![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by zana on September 27, 2003, at 16:47:53
Have been taking Provigil (200mg am and afternoon) as aguementation to Prozac (30mg)for 11/2 yrs. Provigil worked well except for some muscle stiffness, blah stomach and a terrible crash every 10-14 days.
Have recently started Lamictal. BI 2 so mood stabilizer may make sense and is supposed to be good antidepressant. Would love to decrease prozac since sex is completely forgotten and have been having sweats and tendonitis.
Am now exhausted every evening even after taking a nap and have to sleep again for an hour or two before I can eat dinner for which I have no appetite since either the 2nd Provigil or the Lamictal is making me nauseous.
Also have noticed since increasing Lam. to 75mg lots of anger.
If I don't take Provigil am listless and irritable. If decrease Prozac am depressed.
Anyone have any experience or insight? It's all driving me crazy.
Thanx
Posted by HenryO on September 27, 2003, at 23:40:17
In reply to Provigil Weirdness, posted by zana on September 27, 2003, at 16:47:53
It can be very useful to change only one element of your med cocktail at a time in order to determine what is causing what.
Posted by zana on September 28, 2003, at 11:23:03
In reply to Re: Provigil Weirdness, posted by HenryO on September 27, 2003, at 23:40:17
Thanx. That's good advice but have only added lamictal and have been having 10-14 day crash with provigil all along.
Anybody else have these cycles with provigil?
Posted by Ame Sans Vie on September 28, 2003, at 19:26:09
In reply to Provigil Weirdness, posted by zana on September 27, 2003, at 16:47:53
> If I don't take Provigil am listless and irritable. If decrease Prozac am depressed.
Hmm... how about decreasing the Provigil? Maybe 200mg AM and 100mg PM? Or the dosing schedule? Like 150/150/100? And if that seems to help at all but the lowered stimulant dose seems to be causing some problems, perhaps you could try an augmentation with a very small dose of methylphenidate or dextroamphetamine, like 5 or 2.5mg respectively. Failing that, what about trading off the Provigil for another pstim entirely (or Strattera/Edronax, for that matter)?
Posted by HenryO on September 28, 2003, at 22:56:16
In reply to Provigil Weirdness, posted by zana on September 27, 2003, at 16:47:53
I always felt that the Provigil was boosting my energy now at the cost of exhaustion later.
Also I think that long term Prozac use wacks out your chemistry and actually limits depression improvement up to a certain point. I remember that tiredles. It has taken a bit less than a year to recover my libido. It's nice.
Even though you feel like poop, the meds may be doing more than you think. After I quit the Prozac and before the Lamictal had started to work, I went through a period of terrible emotional pain.
Keep moving up the ladder with the Lamictal nice and slow. It has been the best thing I've taken to date. Of course your results may vary.
You are doing very nearly what I did and it has worked out great for me. I take only Lamictal now, 225mg a day. Ocassionally I take 18mg of Concerta (Ritalin slow release)
Posted by HenryO on September 28, 2003, at 23:03:19
In reply to Provigil Weirdness, posted by zana on September 27, 2003, at 16:47:53
If I were you I'd also crosscheck or research some of the other posts and advice by some of the posters on this board to get a feel for their over all mindset. There are some who have distinguished themselves in my opinion as fairly loopy.
Posted by zana on September 28, 2003, at 23:38:08
In reply to Re: Provigil Weirdness, posted by HenryO on September 28, 2003, at 23:03:19
Thanx O'Henry and Ame Sans Vie.
I think changing the dosing of the Provigil is a good idea. I have lately tried skipping it in the am since I am most energetic then anyway. If I skip pm I am really irritable and unhappy.
Strattera was really weird and unpleasant. I tried methyphen once and did not improve my mood the way provigil does.Prozac pooped out for me completely but after a year or so off and a really unpleasant year with Effexor and a really really unpleasant time getting off it Prozac did a little but it now gives me a lot more of the obessive song stuck in my head stuff and less antidepressant effect, thus the provigil and the lamictal. I am a little discouraged about the lamictal since I had to back off 87.5 because it was making me really angry, not irritable, not "i'm not depressed anymore and I feel angry." Just this grinding uncomfortable anger. It seems to have stopped since dropping back to 75...
I know all this stuff is helping and that I'd be really really disfunctional and miserable without it. I'd just like to have a few more of the good effects and fewer of the bad ones.
Thanx again.
More advice is always apprechiated
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
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.