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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 loolot on September 6, 2003, at 10:54:05
I have just started provigil (about 5 days now). I like the effects on my depression, lack of vigilance, etc, but I cant sleep too well. I tried melatonin last night and it seemed to work okay, although I was on a low dose of provigil yesterday. Does anyone know if these two things work together?
Also, would I be better off on adrafinil because it is a little less potent? The provigil stays in the system for 15 hours average (for me its more like 18-20) , so in order to be able to sleep I have to get up at an ungodly hour.
Also, a silly question, but, if I drink more water will the monafidil leave my system faster?
I have some nausea too.
Should I take the malatonin, should I go on adrafinil? Anyone tried both to compare?
If this doesnt work out I am going on a stimulant!
Posted by utopizen on September 6, 2003, at 17:02:01
In reply to Modafinil+ melatonin for sleep, adrafinil instead?, posted by loolot on September 6, 2003, at 10:54:05
Provigil didn't work for me, I have idiopathic hypersomnia (like narcolepsy's sister, no cataplexy).
And I tried 500mg. So I'm glad to hear Provigil works for you. I have difficulty even with Adderall, so I switched to Xyrem and now I don't even need caffiene, I'm awake all day. Best part: the drug's completely out of your system the moment you wake up, it leaves through exhalating, not even in your urine/stool.
So you don't feel like you're on a drug during the day, yet you're wide awake until you take it to go to sleep, which puts you to sleep instanteously (you're directed to take it while lying in bed!)
Do you feel tired during the day? Provigil, in my opinion, isn't as "safe" as amphetamines... when you consider how many billions of patient years amphetamines have, and their relatively few adverse effects. But it's certainly safer than Adafinal, which I would discourage. It's not even legal in the states, to my knowledge, so it may be a violation to discuss it on this board if you mention how to acquire it or something.
Stick with Provigil. Melatonin has no real research to prove it works, and it only lasts like 2 hours later-- not that I've tried a drug that it that poorly documented.
Ambien is very safe, doesn't interrupt sleep stages like other sleep aides do. Have you tried that? Only downside is that not everyone finds it lasts long enough, so it could leave you with early-morning awakenings.
But in 2005, Ambien-SR is coming. 2005 will also see many hi-tech sleeping pills, including one that is a tweaked version of melatonin that lasts all night.
But I wish doctors realized the implications of having to take drugs for the side-effects of other drugs isn't necessary if Xyrem works for one's sleep and resulting reduction in daytime fatigue. Seriously! I've been able to go off of Desoxyn (methamphetamine) for my ADD just because Xyrem made me sleep so well my ADD symptoms are virtually gone, must have alll been a result of my underlying fatigue during the day.
Xyrem has to be the most under-appreciated drug in psychopharmacology today. It's sad how it will take so long for doctors to feel more "comfortable" about it, even after the intensive, 18-site research trials that proved its safety over thousands of patient years since 2000. Very sad indeed.
I disagree with hating Orphan for their sale of Xyrem. It's necessary that they have enough funds to promote it to doctors with a sales force, otherwise it would never be the success it is today with treating cataplexy. And they desperately needs funds for this, they don't have the infrastructure thatt other companies do who already have sales forces... they have to create their own.
And I think what, they have 20 sales people? They can barely reach sleep disorders centers, let alone psychiatrists! They give it for free if someone qualifies and they have narcolepsy with cataplexy, let's give them some credit-- it took millions to research it for the FDA, to prove it was safe. It was one of the most researched pre-market drugs in the past decade, let's give them our idealogical support.
And no, they don't have a "patent" on Xyrem-- they won't until they release their controlled release, 6-8 hour version. Which is another reason to favor the patent system in this country, otherwise they'd have no incentive to research, develop and test (millions of dollars to do) a method that allows us not to have to re-dose every 2-4 hours at nighttime.
Personally, I think that'll be worth every penny. I have problems with insurance companies paying for Viagra, and I'm a guy (albeit 20). I have no problem with them paying money to a company that could influence the most profound changes in the treatment of psychiatric illnesses this century. More power to them!
Posted by Soljah on September 6, 2003, at 21:44:56
In reply to Re: Modafinil+ melatonin for sleep, adrafinil inst, posted by utopizen on September 6, 2003, at 17:02:01
I used Provigil for about 6 months as a stimulant to help counter the fatigue and daytime somulance cuased by the other meds I was taking for depression.
In order to sleep okay at a reasonable hour, I had to play around with my dosage and the time I took it. I found 100mg was all I really needed, but finding the right time to take it was critical...if I took it 1st thing in the morning I would crash pretty hard by around 4-5pm.
So I would recommend playing around with the time you take the med and also the dosage...you can take 200mg tabs and half or third'em. I would seek the lowest dose that can keep you alert during the important parts of your day.
I had to stop taking it after about 6 months because I would become very edgy if I didn't increase my dosage and then I wouldn't be able to sleep. Hope it works for you, cause when I started it I felt great!
Good Luck!
Posted by loolot on September 6, 2003, at 22:21:33
In reply to Re: Modafinil+ melatonin for sleep, adrafinil inst, posted by Soljah on September 6, 2003, at 21:44:56
> I used Provigil for about 6 months as a stimulant to help counter the fatigue and daytime somulance cuased by the other meds I was taking for depression.
>
> In order to sleep okay at a reasonable hour, I had to play around with my dosage and the time I took it. I found 100mg was all I really needed, but finding the right time to take it was critical...if I took it 1st thing in the morning I would crash pretty hard by around 4-5pm.
>
> So I would recommend playing around with the time you take the med and also the dosage...you can take 200mg tabs and half or third'em. I would seek the lowest dose that can keep you alert during the important parts of your day.
>
> I had to stop taking it after about 6 months because I would become very edgy if I didn't increase my dosage and then I wouldn't be able to sleep. Hope it works for you, cause when I started it I felt great!
>
> Good Luck!
Thanks! The first day I took the provigil it was amazing!I felt really good. It seems to be mellowing out a bit bc I managed to take 100 mg this morning (early) and I feel like I will be able to sleep tonight. This is good, but also not so good because my mood was pretty crummy today. I went off of effexor aprx. 1 1/2 weeks ago so the bad mood may have been the emotional parts of the effexor wearing off.
I may have to do ritalin or adderall in the long run, because I also feel pretty irritable in the afternoon. I am afraid I will build up a tolerance like you did. I also feel like a need something with a little more dopamine stimulating effect, so maybe provigil isnt for me.
I dont know. I am getting really bummed out about this stuff. Since my wellbutrin pooped out I justcant find a good depression med. I hate seratonin acting meds. Ugh
Posted by loolot on September 6, 2003, at 22:28:02
In reply to Re: Modafinil+ melatonin for sleep, adrafinil inst, posted by utopizen on September 6, 2003, at 17:02:01
>
> But I wish doctors realized the implications of having to take drugs for the side-effects of other drugs isn't necessary if Xyrem works for one's sleep and resulting reduction in daytime fatigue. Seriously! I've been able to go off of Desoxyn (methamphetamine) for my ADD just because Xyrem made me sleep so well my ADD symptoms are virtually gone, must have alll been a result of my underlying fatigue during the day.
>
> Xyrem has to be the most under-appreciated drug in psychopharmacology today. It's sad how it will ta,Interesting. I have never heard of this med before. Do you think it works for depression/mood changes? How does it work?
Posted by utopizen on September 7, 2003, at 14:38:32
In reply to Re: Modafinil+ melatonin for sleep, adrafinil inst, posted by loolot on September 6, 2003, at 22:28:02
> Interesting. I have never heard of this med before. Do you think it works for depression/mood changes? How does it work?
>Perhaps, if you notice you are tired during the day, as fatigue can cause irritability, depression and mood swings.
You take it at night, and it's out of your system entirely by the time you wake up. It's hard to believe this is how it works, but not if you appreciate the implications of sleep for the mind-- how it refreshes, helps our memory, more than any stimulant or herb ever could.
It's like super-energizing to your sleep, which helps you be energetic during the day as a result. If you aren't tired during the day, it's difficult to think it would help, realistically-- it helps excessive daytime sleepiness, fibro, narcolepsy and cataplexy, by the research the maker has... it expects future indications as well, and is researching those too. (Including fibro and EDS).
www.xyrem.info
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