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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by qbsbrown on March 21, 2010, at 20:25:31
I just recently started this combo. Although I do understand that one is a cns depressant, and the other a mild stimulant, I find that they work well. The xanax controls the anxiety, while the provigil helps the depression and adhd problems. In most places I see that the max provigil is 400mgs, but we would like to take 600mgs, 200 3xs a day, along with my xanax 2mgs 3 times a day. Do you foresee issues with this?
Eventually we are also going to attempt to add celexa, and some trileptal.
Thank you for pointing out an glaring contradictions in taking these meds, but I feel as if it might work well for me.
Thank you for the input.
Regards,
Brian
Posted by alchemy on March 22, 2010, at 20:08:50
In reply to Provigil + xanax an ok combo?, posted by qbsbrown on March 21, 2010, at 20:25:31
I've tried Provigil while taking Xanax. I had high hopes, but Provigil didn't really do anything for me. I don't know what the different mechanisms are, but they can be taken together.
Posted by qbsbrown on March 25, 2010, at 18:14:52
In reply to Re: Provigil + xanax an ok combo?, posted by alchemy on March 22, 2010, at 20:08:50
Provigil, seemingly one of the very few meds that has ever worked for me. Does the max dose say 400mgs? But i've seen Drs push it higher to 600-800, especially for bipolar depression/adhd. Is this uncommon?
Regards,
Brian
Posted by qbsbrown on March 28, 2010, at 12:59:01
In reply to Is there a max dose for Provigil???, posted by qbsbrown on March 25, 2010, at 18:14:52
Thoughts?
Posted by Justherself54 on March 28, 2010, at 13:59:47
In reply to Re: Provigil + xanax an ok combo?, posted by alchemy on March 22, 2010, at 20:08:50
I don't know what the max dosage would be. I would think it would vary depending on what it's being used for. I think it was primarily used for narcolepsy and sleep apnea. I have fibromyalgia which comes with "fibro fog". This med really helps with that symptom.
I take 100 mg in the AM, sometimes an extra 100 in the early afternoon. Works very well for me with no side effects. It makes me more alert and focused. If I have to be in an social situation where my anxiety might get out of control, I take a small amount of clonazapam along with it, so I don't see why Xanax couldn't be taken, but I'd check with your doctor to make sure.
It's been a very good med for me.
Posted by bearfan on April 1, 2010, at 16:53:26
In reply to Provigil + xanax an ok combo?, posted by qbsbrown on March 21, 2010, at 20:25:31
I remember reading somewhere it was 400mg, but I guess you could goto 600mg with your doctors supervision.
Posted by anewoman on July 1, 2010, at 11:56:27
In reply to Is there a max dose for Provigil???, posted by qbsbrown on March 25, 2010, at 18:14:52
Hi Brian ~ I had the same question myself and Googled - found this study, which says that up to 600 should be OK safety-wise before (at 800) experiencing increased blood pressure and pulse:
"A double-blind, placebo-controlled, ascending-dose evaluation of the pharmacokinetics and tolerability of modafinil tablets in healthy male volunteers" by Wong YN, Simcoe D, Hartman LN, Laughton WB, King SP, McCormick GC, Grebow PE; Drug Safety and Disposition, Cephalon, Inc., West Chester, Pennsylvania, USA. J Clin Pharmacol 1999 Jan; 39(1):30-40
ABSTRACT
A randomized, double-blind, placebo-controlled, ascending-dose study was conducted to evaluate the pharmacokinetic and safety profiles of increasing modafinil doses (200 mg, 400 mg, 600 mg, 800 mg) administered orally over a 7-day period in normal healthy male volunteers. Eight subjects (six modafinil; two placebo) were randomized to each of the four dose groups. Modafinil or a placebo was administered once daily for 7 days. Serial blood samples were obtained following administration of the day 1 and day 7 doses for characterization of pharmacokinetics, and trough samples were obtained prior to dosing on days 2 through 6 to assess the time to reach the steady state. Pharmacokinetic parameters were calculated using noncompartmental methods. Modafinil steady state was reached after three daily doses. Modafinil pharmacokinetics were dose and time independent over the range of 200 mg to 800 mg. Steady-state pharmacokinetics of modafinil were characterized by a rapid oral absorption rate, a low plasma clearance of approximately 50 mL/min, a volume of distribution of approximately 0.8 L/kg, and a long half-life of approximately 15 hr. Modafinil was primarily eliminated by metabolism. Modafinil acid was the major urinary metabolite. Stereospecific pharmacokinetics of modafinil were demonstrated. The d-modafinil enantiomer was eliminated at a threefold faster rate than 1-modafinil. Modafinil 200 mg, 400 mg, and 600 mg doses were generally well tolerated. The modafinil 800 mg dose panel was discontinued after 3 days of treatment due to the observation of increased blood pressure and pulse rate. The safety data from this study suggest that the maximum tolerable single daily oral modafinil dose, without titration, may be 600 mg.
Regards, Amanda
> Provigil, seemingly one of the very few meds that has ever worked for me. Does the max dose say 400mgs? But i've seen Drs push it higher to 600-800, especially for bipolar depression/adhd. Is this uncommon?
>
> Regards,
>
> Brian
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