Posted by SLS on July 15, 2000, at 10:13:12
In reply to Re: World Wide ADRAFINIL - SLS, posted by JohnL on July 15, 2000, at 7:49:26
Hi John.
I hope you continue to experience such a wonderful life as the result of having found adrafinil.
> I agree with you completely. I wish I knew more about potential adverse effects on the liver. I've searched high and low and can't find anything. Ironically, that actually makes me a little more comfortable about it. That's because if there were some troubling cases of liver toxicity out there, they would be in print. There would be at least one or two or more abstracts concerning that at mentalhealth.com. But there aren't any. Not with Adrafinil anyway.
When I read your post questioning whether or not there was really any liability for adrafinil to affect the liver, I thought perhaps the concerns fostered by the package-insert were unwarranted. Sometimes, an observed event must be included in a list of adverse reactions for a drug, regardless of whether the event had truly been caused by it.
> Everything I've read says that if liver enzymes are elevated, as evidenced by a blood test, then either reducing or eliminating the dose of Adrafinil is the way to get those liver enzymes back to normal.
So, from what you've read, liver enzyme elevations do occur with some frequency? Where can I find the information you've encountered?
> That implies that the condition is reversible.
It implies that the elevation of enzymes is reversible. It doesn't imply that any hepatic injury that may have been incurred is reversible (sorry, I am cursed with a sometimes logical mind). You're probably right, though.
> The first blood test is recommended at 30 days. Then twice a year after that.
You have certainly collected some detailed and important information about adrafinil. I am not terribly experienced with tracking down information on the Internet. Perhaps you should start one of these "tips" folders on adrafinil. Even specifying the recommended schedule for liver testing is invaluable information that people here may not be aware of or have access to.
> I've never seen any information suggesting Adrafinil is metabolized into Modafinil. Since I've tried both, all I can say is it sure doesn't feel like that is happening. My system didn't like Modafinil at all, but seems to embrace Adrafinil.
Actually, after I had posted the info regarding adrafinil metabolism, I began to think about your experiences with the two. One would think that if adrafinil were so extensively metabolized into modafinil, you would have experienced some of the anxiety and headaches you had while you were taking modafinil.
One analogy I am aware of, however, suggests the possibility that such a metabolism would not exclude your observed reactions. Imipramine is converted to desipramine in the body. At steady state, there is far more plasma desipramine than there is imipramine. Desipramine is a more potent NE reuptake inhibitor than is imipramine. When given separately as drugs, desipramine often produces more activation and anxiety than does imipramine. Personally, I would hope that modafinil is not the metabolic product of adrafinil, as I have not had a good experience with Provigil.
I began taking Provigil Monday morning. I experienced a mild antidepressant effect within an hour after taking my first 100mg dose on an empty stomach. It lasted for about half the day. Then I began to feel kind of spacy or hazy, with the improvement having waned. This weird feeling wore off within 24 hours as I kept a 200mg/day schedule. I was left with a bit more energy, but I experienced a low level anxiety and a dull headache. After four days, however, any increase in energy and cognition disappeared, and I just plain didn't like the way I felt. I cut back to 100mg yesterday and do not plan to take any more. I have begun to feel more like my usual sick self. How wonderful.
How similar is this experience to yours?
I am encouraged by reading the accounts of people who did not respond well to Provigil who went on to respond happily to adrafinil. I guess what I would like to know is, exactly how severely depressed these folks have been and how relevant their cases are to mine. I am considering trying adrafinil in the hopes I will experience a scenario similar to yours and the others'. If it is only partially effective, I would like to add Parnate to it. What do you think about this? Has anyone here tried combining adrafinil with an MAOI?
> I take herbal supplements of Milk Thistle. This herb has a huge documented track record of preventing and even reversing liver damage. One test in particular stands out in my mind. Patients were protected from liver toxicity of poisonous mushrooms by taking Milk Thistle immediately afterwards. The active ingredient in Milk Thistle is the same one in many of the prescription liver medications. With scant information available on Adrafinil, this affords me a little more comfort level.
> One thing is for sure. Having this risk in the back of my mind is definitely a fair tradeoff considering my notable improvement.
I agree emphatically.
> It's nice to actually enjoy living again. To know the meaning of the words 'fun', 'motivated', 'anticipation of pleasureable activities'. To be depression free.
Yeah, I could put up with that.
Listen, John, you are an important resource here on Psycho-Babble. I always appreciate any ideas you offer me regarding my condition.
Thanks.
Sincerely,
Scott----------------------------------------------------
P.S. I thought you might enjoy the following: Just chop-off an oxygen and voila...* If it does not look right on your browser, cut and paste it into a word processor and choose a fixed-space font "Courier New". It might show properly in the Follow-Up window.
Adrafinil: 1[(diphenylmethyl)sulfinyl]acetohydroxamic acid (C15H15NO3S)
_____
/ _ \
\_____/ O O
\ " " H
>--S--CH2--C--N
_____/ OH
/ _ \
\_____/Modafinil: [(Diphenylmethyl)sulfinyl]acetamide (C15H15NO2S)
Modafinil CAS nr: [68693-11-8]
_____
/ _ \
\_____/ O O
\ " " H
>--S--CH2--C--N
_____/ H
/ _ \
\_____/
poster:SLS
thread:40385
URL: http://www.dr-bob.org/babble/20000708/msgs/40515.html