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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Smithfrau on February 12, 2004, at 8:04:18
I have had Provigil and Zonegran added to my daily regimine. I have read what others have to say about Zonegran, but I am wondering if anyone has had Provigil used for resistent depression. I am bi-polar and up to this point, ALL antidepressants have flipped me into mania. Provigil seems to act differently. I'd welcome any comments. Thanks.
Smithfrau
Posted by Bill LL on February 12, 2004, at 12:35:45
In reply to Provigil, posted by Smithfrau on February 12, 2004, at 8:04:18
I've never taken either drug, but I think that Provigil is used for depression (along with an antidepessant), especially with people who need more energy. Docs like it because for most people, the side effects are minimal.
Posted by theo on February 12, 2004, at 16:53:12
In reply to Re: Provigil, posted by Bill LL on February 12, 2004, at 12:35:45
Posted by PsychoSage on February 12, 2004, at 23:42:42
In reply to Provigil, posted by Smithfrau on February 12, 2004, at 8:04:18
> I have had Provigil and Zonegran added to my daily regimine. I have read what others have to say about Zonegran, but I am wondering if anyone has had Provigil used for resistent depression. I am bi-polar and up to this point, ALL antidepressants have flipped me into mania. Provigil seems to act differently. I'd welcome any comments. Thanks.
>
> Smithfrau
I take Trileptal 1200mg and wellbutrin xl300, and I just added Provigil 100mg. I am starting at 50mg which is my choice. The second day just ended, and it is not like amphetamine or methylphenidate so far. I am bipolar also.I am using it for energy and attention because I have ADD symptoms from meth abuse which ended 3 years ago.
I will be exploring this one side by side with you. I would stay away from Schedule 2 stimulants though. A bipolar friend, highly intelligent; we met at our renowned university, just recently suffered a hideous depression, and she ie recuperating at her parents. She was on Ritalin, and it was for her depression and energy. I think it burned her brain out.
It really depends who you are though, but stick with the provigil, and I would try to stay on the lowest dose as possible for the longest time since we know these drugs all tend to poop out eventually.
I need to stay aware of psychotic symptoms and rage while on this. I was never violent or raged on anyone, but my doctor emphasized the dopamine issue. Naturally, those symptoms coincide with mania, so keep an eye out.
Posted by Smithfrau on February 13, 2004, at 8:51:08
In reply to Re: Provigil, posted by PsychoSage on February 12, 2004, at 23:42:42
I had used Ritalin for a while, it helped the depressions, but eventually I felt the pressure building up that signals for me an oncoming manic episode, so that's no longer a possibility. I also take only 50 mg of Provigil, although at my disgression I have permission to take a prn dose of 100 mg if I hit a day when I am flattened with depression.
I had been told that my pattern of sleeping during depressions (most of the time) was because of lack of structure in my life. I had a doc who refused to treat me anymore because she felt I was not "engaged" in outside life. I tried to point out that I was a super-compliant patient, but that the issue of this depressive lethargy was something I couldn't control. Now, with the Provigil, I can get up, keep house, engage in hobbies, read, get out, etc. It's great to wake up and feel as if I want to get out of bed and do things. Any comments?
Posted by PsychoSage on February 13, 2004, at 11:34:38
In reply to Re: Provigil » PsychoSage, posted by Smithfrau on February 13, 2004, at 8:51:08
I hope that happens to me. I feel so guilty for living like a basketcase. My life before mental illness was about striving, curiosity, achieving, and hard work. Now I wish I can just read a news article and understand what it means. I don't want to be paralyzed by racing thoughts and loops in my mind. I'll keep posting abut how I am feeling and doing.
Posted by Smithfrau on February 13, 2004, at 12:04:35
In reply to Re: Provigil » Smithfrau, posted by PsychoSage on February 13, 2004, at 11:34:38
> I hope that happens to me. I feel so guilty for living like a basketcase. My life before mental illness was about striving, curiosity, achieving, and hard work. Now I wish I can just read a news article and understand what it means. I don't want to be paralyzed by racing thoughts and loops in my mind. I'll keep posting abut how I am feeling and doing.
By all means, keep posting: it will help you feel less alone. I know about life before and after this illness. I had a full National Merit Scholarship to U of Michigan and got my MS at Columbia. Worked in my field against all odds for twenty years, while the illness got worse and worse. Finally a p-doc who was head of a prestigious hospital's psychiatric program told me he thought I needed to file for disability or I would destroy myself. Three weeks later the disability was okayed. I don't say that with pride, quite the reverse, but I do think it saved my life. My nearest sibling had killed himself some years ago, and I was headed there.
As to being a basketcase, please try not to judge yourself so harshly: it will only harm you. I like to believe that I work as hard in managing my illness as I ever did in my career. I am super-compliant about meds, although my current p-doc and I have tried eveything in the field: we keep trying. I also belive in faith and trust. Not in the sense of religion, but in fighting to retain optimism. I should also mention that my husband is a rock; I don't know where he gets his patience. I see my p-doc every week and we see a family therapist every week too. I am also followed by a case manager from a local psychiatric facility. I feel I do my part and that is super-important.
I wish you the best. Write all you want, up or down, or questions.
sincerely,
Smithfrau
Posted by PsychoSage on February 13, 2004, at 13:13:44
In reply to Re: Provigil » PsychoSage, posted by Smithfrau on February 13, 2004, at 12:04:35
> > I hope that happens to me. I feel so guilty for living like a basketcase. My life before mental illness was about striving, curiosity, achieving, and hard work. Now I wish I can just read a news article and understand what it means. I don't want to be paralyzed by racing thoughts and loops in my mind. I'll keep posting abut how I am feeling and doing.
>
> By all means, keep posting: it will help you feel less alone. I know about life before and after this illness. I had a full National Merit Scholarship to U of Michigan and got my MS at Columbia. Worked in my field against all odds for twenty years, while the illness got worse and worse. Finally a p-doc who was head of a prestigious hospital's psychiatric program told me he thought I needed to file for disability or I would destroy myself. Three weeks later the disability was okayed. I don't say that with pride, quite the reverse, but I do think it saved my life. My nearest sibling had killed himself some years ago, and I was headed there.
>
> As to being a basketcase, please try not to judge yourself so harshly: it will only harm you. I like to believe that I work as hard in managing my illness as I ever did in my career. I am super-compliant about meds, although my current p-doc and I have tried eveything in the field: we keep trying. I also belive in faith and trust. Not in the sense of religion, but in fighting to retain optimism. I should also mention that my husband is a rock; I don't know where he gets his patience. I see my p-doc every week and we see a family therapist every week too. I am also followed by a case manager from a local psychiatric facility. I feel I do my part and that is super-important.
>
> I wish you the best. Write all you want, up or down, or questions.
>
> sincerely,
>
> Smithfrau
>
>
Thanks for personalizing your response with some color and volume. I have been on leave from UPenn {undergrad} every other year for what seems forever. Zyprexa knocked me out of my last comeback which began relatively promising. During my last time there I was happy to have a little work-study job again and to have some purpose. I worked in the office of a very prominent psych professor for his grad students and secretary. I miss the environment. I have been exorcising demons in the meantime. Fortunately, I've had an appalling string of victories over substance abuse this time around. However, I am still mad at Zyprexa. I am mad at my choice to take it after a substitute doctor at school psych services convinced me before the fall of 02. I became stubborn, and I stuck with it. I gained 35 pounds in 6 weeks, and I began to sleep 10 hours a day. I still insisted I could get by, but I was delusional about Zyprexa ironically. Up to now I just haven't mustered up the courage to finish my incompletes and return. I have two puny papers, but this is my recurrent roadblock. I have used the "w" to move on before, but I have so many that I can not utilize that option. The final paper is my nemesis.I am trying provigil in an attempt to light my gas stove. I realize that other issues and compulsions aside from substances have impeded me during my comeback in 2002 and to this day. My condition before Zyprexa in 2002 was one of weak academic stamina, but I wanted to change that through working through a full course load. I want to build some strength now, and unfortunately, I think I need some scripts to help in this area of life. In the mean time, I am still untangling my life's mess, but it is time to make some moves. My friends are in grad school or have well-paying jobs which as symbols remind of the work I haven't completed. I have one more year after I return. It's really important to me that I reach a state where I know I am working hard for many days and weeks and months without worrying excessively about the outcome. That is more important because that leads to the outcome and that is the reward really. I can't get the engine started though.
Posted by Smithfrau on February 14, 2004, at 6:07:40
In reply to Re: Provigil, posted by PsychoSage on February 13, 2004, at 13:13:44
It's really posible that Provigil may help you: but I feel I should add the proviso that the differences between individuals are far greater that their shared similarities when it comes to psychotropic meds. I do, however, agree with you about Zyprexa: I detest it. Fortunately, my p-doc listens when I tell him things AND is an astute observer. He saw how emotionally and cognitively flat Zyprexa made me and we switched to Serequel (a low dose at that.) After thirteen years on Depakote, I am finally pressing, respectfully, but insistently, to have it titrated down, replacing it with Zonegran. Be your own advocate!
I can't comment on the substance abuse except to say that when I referred a dear friend (and a brilliant artist) to a doctor for bi-polar disorder, he was unable to help her due to her past (not present) abuse problems. Nevertheless, I urge you to continue your struggle.
One last insignificant coincidence: my youngest brother got his Ph.D. last summer and now works at U Penn--Erie. I'm sure you're at Mother Ship, but the "small world" feeling always tickles me.
sincerely,
Smithfrau
Posted by PsychoSage on February 15, 2004, at 4:02:13
In reply to Re: Provigil » PsychoSage, posted by Smithfrau on February 14, 2004, at 6:07:40
> It's really posible that Provigil may help you: but I feel I should add the proviso that the differences between individuals are far greater that their shared similarities when it comes to psychotropic meds. I do, however, agree with you about Zyprexa: I detest it. Fortunately, my p-doc listens when I tell him things AND is an astute observer. He saw how emotionally and cognitively flat Zyprexa made me and we switched to Serequel (a low dose at that.) After thirteen years on Depakote, I am finally pressing, respectfully, but insistently, to have it titrated down, replacing it with Zonegran. Be your own advocate!
>
> I can't comment on the substance abuse except to say that when I referred a dear friend (and a brilliant artist) to a doctor for bi-polar disorder, he was unable to help her due to her past (not present) abuse problems. Nevertheless, I urge you to continue your struggle.
>
> One last insignificant coincidence: my youngest brother got his Ph.D. last summer and now works at U Penn--Erie. I'm sure you're at Mother Ship, but the "small world" feeling always tickles me.
>
> sincerely,
>
> Smithfrau
Mother ship? I am not sure what you mean. Is there a PSU campus at Erie? Are you talking about PSU? I am on leave from the University of Pennsylvania which is the private school in Philadelphia.
How is Zonegran? I have never heard of that anticonvulsant before until last month. I may suggest it to a friend. What are its benefits? Depakote is very sedating I have noticed through others.I am sober now, and I have not abused anyting illicit in 34 months, and I have not had alcohol in 2 years. I still have to be on top of anything that may make me slip. Stimulants are powerful enough to create a euphoria long and powerful enough for me to set aside long term consequences for a short term high. I use to think that time and change can put a person in recovery further from any desires or irrational thinking, but that is far from the truth. A combination of poor factors with a strong psychiatric drug can lead to a relapse.
Luckily, there are dual diagnosis clinicians out there.
I would love to hear more about provigil as things progress for you.
Take care.
Posted by Smithfrau on February 15, 2004, at 7:22:30
In reply to Re: Provigil, posted by PsychoSage on February 15, 2004, at 4:02:13
"Mother ship" is an old idiom meaning that I know you go to the main campus of the private University of Penn in Philapelphia. My brother teaches at a satellite campus of the same school in Erie, PA.
Zonegran is a relatively new anti-convulsant being used in treatment of bi-polar disorder in the same way as older ones like Depakote, etc. It is somewhat less sedating, especially as you become acclimatized to it over time. It's also cleaner in many respects: you don't gain weight on it for the most part, for example. BE WARNED: there are some life-threatening side-effects for a very small minority of patients. (See the Zonegran thread here at Psycho-babble.) It has worked well for me, however, but I was put on a psych-ward while I titrated off my old meds and onto Provigil and Zonegran. Nasty, but in my case, at least, necessary, as I often over-react to med-changes. Can't take any anti-depressant: I cycle immediately and become manic.
I meant to wish you good luck with your paper. The pressure of unfinished papers is the bane of academia, without adding in a psych-dx. Good luck with it.
I can't comment on the substance abuse issue except to say that I know it complicates pychiatric illnesses and their diagnoses. Glad you have found a good dual-diagnosis clinician.
Be well.
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