![[dr. bob]](/dr-bob-sm.gif)
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 Zo on March 18, 2002, at 17:19:55
I think I had the best week of my entire life, last week. Added Progivl to my already good meds, as it seemed to offer more mental clarity. Which I got--and then on the 7th day, it totally disappeared. I am horrified, and very scared and very low. It didn't feel like hypomania--and I don't poop-out problems, as a rule. Sometimes meds have begun well and then have to build back up--but this is severe, the difference btwn. night and day.
I thought Provigil worked on that day. Does it have to build up? Will the good part come back? What does this mean? I don't understand, and am profoundly discouraged. It's been such a loooong search. Any help appreciated.
Zo
Posted by IsoM on March 18, 2002, at 18:12:22
In reply to Need Provigil HELP - JohnX2? Anybody?, posted by Zo on March 18, 2002, at 17:19:55
Zo, this is only conjecture that I offer, but I do think there's some basis in truth here.
When I first started taking adrafinil (Provigil's cousin), I found no effect for the first week. Week two showed some improvement then week three was good. Week four was great & it continued great for another month. Then I noticed I still had benefits from adrafinil but not as strong as I'd noticed as previously & wondered why.
I'm very much a skeptic & never have had a placebo effect with any meds, even when I fully expected them to work, so I know it wasn't myself thinking it was working. But I got thinking of how our body reacts to something new & good. As someone with ADD too, I know I strongly react like this. When something exciting comes along in our life (or something that makes us excited & happy - like falling in love), our brain's all concerned & focused on this new 'event' & releases a chemical called PEA, or phenylethylamine. It's an amphetamine-like substance that further releases dopamine. The combination of the two gives us that bright, focused, energetic, so good feeling. Because our brains can't maintain that 'high' for too long without becoming depleted, the effects will wear off. When our natural 'high' has worn off, then we're left with the real effects of the new medication & its effects only.
I find that to truly benefit from adrafinil, I nneded to increase my dose & I once again feel better. Now, it's only the adrafinil working & not my PEA too. I'm wondering if it's possible that you did have a placebo effect & now that it's worn off, you need Provigil increased? Some have mentioned that they felt an immediate effect from Provigil or adrafinil but I didn't. I did need a short time for it to kick in, much like most ADs. From the literature that I've read on it, so did most others.
Posted by Mark H. on March 18, 2002, at 18:51:28
In reply to Need Provigil HELP - JohnX2? Anybody?, posted by Zo on March 18, 2002, at 17:19:55
Zo,
My experience with Provigil was mixed. On one tablet, I didn't feel anything. On two, however, I felt considerably better within about one hour (on an empty stomach in the morning).
It worked fine for the three months or more that I took it, except that I lost all motivation and got almost nothing accomplished! Fortunately for others, my experience was unusual in this regard.
I'm sorry you've had a set-back.
Best wishes,
Mark H.
Posted by 3 Beer Effect on March 18, 2002, at 22:01:44
In reply to Need Provigil HELP - JohnX2? Anybody?, posted by Zo on March 18, 2002, at 17:19:55
Be sure to take 200 mg/day, the standard starting dose. Many doctors try to prescribe 100 mg which is usually too low. Steady state blood level is reached in about 3 days. Provigil 200 mg worked great all day for almost 2 months, but now the benefits are waning & the benefits only last 5-6 hours. An increase to 400 mg would help most anyone- they recently found out the effects of Provigil are dose related. 87% of narcoleps improved on 400 mg versus only 27% on 200 mg.
I am going to switch to the long acting Dexedrine Spansules, or perhaps Focalin (the new d-isomer only of Ritalin) which is short acting (3.5 hrs) like Ritalin but causes equal brain stimulation with less nervousness.
Posted by Zo on March 19, 2002, at 0:10:59
In reply to for me, worked for 2 months then pooped out, posted by 3 Beer Effect on March 18, 2002, at 22:01:44
pdoc called, and he is of the opinion i shoulda stayed at 100mg. . .but what a counter-intuitive med. i didn't know it takes like 48 hrs to drop or increase to steady state. i did well at 100, seriously crashed at 200. .. and am HUGELY relieved to learn that provigil just doesn't provoke mania. i know its pathways are very different. . .unusual for a med to have such a narrow window, and to really fork one up if the dose is too high.thanks so much for your support. i was just banging off the walls, it made no sense.
zo
Posted by JohnX2 on March 19, 2002, at 4:32:08
In reply to Need Provigil HELP - JohnX2? Anybody?, posted by Zo on March 18, 2002, at 17:19:55
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.