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Dr. Bob is Robert Hsiung, MD,
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Posted by tecknohed on February 3, 2008, at 1:34:45
In reply to Re: What dose of provigil are you on?, posted by delna on January 30, 2008, at 11:31:45
As an alternative to Provigil you could try ALCAR (Acetyl-L-Carnitine). If it wern't for ALCAR I would be fatigued most of the day. I get mine from here: http://www.1fast400.com/?products_id=1186 at a very reasonable price. Take 2-3g per day. Split doses into 2 - morn & midday. Take on an empty stomache at least 1/2hr BEFORE food, preferably stirred into fruit juice as its very acidic. 1/4tsp = 620mg. It wont interact with your meds.
Bupropion MIGHT be another option but it may interact with your AP &/or bipolar. Might be worth asking your doc though. For me it was ALOT more stable than what Provigil ever was.
IMHO I think Provigil might not be the best med for you.
Just suggestions ;)
teck
Posted by tecknohed on February 3, 2008, at 1:34:45
In reply to Re: What dose of provigil are you on?, posted by delna on January 30, 2008, at 11:31:45
Some reviews on ALCAR can be found here: http://www.1fast400.com/product_reviews.php?products_id=1186
and here: http://www.revolutionhealth.com/drugs-treatments/rating/acetyl-l-carnitine-for-chronic-fatigue-syndrome-cfs-cfids-me
Heres a study: http://www.psychosomaticmedicine.org/cgi/content/full/66/2/276
And heres a recent thread: http://www.dr-bob.org/babble/alter/20071031/msgs/801402.html
Posted by kingcolon on February 5, 2008, at 18:06:53
In reply to Re: What dose of provigil are you on? » delna, posted by tecknohed on February 3, 2008, at 1:34:45
Here's a recent article on ALCAR for fatigue in the elderly. If it works for them, I suspect it might for younger folks too. I've tried Provigil too, but find it unpredictable and possible loses efficacy with time. It also can make me a little anxious or tense, and causes a severe dry mouth, even with 100mg. The ALCAR does seem to help. I'm using 1200 mg daily.
Posted by kingcolon on February 5, 2008, at 18:13:42
In reply to Re: What dose of provigil are you on? » delna, posted by tecknohed on February 3, 2008, at 1:34:45
Sorry, the link I gave doesn't seem to go to the article directly on Pub Med. Here's a copy of the abstract.
Acetyl l-carnitine (ALC) treatment in elderly patients with fatigue.
Malaguarnera M, Gargante MP, Cristaldi E, Colonna V, Messano M, Koverech A, Neri S, Vacante M, Cammalleri L, Motta M.Centro di Ricerca La Grande Senescenza, Università degli Studi di Catania, Via Messina 829, I-95126 Catania, Italy.
Fatigue is one of the conditions most frequently complained by the elderly. There are few effective treatment options for patients with chronic fatigue syndrome. To determine the efficacy, tolerability and impact on the fatigue, as well as on cognitive and functional status of elderly subjects with acetyl l-carnitine (ALC), 96 aged subjects (>70 years, range 71-88) were investigated (50 females and 46 males; mean age 76.2+/-7.6 and 78.4+/-6.4 years, respectively). They met four or more of the Holmes major criteria or at least six of Fukuda minor criteria. Fatigue was measured with the Wessely and Powell [Wessely, S., Powell, R., 1989. Fatigue syndromes: a comparison of chronic postviral fatigue with neuromuscular and affective disorders. J. Neurol. Neurosurg. Psychiatry 52, 940-948] scores, with the fatigue severity scale. At the end of the treatment, we observed a decrease of physical fatigue: 6.2 (p<0.001), of mental fatigue: 2.8 (p<0.001), of severity fatigue: 21.0 (p<0.001) and improvements in functional status: 16.1 (p<0.001) and cognitive functions: 2.7 (p<0.001). By the end of the treatment, significant differences between the two groups were found for the following parameters: muscle pain -27% versus -3% (p<0.05); prolonged fatigue after exercise: 51% versus -4% (p<0.0001); sleep disorders: 28% versus 4% (p<0.05); physical fatigue: 7 versus -0.5 (p<0.0001); mental fatigue: -3.3 versus 0.6 (p<0.0001); fatigue severity scale: -22.5 versus 1.2 (p<0.0001); functional status 17.1 versus 0.6 (p<0.0001); mini mental state examination (MMSE) improvements: 3.4 versus 0.5 (p<0.0001). Our data show that administering ALC may reduce both physical and mental fatigue in elderly and improves both the cognitive status and physical functions.
PMID: 17658628 [PubMed - as supplied by publisher]
Related Links
* L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial. [Am J Clin Nutr. 2007]
* The feeling of fatigue--fatigue severity by unidimensional versus composite questionnaires. [Behav Med. 2004]
* Transdermal buprenorphine patches applied in a 4-day regimen versus a 3-day regimen: a single-site, Phase III, randomized, open-label, crossover comparison. [Clin Ther. 2007]
* Fatigue in chronic migraine patients. [Cephalalgia. 2002]
* Cognitive dysfunction and depression may decrease activities in daily life more strongly than pain in community-dwelling elderly adults living with persistent pain. [Pain Pract. 2007]
* » See all Related Articles...Display
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