Posted by SLS on June 12, 2000, at 8:56:11
In reply to Re: Adderall/Provigil? » JohnL , posted by michael on June 11, 2000, at 16:33:55
Hi Michael.
> I'm thinking about asking my pdoc for a trial run of provigil - also of ritalin, adderall, dexedrine and desoxyn. The short comparison trial theory you've been championing. We'll see if she buys it...
I know I haven't been such a champion of Martin Jensen's ideas regarding trials of less than a week for *antidepressants*. However, there are certain drugs for which a positive response will more often than not show up within the first week, especially if they are added to an ongoing treatment with antidepressants. The latter four drugs you listed are stimulants that show this pattern. As far as adrafinil and Provigil (modafinil) are concerned, I don't know for sure.I included below an abstract studying the use of Provigil as an augmenting agent to antidepressants.
* I would like to thank Rick for finding this.
- Scott
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1: J Clin Psychiatry 2000 May;61(5):378-81Modafinil augmentation of antidepressant treatment in depression.
Menza MA, Kaufman KR, Castellanos A
Department of Psychiatry, University of Medicine and Dentistry of New Jersey,
Robert Wood Johnson Medical School, Piscataway 08854, USA. menza@umdnj.edu[Medline record in process]
BACKGROUND: Despite a relative lack of controlled data, stimulants are often
used to augment antidepressant treatment in patients who have had only a partial
response to first-line therapy. Modafinil is a novel psychostimulant that has
shown efficacy in, and was recently marketed for, treating excessive daytime
sleepiness associated with narcolepsy. The mechanism of action of modafinil is
unknown, but, unlike other stimulants, the drug is highly selective for the
central nervous system, has little effect on dopaminergic activity in the
striatum, and appears to have a lower abuse potential. METHOD: In this
retrospective case series, we describe 7 patients with DSM-IV depression (4 with
major depression and 3 with bipolar depression) for whom we used modafinil to
augment a partial or nonresponse to an antidepressant. The Hamilton Rating Scale
for Depression was administered as part of routine clinical practice prior to
treatment and at each subsequent visit. RESULTS: At doses of 100 to 200 mg/day,
all 7 patients achieved full or partial remission, generally within 1 to 2
weeks. All patients had some residual tiredness or fatigue prior to starting
modafinil, and this symptom was particularly responsive to augmentation. Side
effects were minimal and did not lead to discontinuation of the drug in any of
the patients. CONCLUSION: Modafinil appears to be a drug with promise as an
augmenter of antidepressants, especially in patients with residual tiredness or
fatigue. It is a particularly attractive alternative to other stimulants because
of its low abuse potential and Schedule IV status.PMID: 10847314, UI: 20303927
poster:SLS
thread:36749
URL: http://www.dr-bob.org/babble/20000610/msgs/37010.html