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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by shellie on June 27, 2000, at 18:47:53
There's been so much written on the board lately about provigil and adafinil. I'm getting confused as to how many people have really tried each. I know John L. has been successful with adrafinil and Rick has been successful with Provigil. And Karen B. is braced for a trial of both, starting with provigil. I started with provigil again today, at a really low dose--but my body doesn't seem to like it very much--at least yet. Has anyone else actually tried either of these drugs, and has the trial yielded success. Also, I don't have social anxiety--I'm diagnosed with major depression (in addition to a dissociative disorder). So I'm particularly interested in both these meds for depression, either solo, or as a booster. Thanks, Shellie.
Posted by JohnL on June 28, 2000, at 5:18:02
In reply to provigil/adafinil, posted by shellie on June 27, 2000, at 18:47:53
Shellie,
Yes I've tried them both. Since we all respond so differently, I think it's difficult to tell which might work best with you. In my n=1 trial I found them to be dramatically different medications, with Adrafinil being the superior one. My preference for Adrafinil is based on its nearly nonexistent side effect profile and its smoothness. Provigil for me was rather harsh and rude. Since Adrafinil costs 1/10th of what Provigil costs, that's nice too. I will be interested to see which--if either--works best for you. I would be wonderful to see your suffering end with one of these.
It does seem like these two meds have stirred up a lot of interest at this board lately. That always seems to happen when someone finally finds the miraculous medication they've been searching for. The person with the miraculous response wants everyone else to experience the same joy. And everyone suffering wants to cling to a new source of hope. And there could be something inherently intriguing when the miraculous response is brought about by an unfamiliar med, a foreign med, or off-label use of some med.
I remember about a year or so ago WayneR found his cure with Naltrexone. For a while Naltrexone took the spotlight at this board. And Adam was in a clinical trial involving a patch version of Deprenyl. His good response stirred up a lot of enthusiasm in Deprenyl for a while. I think we see these cycles come and go periodically. Adrafinil/Provigil are a continuation of that pattern I think, primarily sparked by yet another miraculous therapeutic response with one of the board participants. If this is anything like previous patterns, the enthusiasm will fade as a few other people try these meds and discover they aren't as miraculous with them. You know how it goes...your mileage may vary. I would like to think these two meds could provide miracles for everyone. That's probably not realistic though. Regardless, they are good alternatives for those who have had disappointing results with more straight forward medication choices.
I'm in your corner cheering for you!
JohnL
Posted by Ant-Rock on June 28, 2000, at 8:55:53
In reply to provigil/adafinil, posted by shellie on June 27, 2000, at 18:47:53
> There's been so much written on the board lately about provigil and adafinil. I'm getting confused as to how many people have really tried each. I know John L. has been successful with adrafinil and Rick has been successful with Provigil. And Karen B. is braced for a trial of both, starting with provigil. I started with provigil again today, at a really low dose--but my body doesn't seem to like it very much--at least yet. Has anyone else actually tried either of these drugs, and has the trial yielded success. Also, I don't have social anxiety--I'm diagnosed with major depression (in addition to a dissociative disorder). So I'm particularly interested in both these meds for depression, either solo, or as a booster. Thanks, Shellie.
Hi Shellie,
I think I mentioned to you before that I am currently trying Adrafanil to augment the 60mg Parnate I am on. I've only been on the Adrafanil for 2weeks, and at a low dose(150mg). Today I started with a whole pill (300mg) and will see if I get a response at this dose. I'm taking it slow with this med since this combo isn't very understood. I'll post again , hopefully with good news as I give this combo some time to work.
Sincerely,Anthony
Posted by KarenB on June 28, 2000, at 11:15:37
In reply to Re: provigil/adafinil, posted by Ant-Rock on June 28, 2000, at 8:55:53
Anthony - What changes in mood and physical well being do you notice so far? The addition of Nardil (an MAOI, as I have never trialed this class) is a suggestion my doctor made, after I see what the Provigil will do. Any comments on that one?
Shellie - Hey, I just wanted you to know, I'm not ignoring you:) I just returned from a camping trip to Leadville, CO and then got a virus/sinus infection that has had me down for the last day or so. So...I hesitate to comment on the effectiveness so far. Something is playing games with my stomach, though. Could be the virus, or the migraine med I took after the heavily MSG laden Chinese food Sunday eve. OR the Provigil. I'm hoping it's not the latter but we'll see.
I received my Adrafinil. Cool but now I need to be patient and give the Provigil a fair trial so I can make an intelligent assessment. Patience is not my forte.
Oh, BTW, I have (recently diagnosed) ADD with hypoactivity and depression. I am taking 10mg BUSPAR 3 x a day, in addition to the stimulant. I have dropped the Inderal I was taking to prevent migraine breakthrough from the Adderall, as I have replaced the Adderall with Provigil. I don't want to take any medication if it's not necessary. The migraine from the MSG responded quickly to the meds and I haven't had a repeat attack since, so I guess I could say that so far, the Provigil is not triggering headaches, which is a big plus to me. Today, I'm feeling much better than yesterday, even though I am still sick. Don't worry - when I've had long enough to really know, I'll report my findings on Provigil. But, as they say, YMMV.
I know the Buspar is helping...somewhat... but I'm not where I'd like to be. I took Amineptine plus Sulpiride while in the Philippines and it worked GREAT. I'm looking to feel that good or better and haven't found what I'm looking for yet.
JohnL - Keep typing, man. You have helped me more than you'd imagine by your detail. I am encouraged and feel that I am going to find my magic combo, very soon. So what if I'm wrong - it certainly feels better to have hope, than not. It keeps me going.
Best of health to all of you!
Karen
Posted by S.D. on June 28, 2000, at 15:56:21
In reply to provigil/adafinil, posted by shellie on June 27, 2000, at 18:47:53
>Also, I don't have social anxiety--I'm diagnosed
> with major depression (in addition to a
>dissociative disorder). So I'm particularly
>interested in both these meds for depression,
>either solo, or as a booster. Thanks, Shellie.Here's a very recent journal abstract that is up your alley.
peace and health,
S.D.
---------------------
1: J Clin Psychiatry 2000 May;61(5):378-81Modafinil augmentation of antidepressant treatment in depression.
Menza MA, Kaufman KR, Castellanos A
Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854, USA. menza@umdnj.edu
BACKGROUND: Despite a relative lack of controlled data, stimulants are often used to augment antidepressant treatment in patients who have had only a partial response to first-line therapy. Modafinil is a novel psychostimulant that has shown efficacy in, and was recently marketed for, treating excessive daytime sleepiness associated with narcolepsy. The mechanism of action of modafinil is unknown, but, unlike other stimulants, the drug is highly selective for the central nervous system, has little effect on dopaminergic activity in the striatum, and appears to have a lower abuse potential. METHOD: In this retrospective case series, we describe 7 patients with DSM-IV depression (4 with major depression and 3 with bipolar depression) for whom we used modafinil to augment a partial or nonresponse to an antidepressant. The Hamilton Rating Scale for Depression was administered as part of routine clinical practice prior to treatment and at each subsequent visit. RESULTS: At doses of 100 to 200 mg/day, all 7 patients achieved full or partial remission, generally within 1 to 2 weeks. All patients had some residual tiredness or fatigue prior to starting modafinil, and this symptom was particularly responsive to augmentation. Side effects were minimal and did not lead to discontinuation of the drug in any of the patients. CONCLUSION: Modafinil appears to be a drug with promise as an augmenter of antidepressants, especially in patients with residual tiredness or fatigue. It is a particularly attractive alternative to other stimulants because of its low abuse potential and Schedule IV status.
PMID: 10847314, UI: 20303927
Posted by shellie on June 28, 2000, at 16:20:57
In reply to Article: Modafinil augmentation of antidepressant, posted by S.D. on June 28, 2000, at 15:56:21
Thanks S.D. I had actually read that study before, but forgot how good the odds were. There is also one other small study with modafinil augmentation and each study had one person combining modafinil with an MAOI (I've been on nardil for years). I am not having a good day, so thanks for reminding me of that study--I'll hang in there. shellie
Posted by Ant-Rock on June 29, 2000, at 8:36:17
In reply to Re:prov./adraf.AntRock,Shellie,JohnL, posted by KarenB on June 28, 2000, at 11:15:37
> Anthony - What changes in mood and physical well being do you notice so far? The addition of Nardil (an MAOI, as I have never trialed this class) is a suggestion my doctor made, after I see what the Provigil will do. Any comments on that one?
>
Too soon to really tell, Karen. Parnate isn't taking care of the depression at 60mg, so i may move up in dosage. Yesterday was my 1st day on adrafanil at 300mg, so it's still to soon to judge.
I will keep you posted though.
Sincerely,Anthony
Posted by ROKFURD on September 20, 2006, at 7:09:35
In reply to Re:prov./adraf.AntRock,Shellie,JohnL » KarenB, posted by Ant-Rock on June 29, 2000, at 8:36:17
I took Provigal for about a month. The doc gave me free samples. I was originally seeing the psychiatrist for OCD. To which he subscribed Lexapro. 20 mg a day, I also informed the doc that I was excessively tired because I was working 2 jobs and attending school full time. So it was hard for me to remain alert and focused. So he kicked down some Provigal samples for me to try. Instantaneously I noticed a vast improvement in my focus at school and work. I no longer recall the mg size given. This continued for a few weeks while his free sample stocks were numerous. When they finally ran out I was given a prescription for 30 days. I went to Walmart to have it filled. This was a while back so I don't recall if it was filled on the spot or if there was a hold place. About a week later I received a letter from Blue Cross stating that Provigal had not been approved for the treatment of OCD and was used mainly for Narcolepsy treatment. So my Provigal was not covered and i had to pay retail which was some absorbent amount like $300 or so, maybe more I don't recall. So when I saw the doc I told him about what happened. I then went on to talk to him about another abnormality i suffer from and that was ADHD. A previous Dr. subscribed to me Straterra which did absolutely nothing. So as I cited more examples as to why I was 100% positive I had it he asked some questions and concluded that Adderall might be a good drug for me to try. He started me on 20 mg CR and after a few hours I noticed a tremendous improvement. I was calm, talked slower and wasn't such a spaz. In my opinion the Adderall Cr worked way better than the Provigal. The only problem is after a while you get more immune to its affects and it does have a somewhat uncomfortable comedown. It does give you tremendous energy and a somewhat happy go lucky demeanor. I am currently on 30 mg cr and it is hard to sleep at times. That is why I am up right now. I am half out of it because I took a rohypinal and it is kicking in. So if this post is full of spelling errors or crazy talk please be understanding. As any of you probably know after taking Ambien you sometime get this crazy buzz and start talking gibberish and making no sense at all. I am moving and came across a box of adrafanil I purchased maybe 8-10 years ago through the mail in London. That was back when you could still order GHB. I never took any of the adrafanil and I came online to find out what it was and what it did. That inquiry led me to here. Be warned though about the Adderall as I can see how it can become addicting. As your body adjusts and becomes acclimated to the drug the effects are less and the desire to do more is powerful. I hope this helped and if I babbled I am sorry. I am off to bed finally. :)
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