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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by dennison on June 30, 2001, at 16:14:44
Hi--Well close to couple weeks on provigil--being used to augment the parnate &cytomel and is replacing cylert --"pemoline" I was taking . So far provigil causes alot of mental confusion and sleepiness just the opposite of what was being sought--of course this is very discouraging --also noise sensitivity is now a problem as well as this darn claminess(stickiness)--like dried sweat on the skin all the time. But obviously the main problem is it's causing sleepiness take the dose 100 mg about half an hour later drowsiness becomes apparent and I have to sleep. Hope somebody can give me some encouragement here that perhaps this is the normal pattern of provigil response and that benefits will soon manifest themselves.
Posted by Rick on June 30, 2001, at 17:01:22
In reply to provigil ---modafinil disheartening results, posted by dennison on June 30, 2001, at 16:14:44
I wouldn't give up on it too quickly, unless your side effects are severe.
I didn't have any of the side effects you describe when I started Provigil, and stil don't (although every once in awhile the wakefulness benefit seems to be taking a day off). In fact, out of the dozen or so psychotropics I've taken, Provigil's the only only one that showed theraputic benefit *and* minimal side effects from the start.
Are you taking the full 100 in the morning? I actually started with 200 mg for a few weeks, then went down to 100. I still spike it to 200 every so often.
Perhaps most important are the meds you're combining it with. I'm taking Provigil with two sedating drugs, Klonopin and Serzone. I'm too lazy to go back and check the research now, but interaction-prone Serzone may very well stretch out and smooth out the benefit of the Provigil by inhibiting its metabolism (never any insomnia, though). Isn't Parnate already an activating drug that an cause agitation? I'm not familiar with Cytomel. Maybe there's some sort of detrimental interaction between Provigil and your other meds.
On the other hand, if you can stick it out a few more weeks, the side effects may very well subside. While I personally "took" to Provigil very quickly, I HAVE read many others in other forums say it took some getting used to. Of course, if time and/or dose and/or other-med adjustment doesn't help, there's always the possibility that it's not for you. Provigil doesn't work for everyone. What does?
Rick> Hi--Well close to couple weeks on provigil--being used to augment the parnate &cytomel and is replacing cylert --"pemoline" I was taking . So far provigil causes alot of mental confusion and sleepiness just the opposite of what was being sought--of course this is very discouraging --also noise sensitivity is now a problem as well as this darn claminess(stickiness)--like dried sweat on the skin all the time. But obviously the main problem is it's causing sleepiness take the dose 100 mg about half an hour later drowsiness becomes apparent and I have to sleep. Hope somebody can give me some encouragement here that perhaps this is the normal pattern of provigil response and that benefits will soon manifest themselves.
Posted by Rick on June 30, 2001, at 17:08:52
In reply to Re: provigil ---modafinil disheartening results, posted by Rick on June 30, 2001, at 17:01:22
PS: Re dosing, going the other way, i.e., cut back to 50 for awhile then tirate up if needed, could be worth trying. Also, I wonder if the sudden replacement of Cylert with a gentler stimulant is causing an adjustment period/withdrwal. If so, that could subside in the next few weeks. It's too bad there are no cut and dried answers to these things. It took me a over year to find the combo that does it for me, and I know for soem people the experimentation takes even a lot longer.
Rick
> I wouldn't give up on it too quickly, unless your side effects are severe.
>
> I didn't have any of the side effects you describe when I started Provigil, and stil don't (although every once in awhile the wakefulness benefit seems to be taking a day off). In fact, out of the dozen or so psychotropics I've taken, Provigil's the only only one that showed theraputic benefit *and* minimal side effects from the start.
>
> Are you taking the full 100 in the morning? I actually started with 200 mg for a few weeks, then went down to 100. I still spike it to 200 every so often.
>
> Perhaps most important are the meds you're combining it with. I'm taking Provigil with two sedating drugs, Klonopin and Serzone. I'm too lazy to go back and check the research now, but interaction-prone Serzone may very well stretch out and smooth out the benefit of the Provigil by inhibiting its metabolism (never any insomnia, though). Isn't Parnate already an activating drug that an cause agitation? I'm not familiar with Cytomel. Maybe there's some sort of detrimental interaction between Provigil and your other meds.
>
> On the other hand, if you can stick it out a few more weeks, the side effects may very well subside. While I personally "took" to Provigil very quickly, I HAVE read many others in other forums say it took some getting used to. Of course, if time and/or dose and/or other-med adjustment doesn't help, there's always the possibility that it's not for you. Provigil doesn't work for everyone. What does?
>
>
> Rick
>
> > Hi--Well close to couple weeks on provigil--being used to augment the parnate &cytomel and is replacing cylert --"pemoline" I was taking . So far provigil causes alot of mental confusion and sleepiness just the opposite of what was being sought--of course this is very discouraging --also noise sensitivity is now a problem as well as this darn claminess(stickiness)--like dried sweat on the skin all the time. But obviously the main problem is it's causing sleepiness take the dose 100 mg about half an hour later drowsiness becomes apparent and I have to sleep. Hope somebody can give me some encouragement here that perhaps this is the normal pattern of provigil response and that benefits will soon manifest themselves.
Posted by dennison on June 30, 2001, at 18:55:29
In reply to provigil ---modafinil disheartening results, posted by dennison on June 30, 2001, at 16:14:44
> Hi--Well close to couple weeks on provigil--being used to augment the parnate &cytomel and is replacing cylert --"pemoline" I was taking . So far provigil causes alot of mental confusion and sleepiness just the opposite of what was being sought--of course this is very discouraging --also noise sensitivity is now a problem as well as this darn claminess(stickiness)--like dried sweat on the skin all the time. But obviously the main problem is it's causing sleepiness take the dose 100 mg about half an hour later drowsiness becomes apparent and I have to sleep. Hope somebody can give me some encouragement here that perhaps this is the normal pattern of provigil response and that benefits will soon manifest themselves.
Hi Rick thanks for the quick response I'm not sure just what to do at this point,obviously it's not going to be like I had hoped I mean I was actually expecting a rather straight forward response from the provigil,such will not be the case. I'll have to figure this dilema out on my own basically as my doctor simply doesn't have the time to ponder but is fairly open to well presented ideas of new strategies!!!
Posted by SalArmy4me on June 30, 2001, at 19:09:13
In reply to Re: provigil ---modafinil disheartening results, posted by Rick on June 30, 2001, at 17:01:22
This is from Dr. Koop's Interaction Checker at:
http://www.drugchecker.drkoop.com/apps/drugchecker/DrugMain?cob=drkoop
Medium Interaction between Serzone (generic: nefazodone) and Provigil (generic: modafinil)
Modafinil is a CYP3A4 inducer and substrate. Nefazodone is a CYP3A4 inhibitor and substrate. If these drugs are to be used together, close monitoring of the patient for adverse effects is recommended.
References:
1. Anonymous. Product Information. Provigil (modafinil). Cephalon, Inc., Northbrook, IL. PROD; : .
Posted by Rick on June 30, 2001, at 21:21:35
In reply to Re: provigil ---modafinil disheartening results, posted by SalArmy4me on June 30, 2001, at 19:09:13
Thanks, SalArmy.
So some sources are *finally* including Provigil in their drug interaction lists! Certainly no surprise here re the Serzone+Provigil, but glad to see it's being reported.
Rick
> This is from Dr. Koop's Interaction Checker at:
>
> http://www.drugchecker.drkoop.com/apps/drugchecker/DrugMain?cob=drkoop
>
> Medium Interaction between Serzone (generic: nefazodone) and Provigil (generic: modafinil)
>
> Modafinil is a CYP3A4 inducer and substrate. Nefazodone is a CYP3A4 inhibitor and substrate. If these drugs are to be used together, close monitoring of the patient for adverse effects is recommended.
>
> References:
> 1. Anonymous. Product Information. Provigil (modafinil). Cephalon, Inc., Northbrook, IL. PROD; : .
This is the end of the thread.
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