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Kramer re: SSRIs/Discontinuation symptoms/Provigil

Posted by IsoM on April 2, 2002, at 2:10:01

Thanks for taking the time to read & answer all the posts, Dr. Kramer.

Many people have experienced discontinuation/withdrawal problems when stopping SSRIs, even over a long period of time. A number have even had long-lasting problems. I was one of them.

When I stopped Luvox (over a 3 month period of gradually diminishing doses), I still never felt 'normal' until I went on Paxil a number of months later. When I weaned off Paxil after 3 1/2 years on it, I had the same reaction. It, too, was done over 3 months when I switched to Celexa. In fact, the vertigo & 'brain zaps' never did leave & necessitated going on 10 mg Paxil daily along with my regular Celexa. It quelled the symptoms but never stopped it completely at that dose.

I have started taking Olmifon (adrafinil) along with the Celexa. I've found that I've been able to completely stop the Paxil & have had no more symptoms. Adrafinil's main metabolite is modafinil (Provigil) so my question is about Provigil & Olmifon.

[Question #1]
Can you hazard a guess as to why modafinil was able to stop these discontinuation symptoms? A report entitled "Adrafinil: A Novel Vigilance Promoting Agent"
from CNS Drug Reviews Vol. 5, No. 3, pp. 193-212 1999 Neva Press, Branford, Connecticut
suggested that adrafinil (modafinil) had the effect of boosting overall brain metabolism and that it affected various neurotransmitters.

[Question #2]
Have you ever heard of Provigil being used to treat discontinuation problems in patients stopping an SSRI?

[Question #3]
Would you hazard a guess that it may be a potential medication used in that manner? Any thoughts on this?

I seriously wonder if Provigil might not be a good strategy for doctors to use on patients with severe symptoms.




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