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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Emily Elizabeth on October 24, 2007, at 22:26:03
Hi gang,
I take lots of sedating meds: Lexapro, Lithium, Abilify. My pdoc used to have me on Provigil to help w the daytime sleepiness. Unfortunately my new insurance won't cover it. I'm not totally heartbroken b/c it was only so-so. Any suggestions for alternative meds? I was on dexedrine for a while, but new pdoc seems a little hesitant to rx it. That seems like it might be a good option to me, but I'll have to work on pdoc. Ideas?!?! Anyone?!!?
Best,
EE
Posted by Mishal on October 25, 2007, at 5:51:53
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
I think you can order modafinil from India. It is available there as Modalert and Modafil and is cheap.I have taken both Provigil and Modalert. Modalert is a little weaker ie. in the place of 100mg Provigil, you will have to take 150mg of Modalert. That's the only difference between both. (Again, my experience)
Posted by Polarbear206 on October 25, 2007, at 9:46:52
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
> Hi gang,
>
> I take lots of sedating meds: Lexapro, Lithium, Abilify. My pdoc used to have me on Provigil to help w the daytime sleepiness. Unfortunately my new insurance won't cover it. I'm not totally heartbroken b/c it was only so-so. Any suggestions for alternative meds? I was on dexedrine for a while, but new pdoc seems a little hesitant to rx it. That seems like it might be a good option to me, but I'll have to work on pdoc. Ideas?!?! Anyone?!!?
>
> Best,
> EE
How about a low dose of wellbutrin?PB
Posted by Phillipa on October 25, 2007, at 12:09:43
In reply to Re: Meds to help daytime sleepiness? » Emily Elizabeth, posted by Polarbear206 on October 25, 2007, at 9:46:52
Hi EE missed you. Glad to see your name back but wish you were not having problems. Phillipa
Posted by Maxime on October 25, 2007, at 18:13:31
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
You should post on the Alternative message board. I bet there are some herbal remedies that would help.
It's good to see you posting again. :)
Maxime
> Hi gang,
>
> I take lots of sedating meds: Lexapro, Lithium, Abilify. My pdoc used to have me on Provigil to help w the daytime sleepiness. Unfortunately my new insurance won't cover it. I'm not totally heartbroken b/c it was only so-so. Any suggestions for alternative meds? I was on dexedrine for a while, but new pdoc seems a little hesitant to rx it. That seems like it might be a good option to me, but I'll have to work on pdoc. Ideas?!?! Anyone?!!?
>
> Best,
> EE
Posted by Mishal on October 27, 2007, at 23:27:12
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
I want to correct my earlier statement with apologies.Modalert is not that weak as I stated in my earlier post. I think this generic version is little long acting than provigil. That would be why I felt it is less potent.
I checked online and confirmed this. SUN pharma produces it in long acting form.
Posted by Astounder on October 31, 2007, at 11:48:50
In reply to Meds to help daytime sleepiness?, posted by Emily Elizabeth on October 24, 2007, at 22:26:03
> Hi gang,
>
> I take lots of sedating meds: Lexapro, Lithium, Abilify. My pdoc used to have me on Provigil to help w the daytime sleepiness. Unfortunately my new insurance won't cover it. I'm not totally heartbroken b/c it was only so-so. Any suggestions for alternative meds? I was on dexedrine for a while, but new pdoc seems a little hesitant to rx it. That seems like it might be a good option to me, but I'll have to work on pdoc. Ideas?!?! Anyone?!!?
>
> Best,
> EEYou could augment the Lexapro with protriptyline (Vivactil) a noradrenergic tricyclic that is supposed to be truly stimulating. Or you can switch out the Lexapro with an SNRI like Cymbalta or Effexor--you could do a fast cross-taper without having withdrawal issues.
You could also try augmenting with EMSAM, a stimulating MAO-B inhibitor patch that preferentially increases dopamine levels.
You can try switching the Abilify with Geodon; both of these are sometimes known to cause behavioral activation, though through different mechanisms.
Perhaps your best bet would be to switch Lithium with Lamictal which unlike other mood stabilizers can actually be stimulating and causes the least cognitive slowing.
There are also OTC stimulants available: Nicotine patches/gum, ephedrine, and caffeine, all of which have synergistic effects when taken together. They can also help control the weight gain and insulin tolerance some of the drugs you're taking are known for.
This is the end of the thread.
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