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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by spike4848 on February 23, 2002, at 21:11:08
I tried 100 mg, then 50 mg, then 25 mg and still palpations/anxiety/wired/huge crash at night. This stuff is deadly! I even added neurontin to zoloft and klonopin .... and still bad reaction to provigil.
I wish it worked. Oh well.
Spike
Posted by ross on February 23, 2002, at 21:33:27
In reply to Provigil is killing me!, posted by spike4848 on February 23, 2002, at 21:11:08
spike why dont you go back on Nardil if it was very effective for you?
Posted by JohnX2 on February 23, 2002, at 23:02:08
In reply to Provigil is killing me!, posted by spike4848 on February 23, 2002, at 21:11:08
Spike,What symptoms were you trying to treat with
provigil?-John
> I tried 100 mg, then 50 mg, then 25 mg and still palpations/anxiety/wired/huge crash at night. This stuff is deadly! I even added neurontin to zoloft and klonopin .... and still bad reaction to provigil.
>
> I wish it worked. Oh well.
>
> Spike
Posted by JohnX2 on February 23, 2002, at 23:09:58
In reply to Re: Provigil is killing me! » spike4848, posted by JohnX2 on February 23, 2002, at 23:02:08
Spike,Provigil I believe is a potent alpha-1
agonist if memory serves me correct. In the
serotonin system, there are actually alpha-1
adrenorectors on the raphe nuclei that enhance
serotonergic release when stimulated. If this
caused sertononin to nail those nasty 5ht-2a or
5ht-2c receptors you would feel very anxious.
One solution would be to block them with an
atypical AP. I'm just guessing at what may be
happening here to cause the anxiety. In the
noradrenergic system I believe the alpha-1
receptors are linked into NMDA glutamate transmission
and increase attention which is the effect one
is looking for.Someone correct me if my shooting from the hip
is wrong.-John
>
> Spike,
>
> What symptoms were you trying to treat with
> provigil?
>
> -John
>
>
>
>
>
>
> > I tried 100 mg, then 50 mg, then 25 mg and still palpations/anxiety/wired/huge crash at night. This stuff is deadly! I even added neurontin to zoloft and klonopin .... and still bad reaction to provigil.
> >
> > I wish it worked. Oh well.
> >
> > Spike
Posted by spike4848 on February 24, 2002, at 7:33:03
In reply to Re: Provigil is killing me! » spike4848, posted by JohnX2 on February 23, 2002, at 23:02:08
> What symptoms were you trying to treat with
> provigil?The zoloft/neurontin/klonopin combo is making me feel about 50 to 60% normal. But I still have some residual depression/apathy/anxiety. It seems many people on here at psychobabble and some pdocs were reporting sucess with SSRI + provigil .... so I gave it a try.
So now I am considering:
Wellbutrin(I think It might have the same effect as provigil though .... anxiety/panic)
Desipramine
Low dose segiline
Bromocriptine
AmantadineWhat do you think would augment zoloft/neurontin/klonopin the best to get rid of the remaining symptoms?
Thanks.
Spike
Posted by JohnX2 on February 24, 2002, at 10:16:59
In reply to Re: Provigil is killing me! » JohnX2, posted by spike4848 on February 24, 2002, at 7:33:03
The serotonin 5ht-2c receptor is associated
with anxiety/panic. This is why some people with
panic disorder initially feel worse especially
when taking the more activating SSRIS like Zoloft.I remember when I was taking St. John's wort for
a week and had to stop it I had withdrawl panic attacks.
When my doctor gave me Zoloft the panic attacks got worse.
Over time they would have gotton better as the medicine
would downregulate the 5ht-2a and 2c receptors, but the
quicker route is to take a medicine that directly blocks
these receptors.I need to do my homework, but Im pretty sure Zyprexa,
Geodon, maybe Risperidone, block the Receptors. Of course
given my latest atypical twitching experience on Zyprexa
maybe i should keep my mouth shut. But I think maybe 5 mg
of zyprexa or a Geodon add-on would be a good step before dumping all of your
medicines and moving on to all those other medicines.
Serzone helps by blocking the 5ht-2a receptors. But it
also is mild alpha-1 antagonist and would counteract provigil.
Hey, it might balance out provigils action though.
I'm not sure about drug interactions with these medicines.PS. what is your entire DX. I forgot the details. sorry.
Regards.
-John
>
> > What symptoms were you trying to treat with
> > provigil?
>
> The zoloft/neurontin/klonopin combo is making me feel about 50 to 60% normal. But I still have some residual depression/apathy/anxiety. It seems many people on here at psychobabble and some pdocs were reporting sucess with SSRI + provigil .... so I gave it a try.
>
> So now I am considering:
>
> Wellbutrin(I think It might have the same effect as provigil though .... anxiety/panic)
> Desipramine
> Low dose segiline
> Bromocriptine
> Amantadine
>
> What do you think would augment zoloft/neurontin/klonopin the best to get rid of the remaining symptoms?
>
> Thanks.
>
> Spike
Posted by spike4848 on February 24, 2002, at 10:47:03
In reply to Re: Provigil is killing me! » spike4848, posted by JohnX2 on February 24, 2002, at 10:16:59
> PS. what is your entire DX. I forgot the details. sorry.
>
> Regards.
> -John
>Diagnosis
Social phobia intermitantly throughout life
Panic disorder started 7 years ago
Severe depression which responds to MAOIs 6 years ago
Family history
father bipolar II
mother unipolar with panicSpike
Posted by JohnX2 on February 24, 2002, at 14:31:41
In reply to Re: Provigil is killing me! » JohnX2, posted by spike4848 on February 24, 2002, at 10:47:03
How long have you been taking Zoloft?
A lot of doctors prefer Paxil for Panic. Its
less irritating. Although Zoloft should work
if you duke it out over a number of weeks to
get the receptors to down regulate.-John
> > PS. what is your entire DX. I forgot the details. sorry.
> >
> > Regards.
> > -John
> >
>
> Diagnosis
>
> Social phobia intermitantly throughout life
> Panic disorder started 7 years ago
> Severe depression which responds to MAOIs 6 years ago
>
>
> Family history
>
> father bipolar II
> mother unipolar with panic
>
> Spike
Posted by Denise528 on February 27, 2002, at 12:38:17
In reply to Re: Provigil is killing me! » JohnX2, posted by spike4848 on February 24, 2002, at 10:47:03
Spike,
Have you considered trying Zyprexa, even if you just take it as and when needed. The only reason I mention it is that it is the only drug so far that has given me a sense of calm and my concentration is much keener and I have more energy after taking it. It's not an ideal situation as sometimes I feel slightly flat and humourless but (and I hate to say it) I really don't know where I'd be without it.
Denise
Posted by Ron Hill on February 28, 2002, at 4:43:58
In reply to Provigil is killing me!, posted by spike4848 on February 23, 2002, at 21:11:08
Spike,
Thanks for posting. I had been considering Provigil as an add-on to my 600 mg Lithobid and 12.5 mg Zoloft in an attempt to counteract the loss of ambition, loss of energy, lack of motivation, blunted emotions, etc caused by the SSRI. Sounds like you have simillar symptoms that you attempted to treat with Provigil. Thanks for taking time to post your experience with the med.
I'm BPII. The Li adequately controls my hypomania but does nothing for my depression. Any of the SSRI's will take away the "I want to die" mood but leaves me with the above mentioned side effects. I tried a ton of other ADs over the years, but I will not bore you with the details.
But here is the good news; I found something that has been working very well! I'm writing this to you in hopes that it might help you as well.
I added 200 mg SAM-e daily and it has helped me more than any of the many ADs I've tried over the years. It is very important to take plenty of B-6, B-12 (sublingual form) and folate with the SAM-e. Here are some links that discuss the biochemical reaction mechanisms. Do some research. Beware, buy a good name brand to ensure product quality.
http://www.biopsychiatry.com/sameart.html
http://more.abcnews.go.com/sections/living/inyourhead/allinyourhead_36.html
http://www.psycom.net/depression.central.same.html
http://www.mhsource.com/expert/exp1041299b.html
http://www.arthritissupport.com/track/goto/rtgoto30l.cfm
There's much more, of course, but this will get you started if you're interested.
-- Ron
--------------------------------------------------
> I tried 100 mg, then 50 mg, then 25 mg and still palpations/anxiety/wired/huge crash at night. This stuff is deadly! I even added neurontin to zoloft and klonopin .... and still bad reaction to provigil.
>
> I wish it worked. Oh well.
>
> Spike
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