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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by vicky on October 13, 2001, at 16:39:15
Started provigil one week ago. very hyper with it at first,
too much energy. (100mg).this side effect wore out
Now its pooped out and pdoc said take 200mg
thou still kinda feel more awake then before, I'm still
kinda tired (like I used to be before the provigil
History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
twice a day)and now provigil 200mg every morning
any suggestions, can I go up on my provigil
has anyone else noticed that provigil seems not to work
as well the longer you take it?
vicky
Posted by Rakken on October 14, 2001, at 13:21:39
In reply to PROVIGIL POOP OUT, posted by vicky on October 13, 2001, at 16:39:15
When I was on Provigil it never worked. I was on 400 mg and no effect. Sometimes I would get tired moreso on it. I do however know that you can develop a tolerance to modafinil. Usually this happens at the high doses like 400-800 mg. But some could be more sensitive to it. If it doesn't work at 200 mg I'd recommend a more powerful stimulant. I don't think provigil works on dopamine. It just stimulates the brainstem. Or you could try a tricylic anti-depressant for energy. Works for some.
Posted by vicky on October 14, 2001, at 20:20:02
In reply to Re: PROVIGIL POOP OUT, posted by Rakken on October 14, 2001, at 13:21:39
re: Probably will ask my pdoc if I can go up to 400 mg if
the effect really wears off, but I think I will just take this provigil
one day at a time
it seems like I have good days and tired days
on it. (Today was an up day and only 100mg taken!!!
When I was on Provigil it never worked. I was on 400 mg and no effect. Sometimes I would get tired moreso on it. I do however know that you can develop a tolerance to modafinil. Usually this happens at the high doses like 400-800 mg. But some could be more sensitive to it. If it doesn't work at 200 mg I'd recommend a more powerful stimulant. I don't think provigil works on dopamine. It just stimulates the brainstem. Or you could try a tricylic anti-depressant for energy. Works for some.
Posted by Cindylou on October 15, 2001, at 13:05:09
In reply to PROVIGIL POOP OUT, posted by vicky on October 13, 2001, at 16:39:15
Hi Vicki,
I talked with you on another post -- said I had just started Provigil and it was helping ... BUT ... no longer.I had a terrible CRASH over the weekend. Was severely depressed yesterday. Because I have had similar crashes with Adderall and Ritilin, my pdoc and I agree the problem was caused by Provigil "poop out." I felt great for the first 2 days or so that I took it, but then things went quickly downhill. (i only took it a total of 5 days.)
Today I did not take the Provigil and feel incredibly better.
For me, increasing the dose would just cause a worse crash. With my pdoc's agreement, I discontinued the Provigil, and will probably never try another stimulant since I am so prone to these crashes.
Although, JohnL (Where has he gone?) would highly recommend trying Adrafinil -- that's not supposed to cause the poop-out. It could be worth a try for you.
good luck,
cindy> Started provigil one week ago. very hyper with it at first,
>
> too much energy. (100mg).this side effect wore out
> Now its pooped out and pdoc said take 200mg
> thou still kinda feel more awake then before, I'm still
> kinda tired (like I used to be before the provigil
> History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> twice a day)and now provigil 200mg every morning
> any suggestions, can I go up on my provigil
> has anyone else noticed that provigil seems not to work
> as well the longer you take it?
> vicky
Posted by vicky on October 15, 2001, at 13:37:57
In reply to Re: PROVIGIL POOP OUT » vicky, posted by Cindylou on October 15, 2001, at 13:05:09
> Hi Vicky
> I talked with you on another post -- said I had just started Provigil and it was helping ... BUT ... no longer.
>
> I had a terrible CRASH over the weekend. Was severely depressed yesterday. Because I have had similar crashes with Adderall and Ritilin, my pdoc and I agree the problem was caused by Provigil "poop out." I felt great for the first 2 days or so that I took it, but then things went quickly downhill. (i only took it a total of 5 days.)
>
> Today I did not take the Provigil and feel incredibly better.
>
> For me, increasing the dose would just cause a worse crash. With my pdoc's agreement, I discontinued the Provigil, and will probably never try another stimulant since I am so prone to these crashes.
>
> Although, JohnL (Where has he gone?) would highly recommend trying Adrafinil -- that's not supposed to cause the poop-out. It could be worth a try for you.
>
> good luck,
> cindy
>
> > Started provigil one week ago. very hyper with it at first,
> >
> > too much energy. (100mg).this side effect wore out
> > Now its pooped out and pdoc said take 200mg
> > thou still kinda feel more awake then before, I'm still
> > kinda tired (like I used to be before the provigil
> > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > twice a day)and now provigil 200mg every morning
> > any suggestions, can I go up on my provigil
> > has anyone else noticed that provigil seems not to work
> > as well the longer you take it?
> > vickyre: Hi Cindylou. Sorry about your experience
with provigil. I must do well with meds
(I'm on 4 now) and I really like this provigil
(so far). I take 100mg in the morning
and am good to go till around noon, then I take another 100mg
provigil and up and at em again.
what other meds are you taking again?
vicky
Posted by kregpark@yahoo.com on October 16, 2001, at 2:49:02
In reply to Re: PROVIGIL POOP OUT » vicky, posted by Cindylou on October 15, 2001, at 13:05:09
Hi -
I know that Provigil doesn't work for everybody.
I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.Others that may interact include anticonvulsants.
I learned when taking gabapentin the "blunting" effect it has on some dopaminergics.
Although in some ways I liked gabapentins anti-anxiety and good mood effect, Wellbutrin suddenly seemed as powerful as a sugar pill.I think Propecia and provigil interact also.
Generally, for now I know that even in the literature it has been shown that certain anticonvulsants and certain hormonal medications (Propecia applies there), have counteracting effects on Provigil.
Even Celexa, for example, is known to have a metabolic interaction with Provigil. The result is that Provigil usually doesn't work for Celexa induced sedation. *However*, Provigil HAS been shown to be effective for Prozac, Zoloft, and Paxil induced sedation!
Propecia (finasteride .. or Proscar at 5mg) reduces effects of Provigil (and vice versa) - I know because I take both!!
In my experience, Serzone also counteracts (to an extent) Provigil, though in some ways it may complement it (both anti-anxiety, but opposing "awakeness" effect).When I tried gabapentin, one reason I didn't like it was not because it was not axiolytic and mood elevating, but rather because it seemed to really "blunt" the effect of other meds, mainly dopaminergic meds (ie; Wellbutrin).
So if I took gabapentin, it was kind of like forget dopaminergic augmentation!Anyway,
I have had good luck with Provigil. I have a sort of "euphoria" type of feeling whenever *first increasing* the dose. That might be the first time taking it or someday when more is taken.
Also, the opposite, lowering the dose one day I might feel a bit less energetic than expected otherwise.There is no wonder pill, but Provigil does have an advantage for most people in that if their dose is in range, stopping it is not likely to cause nearly as much problem with "rebound" hyper sleep (hypersomnia).
> Hi Vicki,
> I talked with you on another post -- said I had just started Provigil and it was helping ... BUT ... no longer.
>
> I had a terrible CRASH over the weekend. Was severely depressed yesterday. Because I have had similar crashes with Adderall and Ritilin, my pdoc and I agree the problem was caused by Provigil "poop out." I felt great for the first 2 days or so that I took it, but then things went quickly downhill. (i only took it a total of 5 days.)
>
> Today I did not take the Provigil and feel incredibly better.
>
> For me, increasing the dose would just cause a worse crash. With my pdoc's agreement, I discontinued the Provigil, and will probably never try another stimulant since I am so prone to these crashes.
>
> Although, JohnL (Where has he gone?) would highly recommend trying Adrafinil -- that's not supposed to cause the poop-out. It could be worth a try for you.
>
> good luck,
> cindy
>
> > Started provigil one week ago. very hyper with it at first,
> >
> > too much energy. (100mg).this side effect wore out
> > Now its pooped out and pdoc said take 200mg
> > thou still kinda feel more awake then before, I'm still
> > kinda tired (like I used to be before the provigil
> > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > twice a day)and now provigil 200mg every morning
> > any suggestions, can I go up on my provigil
> > has anyone else noticed that provigil seems not to work
> > as well the longer you take it?
> > vicky
Posted by kregpark@yahoo.com on October 16, 2001, at 3:15:31
In reply to Re: PROVIGIL POOP OUT, posted by vicky on October 15, 2001, at 13:37:57
Hi -
I just looked up perphenazine, was curious.
If I looked correctly, perphanazine is similar to an antipsychotic,
and although it says they don't know how it works very well in what I read,
it has "anti-dopamine" and "anti Serotonin-3" effects.
Provigil's effects are thought to be partly releated to dopamine and Serotonin-3 (increasing both in a certain part of the brain).I would think there's a good chance perphenazine counteracts provigil.
Btw, Serotonin-3 antagonists (ie; granisetron) effectively reduce stomach ache and increase hunger (opposite of possible provigil side effects, nausea and less hungry)
kregpark@yahoo.com
http://www.socialfear.com/> > > Started provigil one week ago. very hyper with it at first,
> > >
> > > too much energy. (100mg).this side effect wore out
> > > Now its pooped out and pdoc said take 200mg
> > > thou still kinda feel more awake then before, I'm still
> > > kinda tired (like I used to be before the provigil
> > > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > > twice a day)and now provigil 200mg every morning
> > > any suggestions, can I go up on my provigil
> > > has anyone else noticed that provigil seems not to work
> > > as well the longer you take it?
> > > vicky
>
> re: Hi Cindylou. Sorry about your experience
> with provigil. I must do well with meds
> (I'm on 4 now) and I really like this provigil
> (so far). I take 100mg in the morning
> and am good to go till around noon, then I take another 100mg
> provigil and up and at em again.
> what other meds are you taking again?
> vicky
Posted by Cindylou on October 16, 2001, at 7:09:27
In reply to Re: PROVIGIL POOP OUT » Cindylou, posted by kregpark@yahoo.com on October 16, 2001, at 2:49:02
Hello,
Thanks for your response. Interestingly, I did start taking Lamictal at the same time I started the Provigil ... that would support your information that Provigil can be negatively affected by an anticonvulsant. Makes sense to me!Thanks again,
cindy
> Hi -
>
> I know that Provigil doesn't work for everybody.
> I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.
>
> It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
> On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.
>
> Others that may interact include anticonvulsants.
>
> I learned when taking gabapentin the "blunting" effect it has on some dopaminergics.
> Although in some ways I liked gabapentins anti-anxiety and good mood effect, Wellbutrin suddenly seemed as powerful as a sugar pill.
>
> I think Propecia and provigil interact also.
>
> Generally, for now I know that even in the literature it has been shown that certain anticonvulsants and certain hormonal medications (Propecia applies there), have counteracting effects on Provigil.
>
> kregpark@yahoo.com
>
> http://www.socialfear.com/
>
> Even Celexa, for example, is known to have a metabolic interaction with Provigil. The result is that Provigil usually doesn't work for Celexa induced sedation. *However*, Provigil HAS been shown to be effective for Prozac, Zoloft, and Paxil induced sedation!
> Propecia (finasteride .. or Proscar at 5mg) reduces effects of Provigil (and vice versa) - I know because I take both!!
> In my experience, Serzone also counteracts (to an extent) Provigil, though in some ways it may complement it (both anti-anxiety, but opposing "awakeness" effect).
>
> When I tried gabapentin, one reason I didn't like it was not because it was not axiolytic and mood elevating, but rather because it seemed to really "blunt" the effect of other meds, mainly dopaminergic meds (ie; Wellbutrin).
> So if I took gabapentin, it was kind of like forget dopaminergic augmentation!
>
>
>
> Anyway,
>
> I have had good luck with Provigil. I have a sort of "euphoria" type of feeling whenever *first increasing* the dose. That might be the first time taking it or someday when more is taken.
> Also, the opposite, lowering the dose one day I might feel a bit less energetic than expected otherwise.
>
> There is no wonder pill, but Provigil does have an advantage for most people in that if their dose is in range, stopping it is not likely to cause nearly as much problem with "rebound" hyper sleep (hypersomnia).
>
>
>
>
>
> > Hi Vicki,
> > I talked with you on another post -- said I had just started Provigil and it was helping ... BUT ... no longer.
> >
> > I had a terrible CRASH over the weekend. Was severely depressed yesterday. Because I have had similar crashes with Adderall and Ritilin, my pdoc and I agree the problem was caused by Provigil "poop out." I felt great for the first 2 days or so that I took it, but then things went quickly downhill. (i only took it a total of 5 days.)
> >
> > Today I did not take the Provigil and feel incredibly better.
> >
> > For me, increasing the dose would just cause a worse crash. With my pdoc's agreement, I discontinued the Provigil, and will probably never try another stimulant since I am so prone to these crashes.
> >
> > Although, JohnL (Where has he gone?) would highly recommend trying Adrafinil -- that's not supposed to cause the poop-out. It could be worth a try for you.
> >
> > good luck,
> > cindy
> >
> > > Started provigil one week ago. very hyper with it at first,
> > >
> > > too much energy. (100mg).this side effect wore out
> > > Now its pooped out and pdoc said take 200mg
> > > thou still kinda feel more awake then before, I'm still
> > > kinda tired (like I used to be before the provigil
> > > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > > twice a day)and now provigil 200mg every morning
> > > any suggestions, can I go up on my provigil
> > > has anyone else noticed that provigil seems not to work
> > > as well the longer you take it?
> > > vicky
Posted by houstongirl on October 16, 2001, at 9:14:09
In reply to Re: PROVIGIL POOP OUT » kregpark@yahoo.com, posted by Cindylou on October 16, 2001, at 7:09:27
I am also interested in learning more about the anticonvulsant interaction with Provigil. Also about the Celexa. Where can I get more info, like to show pdoc? (kregpark, anything?) I'm currently on 1500mg Depakote, 100mg Celexa and 200mg Provigil and I'm STILL sleeping 10-12 hours a night. Waking up in the morning is next to impossible, even with a light box. All I do is dream that I can't open my eyes and I'm getting fired from my job...
Thanks,
Cristy> Hello,
> Thanks for your response. Interestingly, I did start taking Lamictal at the same time I started the Provigil ... that would support your information that Provigil can be negatively affected by an anticonvulsant. Makes sense to me!
>
> Thanks again,
> cindy
>
>
> > Hi -
> >
> > I know that Provigil doesn't work for everybody.
> > I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.
> >
> > It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
> > On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.
> >
> > Others that may interact include anticonvulsants.
Posted by kregpark@yahoo.com on October 17, 2001, at 1:53:24
In reply to Re: PROVIGIL POOP OUT, posted by houstongirl on October 16, 2001, at 9:14:09
Hi Cristy -
(also thanks Cindi for the comments...)Wow this is a fun board so many girls! :)
Here is a URL: Has a study mentioning Celexa and Provigil.
http://www.talkaboutsleep.com/news/Provigil_Depression.htmThere aren't many studies yet for Provigil that are on
Medline anyway, but in the PDR (has to be 1999 or later I think), in contraindications in mentions some medications that interact with Provigil. If memory serves me correct carbemazapine(sp?) and possibly valproic acid? I'm a bit too tired to dig out the big book but you should be able to find the PDR info on the Internet. If not, any pharmacists will give you a copy. If you haven't read the PDR, don't worry about all the techical mumbo jumbo I think even the Dr's skip most of this stuff - in "Contrindications", and "Adverse Reactions" and so on you can skim for relevant stuff.It may be in PDR, or else Medline, 1 of the atypical antipsychotics appears to act in almost direct opposition to Provigil, and vice-versa.
kregpark
http://www.socialfear.com/> I am also interested in learning more about the anticonvulsant interaction with Provigil. Also about the Celexa. Where can I get more info, like to show pdoc? (kregpark, anything?) I'm currently on 1500mg Depakote, 100mg Celexa and 200mg Provigil and I'm STILL sleeping 10-12 hours a night. Waking up in the morning is next to impossible, even with a light box. All I do is dream that I can't open my eyes and I'm getting fired from my job...
>
> Thanks,
> Cristy
>
> > Hello,
> > Thanks for your response. Interestingly, I did start taking Lamictal at the same time I started the Provigil ... that would support your information that Provigil can be negatively affected by an anticonvulsant. Makes sense to me!
> >
> > Thanks again,
> > cindy
> >
> >
> > > Hi -
> > >
> > > I know that Provigil doesn't work for everybody.
> > > I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.
> > >
> > > It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
> > > On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.
> > >
> > > Others that may interact include anticonvulsants.
Posted by kregpark@yahoo.com on October 17, 2001, at 2:08:46
In reply to Re: PROVIGIL POOP OUT, posted by houstongirl on October 16, 2001, at 9:14:09
Woops, just noticed something again forgot to mention.
I'm not sure what the Celexa and Depakote (sp?) are for ... (pause) ...
... I just looked on Internet, depakote = valproic acid???100 Celexa (pretty high dose) + Depakote just from the little I know about those sounds like a good chance to blunt much of Provigil's effect.
Again, not sure what the 2 meds are for but since I just read that depakote is anti-manic then it sounds like it may be sedating, and probably moreso combined with a pretty relaxing ssri like Celexa.
I'm just kind of curious if switching 1 or both of the original medicines might not be worth trying also, as an alternative option to finding a 3rd med to counteract sedation from the first 2.
> I am also interested in learning more about the anticonvulsant interaction with Provigil. Also about the Celexa. Where can I get more info, like to show pdoc? (kregpark, anything?) I'm currently on 1500mg Depakote, 100mg Celexa and 200mg Provigil and I'm STILL sleeping 10-12 hours a night. Waking up in the morning is next to impossible, even with a light box. All I do is dream that I can't open my eyes and I'm getting fired from my job...
>
> Thanks,
> Cristy
>
> > Hello,
> > Thanks for your response. Interestingly, I did start taking Lamictal at the same time I started the Provigil ... that would support your information that Provigil can be negatively affected by an anticonvulsant. Makes sense to me!
> >
> > Thanks again,
> > cindy
> >
> >
> > > Hi -
> > >
> > > I know that Provigil doesn't work for everybody.
> > > I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.
> > >
> > > It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
> > > On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.
> > >
> > > Others that may interact include anticonvulsants.
Posted by houstongirl on October 17, 2001, at 9:57:15
In reply to Re: PROVIGIL - forgot something » houstongirl, posted by kregpark@yahoo.com on October 17, 2001, at 2:08:46
Yeah, Celexa 100 mg is as high as they will go on it. It's an SSRI, supposedly with the "cleanest" side-effect profile. I've been through a lot- Zoloft, Prozac, Paxil, Effexor, Wellbutrin, amitriptyline, nortriptyline, lithium, Ritalin, adderall, T4, that's all I can think of for now. I'm BPII - rapid cycling. I also had a grand mal seizure on Wellbutrin (w/in 38 hrs of first dose). EEG shows "epileptiform" brain wave activity, so I have to be an anti-convulsant anyway. I'm thinking of switching to Topamax (topiramate)- mostly b/c of weight gain from Depakote. I'm relatively stable now, though and I'd have to really taper Depakote before starting Topamax, so I'm just not sure...
any advice?
Cristy
> Woops, just noticed something again forgot to mention.
>
> I'm not sure what the Celexa and Depakote (sp?) are for ... (pause) ...
> ... I just looked on Internet, depakote = valproic acid???
>
> 100 Celexa (pretty high dose) + Depakote just from the little I know about those sounds like a good chance to blunt much of Provigil's effect.
>
> Again, not sure what the 2 meds are for but since I just read that depakote is anti-manic then it sounds like it may be sedating, and probably moreso combined with a pretty relaxing ssri like Celexa.
>
> I'm just kind of curious if switching 1 or both of the original medicines might not be worth trying also, as an alternative option to finding a 3rd med to counteract sedation from the first 2.
>
> kregpark@yahoo.com
>
>
>
Posted by kregpark@yahoo.com on October 17, 2001, at 12:08:31
In reply to Re: PROVIGIL - forgot something, posted by houstongirl on October 17, 2001, at 9:57:15
I'm not sure if bp2 means rapid cycling or also a tendency on 'low' or high'.
Wellbutrin and Cyclert are pretty opposite from Celexa and Zoloft.
Maybe those were used in combinations ...
One idea might be to pick out a few meds that you liked the most.
There may be even a single one you like as a "base" to work around.
(For me, Klonopin is my clearcut "main med" for Generalized SP that I have worked around for several years.)If you have a general idea which types of meds have helped most that can be useful in future changes.
What about newer anticonvulsants like gabapentin and lamictal.
Also, Klonopin was FDA approved originally as an anticonvulsant, even though it is a benzodiazepine.
I think Klonopin may not be a preferred anticonvulsant nowadays but I'm not sure ...I guess as a one with pretty limited knowledge on this .. with what I know I'd wonder first about gabapentin, lamictal, and also how lithium worked out.
Also, if there was a preference for SSRI's versus stimulating antidepressants (Wellbutrin) or stimulants.If it seems a mix between SSRI's and Wellbutrin / stimulants, (different drawbacks with each) - then an MAOI might be worth trying.
For example, Nardil or Parnate, taken with an anticonvulsant.MAOI's are the post powerful antidepressant, and experts consider them underutilized.
Nardil is more relaxing, Parnate is more stimulating.
High doses are not necessary, and lower doses generally have low side effects.kregpark@yahoo.com
http://www.socialfear.com/> Yeah, Celexa 100 mg is as high as they will go on it. It's an SSRI, supposedly with the "cleanest" side-effect profile. I've been through a lot- Zoloft, Prozac, Paxil, Effexor, Wellbutrin, amitriptyline, nortriptyline, lithium, Ritalin, adderall, T4, that's all I can think of for now. I'm BPII - rapid cycling. I also had a grand mal seizure on Wellbutrin (w/in 38 hrs of first dose). EEG shows "epileptiform" brain wave activity, so I have to be an anti-convulsant anyway. I'm thinking of switching to Topamax (topiramate)- mostly b/c of weight gain from Depakote. I'm relatively stable now, though and I'd have to really taper Depakote before starting Topamax, so I'm just not sure...
>
> any advice?
>
> Cristy
>
>
> > Woops, just noticed something again forgot to mention.
> >
> > I'm not sure what the Celexa and Depakote (sp?) are for ... (pause) ...
> > ... I just looked on Internet, depakote = valproic acid???
> >
> > 100 Celexa (pretty high dose) + Depakote just from the little I know about those sounds like a good chance to blunt much of Provigil's effect.
> >
> > Again, not sure what the 2 meds are for but since I just read that depakote is anti-manic then it sounds like it may be sedating, and probably moreso combined with a pretty relaxing ssri like Celexa.
> >
> > I'm just kind of curious if switching 1 or both of the original medicines might not be worth trying also, as an alternative option to finding a 3rd med to counteract sedation from the first 2.
> >
> > kregpark@yahoo.com
> >
> >
> >
Posted by vicky on October 20, 2001, at 11:02:26
In reply to Re: PROVIGIL : + perphenazine » vicky, posted by kregpark@yahoo.com on October 16, 2001, at 3:15:31
> Hi - thanks for the information Kreg on the perphenazine.
it is indeed an antipscychotic, but seems to work really well for me
It certainly helped me with the prozac about 10 years ago when
I first took prozac, and prozac stopped working by itself.
Back to provigil, Having great success with it now,been about 3 weeks
I find I can go all morning, (with mild drowsniness, unlike before when I would just have to lie down for 2 hours)and I take another 100mg around noon
and good to go the rest of the day. I hope this continues. I like making my bed now!!!
Used to see no need as I would be back in it of and on all day, then all night long!!
Vicky
>
> I just looked up perphenazine, was curious.
> If I looked correctly, perphanazine is similar to an antipsychotic,
> and although it says they don't know how it works very well in what I read,
> it has "anti-dopamine" and "anti Serotonin-3" effects.
> Provigil's effects are thought to be partly releated to dopamine and Serotonin-3 (increasing both in a certain part of the brain).
>
> I would think there's a good chance perphenazine counteracts provigil.
>
> Btw, Serotonin-3 antagonists (ie; granisetron) effectively reduce stomach ache and increase hunger (opposite of possible provigil side effects, nausea and less hungry)
>
> kregpark@yahoo.com
> http://www.socialfear.com/
>
>
>
> > > > Started provigil one week ago. very hyper with it at first,
> > > >
> > > > too much energy. (100mg).this side effect wore out
> > > > Now its pooped out and pdoc said take 200mg
> > > > thou still kinda feel more awake then before, I'm still
> > > > kinda tired (like I used to be before the provigil
> > > > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > > > twice a day)and now provigil 200mg every morning
> > > > any suggestions, can I go up on my provigil
> > > > has anyone else noticed that provigil seems not to work
> > > > as well the longer you take it?
> > > > vicky
> >
> > re: Hi Cindylou. Sorry about your experience
> > with provigil. I must do well with meds
> > (I'm on 4 now) and I really like this provigil
> > (so far). I take 100mg in the morning
> > and am good to go till around noon, then I take another 100mg
> > provigil and up and at em again.
> > what other meds are you taking again?
> > vicky
Posted by kregpark@yahoo.com on October 20, 2001, at 14:17:36
In reply to Re: PROVIGIL : + perphenazine, posted by vicky on October 20, 2001, at 11:02:26
Hi Vicky,
That is great to hear. Very encouraging.
I take less Provigil because Nardil even at mild dose enhances effect, but I often take a 2nd (smaller than am) dose of Provigil around noon myself.
For me, the doses are around 50mg AM, and 25 noon, but again the Nardil seems to enhance the effect so otherwise my doses would probably be higher.
Anyhow, thanks for the feedback. Good news.
kregpark> > Hi - thanks for the information Kreg on the perphenazine.
> it is indeed an antipscychotic, but seems to work really well for me
> It certainly helped me with the prozac about 10 years ago when
> I first took prozac, and prozac stopped working by itself.
> Back to provigil, Having great success with it now,been about 3 weeks
> I find I can go all morning, (with mild drowsniness, unlike before when I would just have to lie down for 2 hours)and I take another 100mg around noon
> and good to go the rest of the day. I hope this continues. I like making my bed now!!!
> Used to see no need as I would be back in it of and on all day, then all night long!!
> Vicky
> >
> > I just looked up perphenazine, was curious.
> > If I looked correctly, perphanazine is similar to an antipsychotic,
> > and although it says they don't know how it works very well in what I read,
> > it has "anti-dopamine" and "anti Serotonin-3" effects.
> > Provigil's effects are thought to be partly releated to dopamine and Serotonin-3 (increasing both in a certain part of the brain).
> >
> > I would think there's a good chance perphenazine counteracts provigil.
> >
> > Btw, Serotonin-3 antagonists (ie; granisetron) effectively reduce stomach ache and increase hunger (opposite of possible provigil side effects, nausea and less hungry)
> >
> > kregpark@yahoo.com
> > http://www.socialfear.com/
> >
> >
> >
> > > > > Started provigil one week ago. very hyper with it at first,
> > > > >
> > > > > too much energy. (100mg).this side effect wore out
> > > > > Now its pooped out and pdoc said take 200mg
> > > > > thou still kinda feel more awake then before, I'm still
> > > > > kinda tired (like I used to be before the provigil
> > > > > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > > > > twice a day)and now provigil 200mg every morning
> > > > > any suggestions, can I go up on my provigil
> > > > > has anyone else noticed that provigil seems not to work
> > > > > as well the longer you take it?
> > > > > vicky
> > >
> > > re: Hi Cindylou. Sorry about your experience
> > > with provigil. I must do well with meds
> > > (I'm on 4 now) and I really like this provigil
> > > (so far). I take 100mg in the morning
> > > and am good to go till around noon, then I take another 100mg
> > > provigil and up and at em again.
> > > what other meds are you taking again?
> > > vicky
Posted by Rick on October 29, 2001, at 0:53:10
In reply to Re: PROVIGIL POOP OUT » kregpark@yahoo.com, posted by Cindylou on October 16, 2001, at 7:09:27
I’ve been taking Provigil 100 mg/day with Serzone+Klonopin (AND Propecia) for over two years and it hasn’t shown any signs of general poop-out whatsoever. It works as well as ever. One or two days every month or two Provigil might seem a bit less effective, and I bump it up to 200 briefly (usually with the mild euphoria effect kregpark mentioned). I believe the reason Provigil loses a little of its oomph at times is that it has the unusual capability to induce its own metabolism. BTW, it's now well over two months since I've experienced that short-lived poop-out phenomenon – the longest ever in the two years I’ve been using Provigil.
It makes sense that Provigil should do a great job countering Serzone-induced fatigue since Serzone is a powerful inhibitor of one of Provigil’s primary metabolization enzymes, P450 CYP3A4. I.e. Serzone increases blood concentrations of Provigil and prolongs its wakefulness effects (no problems sleeping when I WANT to, though). It’s a great combo, especially given Provigil’s motivational and confidence-building properties (I have non-depressive Social Phobia). Klonopin is also believed to be metabolized largely via CYP3A4, so its anti-anxiety effect is prolonged by Serzone as well. This all allows me to take lower doses of everything – all of it first thing in the morning.
Rick
> Hello,
> Thanks for your response. Interestingly, I did start taking Lamictal at the same time I started the Provigil ... that would support your information that Provigil can be negatively affected by an anticonvulsant. Makes sense to me!
>
> Thanks again,
> cindy
>
>
> > Hi -
> >
> > I know that Provigil doesn't work for everybody.
> > I was curious though; about the people who didn't have any success with it in the long run...if there may be drug interaction causing part of the problem.
> >
> > It is already known for example that Provigil and Celexa have a metabolic interaction which tends to make Provigil largely ineffective for Celexa induced sedation.
> > On the other hand, Provigil has been shown effective for Zoloft, Prozac, and Paxil induced sedation.
> >
> > Others that may interact include anticonvulsants.
> >
> > I learned when taking gabapentin the "blunting" effect it has on some dopaminergics.
> > Although in some ways I liked gabapentins anti-anxiety and good mood effect, Wellbutrin suddenly seemed as powerful as a sugar pill.
> >
> > I think Propecia and provigil interact also.
> >
> > Generally, for now I know that even in the literature it has been shown that certain anticonvulsants and certain hormonal medications (Propecia applies there), have counteracting effects on Provigil.
> >
> > kregpark@yahoo.com
> >
> > http://www.socialfear.com/
> >
> > Even Celexa, for example, is known to have a metabolic interaction with Provigil. The result is that Provigil usually doesn't work for Celexa induced sedation. *However*, Provigil HAS been shown to be effective for Prozac, Zoloft, and Paxil induced sedation!
> > Propecia (finasteride .. or Proscar at 5mg) reduces effects of Provigil (and vice versa) - I know because I take both!!
> > In my experience, Serzone also counteracts (to an extent) Provigil, though in some ways it may complement it (both anti-anxiety, but opposing "awakeness" effect).
> >
> > When I tried gabapentin, one reason I didn't like it was not because it was not axiolytic and mood elevating, but rather because it seemed to really "blunt" the effect of other meds, mainly dopaminergic meds (ie; Wellbutrin).
> > So if I took gabapentin, it was kind of like forget dopaminergic augmentation!
> >
> >
> >
> > Anyway,
> >
> > I have had good luck with Provigil. I have a sort of "euphoria" type of feeling whenever *first increasing* the dose. That might be the first time taking it or someday when more is taken.
> > Also, the opposite, lowering the dose one day I might feel a bit less energetic than expected otherwise.
> >
> > There is no wonder pill, but Provigil does have an advantage for most people in that if their dose is in range, stopping it is not likely to cause nearly as much problem with "rebound" hyper sleep (hypersomnia).
> >
> >
> >
> >
> >
> > > Hi Vicki,
> > > I talked with you on another post -- said I had just started Provigil and it was helping ... BUT ... no longer.
> > >
> > > I had a terrible CRASH over the weekend. Was severely depressed yesterday. Because I have had similar crashes with Adderall and Ritilin, my pdoc and I agree the problem was caused by Provigil "poop out." I felt great for the first 2 days or so that I took it, but then things went quickly downhill. (i only took it a total of 5 days.)
> > >
> > > Today I did not take the Provigil and feel incredibly better.
> > >
> > > For me, increasing the dose would just cause a worse crash. With my pdoc's agreement, I discontinued the Provigil, and will probably never try another stimulant since I am so prone to these crashes.
> > >
> > > Although, JohnL (Where has he gone?) would highly recommend trying Adrafinil -- that's not supposed to cause the poop-out. It could be worth a try for you.
> > >
> > > good luck,
> > > cindy
> > >
> > > > Started provigil one week ago. very hyper with it at first,
> > > >
> > > > too much energy. (100mg).this side effect wore out
> > > > Now its pooped out and pdoc said take 200mg
> > > > thou still kinda feel more awake then before, I'm still
> > > > kinda tired (like I used to be before the provigil
> > > > History. (taking prozac 40mg,perhphenazine 4mg, buspar 15mg
> > > > twice a day)and now provigil 200mg every morning
> > > > any suggestions, can I go up on my provigil
> > > > has anyone else noticed that provigil seems not to work
> > > > as well the longer you take it?
> > > > vicky
Posted by JGalt on October 29, 2001, at 10:04:38
In reply to Re: PROVIGIL POOPOUT: 2 YEARS, STRONGER THAN EVER, posted by Rick on October 29, 2001, at 0:53:10
Interesting on the enzyme bit. It would seem to follow that using Klonopin+Provigil would also prolong the effects of each, at least until the body managed to produce enough extra enzyme to counteract both, if it does so in this case.
> It makes sense that Provigil should do a great job countering Serzone-induced fatigue since Serzone is a powerful inhibitor of one of Provigil’s primary metabolization enzymes, P450 CYP3A4. I.e. Serzone increases blood concentrations of Provigil and prolongs its wakefulness effects (no problems sleeping when I WANT to, though). It’s a great combo, especially given Provigil’s motivational and confidence-building properties (I have non-depressive Social Phobia). Klonopin is also believed to be metabolized largely via CYP3A4, so its anti-anxiety effect is prolonged by Serzone as well. This all allows me to take lower doses of everything – all of it first thing in the morning.
>
> Rick
>
>
This is the end of the thread.
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