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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Mandybella on May 11, 2004, at 14:37:38
My psych dr recently started me on provigil because of fatigue and difficulty getting going in the morning plus I have sleep apnea and am on CPAP. I am also on mood stabilizers and antidepressants for bipolar. So much medicine!! My question is does provigil work right away and does it work the same each day? It seemed to help in the beginnng but not lately? So can I stop and start this med or is it like AD's that take time to get working in the body? I hate taking another medication if it is not really helping and I am just not sure if this helps or not. Thanks for any input
Posted by blondegirl47 on May 11, 2004, at 15:21:56
In reply to Question about provigil, posted by Mandybella on May 11, 2004, at 14:37:38
Provigil didn't work for my ADD, It actually made me tired and hungry all of the time. If it worked at first maybe you just need to fine toon your dose. I would talk with your pdoc. Its one of the most expensive medications you can take, if its not working I'd want to try something else. Not sure about stopping all of a sudden. I would do a search on provigil on this site. It has been discussed quite a bit. :) Good luck, I know getting your meds right is very frustrating.
Blondegirl
Posted by psychosage on May 11, 2004, at 22:19:08
In reply to Question about provigil, posted by Mandybella on May 11, 2004, at 14:37:38
> My psych dr recently started me on provigil because of fatigue and difficulty getting going in the morning plus I have sleep apnea and am on CPAP. I am also on mood stabilizers and antidepressants for bipolar. So much medicine!! My question is does provigil work right away and does it work the same each day?
it works in two hours and peaks about four hours after taking it.
Side effects take a couple weeks to go away, and it will appear strongest as far as stimulation in the beginning until you tolerate it a little.
It seemed to help in the beginning but not lately?It should work in the background. You should not be constantly self-conscious of being revved up all the time. It's not supposed to feel that way. So, you should have less "subjective" effects and less of the initial supercharge that came in the beginning when your body was niave to it, naturally.
So can I stop and start this med or is it like AD's that take time to get working in the body? I hate taking another medication if it is not really helping and I am just not sure if this helps or not. Thanks for any input
You can take as needed, and there is little withdrawal, but going on and off may subtley make you cranky. It depends on the person.
I find it to be a powerful and positive drug that helps me tolerate my antidepressant and mood stabilizer. It's far more manageable than ritalin or amphetamines which are more powerful in overall physical stimulation, but have harsher come downs and are more prone to cause depression in some people due to the bumpy ride. As far as building tolerance, provigil is not worse than any other stimulant.
My suggestion is to go slow and to build up on the dose until you reach something high then take holidays. I imagine a lot of people will end up having to increase the dosage overtime to get more oomph.
It's like coffee or cigarettes. They can be nice and can work, but they are not as potent as they were when you first tried them or first had them again after a long layoff.
Posted by psychosage on May 12, 2004, at 1:56:20
In reply to Question about provigil, posted by Mandybella on May 11, 2004, at 14:37:38
> My psych dr recently started me on provigil because of fatigue and difficulty getting going in the morning plus I have sleep apnea and am on CPAP. I am also on mood stabilizers and antidepressants for bipolar. So much medicine!! My question is does provigil work right away and does it work the same each day? It seemed to help in the beginnng but not lately? So can I stop and start this med or is it like AD's that take time to get working in the body? I hate taking another medication if it is not really helping and I am just not sure if this helps or not. Thanks for any input
Here is an article that proves my point about Provigil working yet not being noticeable in the last paragraph.http://www.af.mil/news/story.asp?storyID=123007615
Air Force scientists battle aviator fatigue
HOLLOMAN AIR FORCE BASE, N.M. -- An F-117A Nighthawk pilot takes a computerized aviation simulation test during a research study into aviator fatigue. (Courtesy photo)
by Tech. Sgt. J.C. Woodring
Air Force Print News4/30/2004 - BROOKS CITY-BASE, Texas -- Air Force scientists here are using their research to help battle fatigue in aviators.
“Fatigue from sustained operations can place pilots at severe risk from (decreased alertness) unless effective fatigue-management strategies are (used)” said Dr. John Caldwell, a scientist with the Air Force Research Laboratory’s fatigue countermeasures branch here.
One strategy involves using medications to enhance alertness. For more than 60 years, dextroamphetamine was the Air Force’s “go pill” of choice. In December, a new compound, modafinil, was approved for some bomber missions, he said.
The scientists studied the effectiveness of modafinil on pilots of single-seat fighters.
Before testing modafinil, researchers studied fatigue in F-117A Nighthawk pilots at Holloman Air Force Base, N.M. They looked at the effects of being awake for 37 hours on alertness and flight performance.
Laboratory and simulator tests were repeated every five hours to help track the pilots’ level of fatigue, officials said.
Researchers looked at the aviators’ ability to monitor flight gauges and calculate basic mathematical equations. They also monitored eye movements and changes in pupil size.
While no one crashed or even came close to crashing, researchers said flight precision most noticeably changed between 9 a.m. and 2 p.m. of the second day of the test.
“This surprised us because we thought it would happen much earlier in the day,” said 2nd. Lt. Jennifer Smith, a behavioral science specialist at the laboratory who worked on the study.
Armed with this data, the scientists returned to Holloman a few months later for the modafinil study.
Once again they repeated the same tests as before; but this time, the pilots were given modafinil.
Scientists said that while the pilots were on the medication, their performance “significantly improved,” especially after 25 hours without sleep. The pilots also sustained brain activity at almost normal levels despite their sleeplessness.
During the simulator tests, modafinil “significantly” reduced the effects of fatigue during flight maneuvers, researchers said.
Under the influence of modafinil, flight performance degraded by 15 to 30 percent. Performance by pilots without the medication degraded by 60 to 100 percent below rested levels.
Researchers concluded that the medication was effective for reducing the impact of fatigue; however, aircrew members did not entirely maintain performance at fully rested levels.
Until more research is done, scientists said modafinil should be viewed as an option to, but not as a replacement for, dextroamphetamine. A 100-milligram dose of modafinil was apparently less effective as three 10-milligram doses of dextroamphetamine.
“Pilots who choose to use modafinil should be warned that [its] effects often are not readily noticeable despite the fact that the drug is working effectively,” Dr. Caldwell said. “Therefore, they should not prematurely discontinue modafinil without consulting with a flight surgeon.”
This is the end of the thread.
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