs, they really don't know. They think it is an alpha-1 agonist, which basically helps existing norepinephrine work better. But, alpha-1 antagonists do not block its effects totally. So something else is up. There is mention of effects on dopamine in certain parts of the brain. Mention of it stimulating glutamate release. Who knows.
I want to try provigil. The closest I've tried is its parent adrafinil, which metabolizes in the body partially to provigil. All I know is that when I take adrafinil I definitely get more energy on the first day with a brightening of mood later in the day. The effects seem to dwindle after that. I think provigil would be cleaner and more powerful. Whether adrafinil and provigil are similar or not I don't know. But I was surprised that while adrafinil energizes me, clears my mind, lets me focus and work, it also cuts the edge off anxiety at the same time. Weird for a stimulant. But nice. The thing I don't like is that after a few days I get a sense of inner tension, inner restlessness, but it's not anxiety. Something different. Maybe I need xanax with it.
I'm in a real bad way waiting for my doctor appointment on Wednesday which seems like an eternity, as all I can think about is either dying or going to the hospital. Both losing propositions. So I guess I have to pull my trusty adrafinil out of the drawer to help me through a couple days.
Some people at rememdyfind say provigil is good for anxiety and some people say it worsens it. Like everything else, mileage varies.
Posted by SLS on January 15, 2007, at 5:34:49
In reply to Re: Can Someone Explain Providgil So many Different Re, posted by blueberry1 on January 15, 2007, at 5:02:23
Provigil was accidentally labeled a NE alpha-1 agonist based on some errant results of an early study.
The drug seems to:
1. Enhance hypocretin neurotransmission, particularly in the hypothalamus. This is probably the mode by which it promotes wakefulness.
2. Glutamate release. This might be responsible for its mood-elevating and motivational properties.
- Scott
Posted by blueberry1 on January 15, 2007, at 16:20:15
In reply to Re: Can Someone Explain Providgil So many Differen, posted by SLS on January 15, 2007, at 5:34:49
HI Scott,
Yeah I think the general understanding of Provigil is it increases glutamate release.
I wonder though, what do you think? I do not know anything about it, but I have read many times about 'glutamate toxicity'. I wonder if Provigil in the longrun does some brain damage? I wonder if Provigil users should be using high doses of anti-oxidants? Or a benzo along with it? Or no concern at all? What are your thoughts?
Posted by Karen44 on January 15, 2007, at 17:27:13
In reply to Re: Can Someone Explain Providgil So many Differen » SLS, posted by blueberry1 on January 15, 2007, at 16:20:15
My pdoc just gave the green light to try Provigil along with the Emsam and Lamictal I already take. If it works, then I will go off the Lamictal. He said it is okay with the Emsam, and from what I read, it's okay with SSRI's. Don't know beyond that. For me it makes sense since I do have sleep apnea, and part of my depression has to do with no energy and being barely able to make it through the day. When I took Parnate years ago, it had the effect on me like a stimulant and brought me out of depression like nothing ever had. This time it didn't work. I hope Provigil works as I want to avoid the ECT at all costs. I read that Provigil at high doses is not good and should be limited to a few months. I will be starting out at 100 mg. and possibly go up to 200mg. Tomorrow I start and will let everyone know what it does for me. I hope it works as the "shock machine" is on the horizon for me otherwise.
Karen44
Posted by SLS on January 15, 2007, at 21:20:42
In reply to Re: Can Someone Explain Providgil So many Differen » SLS, posted by blueberry1 on January 15, 2007, at 16:20:15
Hi Blueberry.
> Yeah I think the general understanding of Provigil is it increases glutamate release.
>
> I wonder though, what do you think? I do not know anything about it, but I have read many times about 'glutamate toxicity'. I wonder if Provigil in the longrun does some brain damage? I wonder if Provigil users should be using high doses of anti-oxidants? Or a benzo along with it? Or no concern at all? What are your thoughts?I'm afraid I don't have any. :-)
Certainly, excessive glutamatergic activity can produce neurotoxicity via calcium influx. However, I don't know the specifics of how Provigil works to know if this is somehow prevented. So far, I have not seen any concern raised in the medical literature.
- Scott
Posted by blueberry1 on January 16, 2007, at 5:45:28
In reply to Re: Can Someone Explain Providgil So many Differen, posted by Karen44 on January 15, 2007, at 17:27:13
Cool. If you haven't already, you might want to go to remedyfind and see what others have to say about their provigil experiences. Most of them are pretty postive, only a few negatives here and there.
One good thing is that if it is going to work it will do so quickly. No long trials needed. Some people though do need high doses. Some people take like 800mg in a day. Most people seem to be in the 200mg to 400mg range, a few at 600mg. Less 200mg doesn't give a fair trial.
> My pdoc just gave the green light to try Provigil along with the Emsam and Lamictal I already take. If it works, then I will go off the Lamictal. He said it is okay with the Emsam, and from what I read, it's okay with SSRI's. Don't know beyond that. For me it makes sense since I do have sleep apnea, and part of my depression has to do with no energy and being barely able to make it through the day. When I took Parnate years ago, it had the effect on me like a stimulant and brought me out of depression like nothing ever had. This time it didn't work. I hope Provigil works as I want to avoid the ECT at all costs. I read that Provigil at high doses is not good and should be limited to a few months. I will be starting out at 100 mg. and possibly go up to 200mg. Tomorrow I start and will let everyone know what it does for me. I hope it works as the "shock machine" is on the horizon for me otherwise.
>
> Karen44
Posted by Karen44 on January 16, 2007, at 10:06:29
In reply to Re: Can Someone Explain Providgil So many Differen » Karen44, posted by blueberry1 on January 16, 2007, at 5:45:28
> Cool. If you haven't already, you might want to go to remedyfind and see what others have to say about their provigil experiences. Most of them are pretty postive, only a few negatives here and there.
>
> One good thing is that if it is going to work it will do so quickly. No long trials needed. Some people though do need high doses. Some people take like 800mg in a day. Most people seem to be in the 200mg to 400mg range, a few at 600mg. Less 200mg doesn't give a fair trial.
>
> > My pdoc just gave the green light to try Provigil along with the Emsam and Lamictal I already take. If it works, then I will go off the Lamictal. He said it is okay with the Emsam, and from what I read, it's okay with SSRI's. Don't know beyond that. For me it makes sense since I do have sleep apnea, and part of my depression has to do with no energy and being barely able to make it through the day. When I took Parnate years ago, it had the effect on me like a stimulant and brought me out of depression like nothing ever had. This time it didn't work. I hope Provigil works as I want to avoid the ECT at all costs. I read that Provigil at high doses is not good and should be limited to a few months. I will be starting out at 100 mg. and possibly go up to 200mg. Tomorrow I start and will let everyone know what it does for me. I hope it works as the "shock machine" is on the horizon for me otherwise.
> >
> > Karen44
>
>I realize 100 mg. is a low dose, but I am so sensitive to all the meds that my pdoc said to start with 100 mg. this week and go to 200mg if I notice I am pooping out by the p.m. I see him on Friday again and may at least try 100mg.for this week. Also have 25 mg. of Seroquel to help me sleep if needed. Before 25mg. knocked me out, but now it does not. Goes to show that my brain is screwed so to speak.
Karen44
Posted by stargazer on January 16, 2007, at 10:48:13
In reply to Re: Can Someone Explain Providgil So many Differen, posted by Karen44 on January 16, 2007, at 10:06:29
Karen...hope the provigil will get you out of your depression...I will be closely following your posts as they could also help the rest of us who are stuck in the same place...Currently on Emsam 6 and amphetamine (generic Adderall)...experimenting with doses....my next step would be to try Strattera or Provigil, so if it works for you, I may go that route if necessary....GOOD LUCK!!!...SG
Posted by psychobot5000 on January 16, 2007, at 14:16:38
In reply to Re: Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 18:55:58
> So if anxiety is making you depressed yes or not you would take it? Love Phillipa
Modafinil/provigil made it impossible for me to sleep (long half-life), and make me tense and anxious when I took it. It made me more wakeful, and maybe little more energetic, but did not boost my mood noticeably. I found it inferior to methylphenidate and amphetamine, for my purposes.
However, it also doesn't cause increased heart-rate and blood-pressure, and many people seem to find it helpful for depression. One (highly respected) doc I talked to thought it a very good med to combine with Nardil and EMSAM. My guess is, with anxiety, it's probably like any other stimulant, in that it can either relieve or cause anxiety. Just a guess, though.
Posted by Phillipa on January 16, 2007, at 18:28:47
In reply to Modafinil can increase anxiety » Phillipa, posted by psychobot5000 on January 16, 2007, at 14:16:38
Thanks psychcobot. Love Phillipa
Posted by Dinah on January 16, 2007, at 18:38:29
In reply to Can Someone Explain Providgil So many Different Re, posted by Phillipa on January 14, 2007, at 12:35:12
A lot of meds make me feel anxious, but Provigil didn't after the first few days or so.
I feel a little guilty that my best medication combination seems to be Risperdal + Provigil, although I never seem to be able to tolerate Risperdal for long periods of time.
I do worry that it's losing its effectiveness though. At one time one a day was fine, now it's two a day and I notice I'm getting sleepy a lot again.
(It was prescribed for idiopathic hypersomnia or mild narcolepsy, but it also helps my ability to focus a whole lot.)
Posted by Llurpsie_Noodle on January 16, 2007, at 18:46:41
In reply to Re: Can Someone Explain Providgil So many Differen » Phillipa, posted by Dinah on January 16, 2007, at 18:38:29
My Mom takes 200mg. Says it makes her feel much less depressed (and she's narcoleptic too). I think she seems much more happy and active since she started to take it.
i also take 200mg. I find it infinitely preferable to caffeine (the only other stimulant I have experience with). I was drinking WAY too much coffee, and still having to take many naps. after provigil, not anymore.
I will stay awake for about 12 hours, although the occasional afternoon nap is not prohibited. No side effects. I feel more motivated when I take it. I think I also feel more focused, probably because I'm not constantly obsessed with keeping myself awake lol
And then there was the night that I mistook my 200mg provigil with my 300mg seroquel. This is not good for anxiety. I was unable to fall asleep and thought "gee, why am I so !@#@#!@$%!$ awake" it was really really annoying.
I have anxiety too. I think it is less-anxiety provoking than caffeine. That is, the dose of caffeine I need to stay alert vs. the dose of provigil I need to stay alert -> provigil has far fewer side effects.
zapZing!
-Ll
Posted by Karen44 on January 16, 2007, at 22:34:10
In reply to GOOD LUCK w provigil...I may also need to try., posted by stargazer on January 16, 2007, at 10:48:13
> Karen...hope the provigil will get you out of your depression...I will be closely following your posts as they could also help the rest of us who are stuck in the same place...Currently on Emsam 6 and amphetamine (generic Adderall)...experimenting with doses....my next step would be to try Strattera or Provigil, so if it works for you, I may go that route if necessary....GOOD LUCK!!!...SG
>
>Did not notice anything from the 100mg Provigil today and probably won't need to take the Seroquel tonight to help me sleep. Fell asleep in the chair watching TV tonight. No change in my mood. I will see how it is tomorrow as I don't think one day is a fair trial.
Karen44
Posted by blueberry1 on January 17, 2007, at 5:39:42
In reply to Re: GOOD LUCK w provigil...I may also need to try. » stargazer, posted by Karen44 on January 16, 2007, at 22:34:10
Karen, glad 100mg went ok. I did not expect you would feel much at that dose. Most people don't feel anything until at least 200mg. Normal doses are double or triple that, sometimes quadruple. Keep at it and keep raising the dose until you definitely feel it. Then give it a few days to get to know it better.
Posted by Karen44 on January 17, 2007, at 11:46:40
In reply to Re: GOOD LUCK w provigil...I may also need to try. » Karen44, posted by blueberry1 on January 17, 2007, at 5:39:42
> Karen, glad 100mg went ok. I did not expect you would feel much at that dose. Most people don't feel anything until at least 200mg. Normal doses are double or triple that, sometimes quadruple. Keep at it and keep raising the dose until you definitely feel it. Then give it a few days to get to know it better.
I just got the green light from my pdoc to go up to 200 mg. on Wednesday, but I didn't see the email until just now. So I will do it tomorrow morning. I am still keeping ECT as a back-up and have an appt. with a doctor at the University of Chicago on January 24th. I need to have a back-up plan and also want to know if this person will be willing to consider my conditions or not. If not, then I would not let him touch me.
Karen44
This is the end of the thread.
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