Posted by Racer on August 30, 2007, at 11:23:17
Hi, I got a Babblemail the other day asking me about Provigil. I hope the sender will read this, since it is in response to that babblemail, and I do want to answer as best I can.
In general, if it's a question that I think might be helpful to others, I prefer to have these interactions on the board, rather than privately, and this was about why I chose to discontinue Provigil after a couple of years. I figure that's something that might be of use to someone later on, so here's the answer on the board.
The questions, with the answers:
"Did you d.c. Provigil because you developed a tolerance you think?"
No. It still worked as well as ever as far as alertness went. What changed was its effect on my mood. I took it to augment my response to antidepressants, and found that it had good mood brightening properties of its own. It did more for my mood for a time than anything else, and it did a great job.
After about two years, though, it lost its mood brightening effects, and seemed to increase my depression. At that point, I stopped it, which is too bad, because I didn't sleep nearly as well without it. (Go figure -- take an alertness drug, and I sleep better...)
"How does Provigil differ from Adderall?"
Adderall is an amphetamine, while Provigil is not. Provigil inhibits GABA, as well as the reuptake of dopamine and norepinephrine. Adderall was not my friend -- increased depression -- so I don't know much about its effects from a subjective standpoint. I do know that Provigil was much smoother for me than pretty much all the conventional psychostimulants.
"Is Provigil 400mg a day way out of line?"
Depends on the doctor. I found 150mg to be ideal for me -- 100mg at breakfast, and 50mg at lunchtime. I think the official story is that 200mg is the highest dose ever necessary. I don't think that's true, based on clinical pictures. Too many people have written about needing higher doses, and at one point I asked about raising it. (VERY conservative pdoc at that point.) The 200mg didn't last me through out the day, and I'd crash heavily about mid afternoon. By splitting the dose, and front loading it -- taking more in the morning, less at lunchtime -- I didn't crash, and my sleep was just wonderful.
Whether 400mg would work for you, you'd have to talk to your doctor about whether it's worth trying.
I hope that answers your questions.
poster:Racer
thread:779747
URL: http://www.dr-bob.org/babble/20070824/msgs/779747.html