Psycho-Babble Medication Thread 851057

Shown: posts 1 to 11 of 11. This is the beginning of the thread.

 

Provigil for mental fatigue?

Posted by chiron on September 8, 2008, at 17:05:07

I have tried Carnitine. I have about 2 hours in the morning and then I can't handle anything. It is really a problem at work. It's also tied into motivation. A small task can seem like a mountain. I could use some more energy as well.

My counselor actually suggested I call my pdoc for it. If I am on a mood stabilizer will it be a problem for BPII?

 

Re: Provigil for mental fatigue?

Posted by Racer on September 8, 2008, at 17:33:55

In reply to Provigil for mental fatigue?, posted by chiron on September 8, 2008, at 17:05:07

Well, if you're sure that what you're describing isn't actually depression -- because that sounds suspicious to me -- and you're 100% positive this isn't a non-psych issue, then it's worth asking ABOUT it. Asking for it? I'd wait to see what your doctor has to say, because there may be better alternatives out there.

Some things that can cause that sort of pattern -- such as sleep apnea, insufficient sleep for various reasons, and a whole host of other medical issues. I'm a big believer that you gotta treat yourself kinda like an animal -- the first thing you do with a behavioral issue is rule out physical causes. (There are limits, of course -- if you have the basic tests done, and they all come back WNL, it's probably not physical.)

Provigil is an odd drug, and many insurance companies will balk at it. My insurance is generally pretty OK, and my doctor's office manager says they're amongst the easiest to get prior authorization from, but even they classify it such that I pay $125 per month, instead of the customary copay -- which I forget right now... It's either $10 or $25, though, so there's a huge discrepancy involved.

Good luck, whatever your doctor says.

 

Re: Provigil for mental fatigue?

Posted by Phillipa on September 8, 2008, at 20:13:58

In reply to Re: Provigil for mental fatigue?, posted by Racer on September 8, 2008, at 17:33:55

I don't mean to harp on it but seriously get a full work up on your thyroid first as all my google searches bring me back to thyroid as being the cause of my tiredness. Good luck. And Take it from there. Phillipa

 

Re: Provigil for mental fatigue? Racer

Posted by Bob on September 9, 2008, at 12:01:23

In reply to Re: Provigil for mental fatigue?, posted by Racer on September 8, 2008, at 17:33:55


>
> Provigil is an odd drug, and many insurance companies will balk at it. My insurance is generally pretty OK, and my doctor's office manager says they're amongst the easiest to get prior authorization from, but even they classify it such that I pay $125 per month, instead of the customary copay -- which I forget right now... It's either $10 or $25, though, so there's a huge discrepancy involved.
>
> Good luck, whatever your doctor says.


Racer,

What do you mean when you say that Provigil is an odd drug?

- Bob

 

Re: Provigil for mental fatigue? Bob

Posted by Racer on September 9, 2008, at 17:08:56

In reply to Re: Provigil for mental fatigue? Racer, posted by Bob on September 9, 2008, at 12:01:23

>
>
> Racer,
>
> What do you mean when you say that Provigil is an odd drug?
>
> - Bob
>
>

Mostly that it's a drug which is appealing to those without any underlying pathology ==> lots of people want to take it, even if they don't have any disorder at all. It's what's being referred to as a "lifestyle drug," because those who are chronically over-stretched in their lives -- don't get enough sleep because they're out playing late at night, etc -- and those who just want a little more mental alertness want to take modafinil, because it's seen as safe, effective, etc. Think of most of the other drugs we take here -- the downside to them is usually pretty obvious, especially since they really don't help people who don't have a disorder to treat. Modafinil is different, because it can give those people a boost, and it seems a safer alternative to conventional psychostimulants.

Even the military is investigating it for use by pilots, since it doesn't cause the sorts of adverse effects that amphetamines do, such as shaky hands.

As a result, insurance companies are very, very hard to convince to cover it. They want a documented sleep disorder -- narcolepsy, which requires testing, or something like "shift work related sleep disorder." Otherwise the insurance company won't cover it. Also, if they do cover it, they'll almost certainly cover it at the highest tier copay. Again, in my case that's $125, and since there's a cap on dosage, my doctor can't just double the number of tablets for me, so I pay that EVERY month. (Or will, if it continues working for me...)

So, not because it has some strange mechanism -- although I understand that it does -- I say it's "odd" because of the practical issues surrounding it.

By the way, my $125 copay covers a prescription which would otherwise cost something over $700. The medication really is priced out of reach for most of us, if we had to pay out of pocket.

Good luck, and I hope you'll let us know what your doctor has to say.

 

Re: Provigil for mental fatigue?

Posted by chiron on September 9, 2008, at 21:47:34

In reply to Re: Provigil for mental fatigue? Bob, posted by Racer on September 9, 2008, at 17:08:56

This odd drug does help some odd problems to which there is no physical explanation or alternative - such as chronic fatigue and ms. As we all know, the body is bizarre and complicated. Society/Medical only knows minimal. I do remember a friend that could barely function with her lack of energy who was able to resume working when she started provigil. It is normal for those who have not experienced this kind of fatigue to not understand or think of them as lazy.
My thryroid is ok, my iron is ok. I actually had 9x the normal amount of epstein barr a while ago. There is nothing they can do about it.

Even my counselors have told me that my depression is physical. (it was my current counselor who suggested provigil). Over 25 years I have read all of the self help books and tried plenty of supplements.
I guess I should try it, but I would like to hear other people's stories & if it has caused any cycling.

Thanks :)

 

Re: Provigil for mental fatigue?

Posted by West on September 10, 2008, at 7:36:15

In reply to Re: Provigil for mental fatigue?, posted by chiron on September 9, 2008, at 21:47:34

I take provigil with cymbalta

Before the provigil the cymbalta had the effect of causing slumps several times during the day. Provigil eliminates the somnolence and stops nausea too.

I have found getting to sleep a little harder, although i should say i have always had problems with sleep. If you're anything like me you can probably expect a little situation-dependent mood brightening and some energy increase: it's listed as a banned substance for athletes and thought to work by inhibiting inhibiting GABA and orexin (a brain chemical which regulates wakefulness, thought to be overabundant in narcoleptics)and enhancing glutamate, although it's exact action has never been publicly defined by manufacturers cephalon. It has a domino effect on various neurotransmitters, is a very weak dose dependent dopamine releaser (in high doses) and increases firing sensitivity at the D2 subreceptor.

Re. aquiring it here, the process was remarkably easy. I simply asked my GP if i could try it to offset the cymbalta. I think its first choice here in the UK for antidepressant induced intrerference of vigilance. All my prescriptions (curently generic zolpidem and brand cymbalta & provigil) are covered by a prepay medical card which costs about 90 a year (about $200). Otherwise each item --in this case 30 x 100mg tablets-- would cost me 6.60 (universal fee per prescription)

Hope that helps

West

 

Re: Provigil for mental fatigue? chiron

Posted by Phillipa on September 10, 2008, at 18:42:48

In reply to Re: Provigil for mental fatigue?, posted by chiron on September 9, 2008, at 21:47:34

Chiron shouldn't Eppstein Barr resolve within four months? Sounds a Bit like lymes when it becomes chronic. Phillipa

 

Re: Provigil for mental fatigue? West

Posted by chiron on September 20, 2008, at 1:08:09

In reply to Re: Provigil for mental fatigue?, posted by West on September 10, 2008, at 7:36:15

Thanks for the positive post West.
Have you been on it long enough to know that it has been a steady drug for you? (adderall made me up & down; or did it poop-ou?)
Unfortunately I'm in the US. I wonder if I'll have to full price for this expensive drug w/out narcolepsy.
If it included some motivation and mood-brightening, I would be happy to pay it.

 

Re: Provigil for mental fatigue?

Posted by West on September 23, 2008, at 6:54:57

In reply to Re: Provigil for mental fatigue? West, posted by chiron on September 20, 2008, at 1:08:09

I took it for a good fortnight though I have stopped taking it recently due to problems sleeping (which i have had before taking provigil). You will know that unlike it's chemical cousin adrafinil, it does not need to accumulate over a period of days in order to deliver its theraputic effect. It will almost certainly provide some degree of motivation and clarity, without the dips you describe, though anxiety can be an issue in some. Are you taking a serotonergic drug already? That might help.

W

 

Re: Provigil for mental fatigue? West

Posted by chiron on September 24, 2008, at 20:53:57

In reply to Re: Provigil for mental fatigue?, posted by West on September 23, 2008, at 6:54:57

>Are you taking a serotonergic drug already?

Ya, I take Celexa. I just talked to my dr. tonight. I have also had horrible fatigue, which somewhat cycles, but is usually donw. He said there is a risk for me with the cycling and agitation. I am on the stablizer Lamictal, so hopefully it will work.

Thanks :)


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