Posted by zeugma on February 20, 2005, at 5:48:09
In reply to Re: ed- your opinion please » zeugma, posted by ed_uk on February 19, 2005, at 12:32:29
> Hi Z,
> Is the Provigil helping yet? What dose are you on? What dose did you previously need to get a good effect?
yes, the Provigil is helping. I'm taking 100 mg/day. This is somewhere around the dose I needed to get a good effect previously, although Provigil is so unlike Ritalin, and seemingly less dose-specific (for Ritalin LA, I needed the 30 mg capsule to get any effect at all; lower doses came with neither side effects nor therapeutic ones). The situation is somewhat confounded by the fact that I was taking Provigil in conjunction with low dose Ritalin (10 mg/day) during much of my previous trial of it, and the two drugs, although both dopaminergic, are completely different in terms of how they affect my cognitive process and mood. Ritalin would speed me up, but also make me feel jagged and irritable. Provigil slows me down, and that is how it seems to help the ADD stuff (for example, I feel the urge to make a sarcastic comment at work, and the Provigil seems to slow me down enough to reflect on it, and as a consequence I 'filter' the comment out of my behavior.) The Ritalin improved my reaction time, but also pushed anxiety to the point where it was difficult to think clearly, and there was no 'filtering' effect on my mental processes.
I should note that although I needed the 30 mg capsule to get an effect when Rit was my only stim, the 10 mg capsule seemed to do something when combined with Provigil. I realize now that the benefits of the combination did not outweigh the confounding effect it had on my assessment of provigil.
I felt something (a slight 'slowing' effect) even at 50 mg provigil. It's the slowing, and the need for less caffeine, that I like. I was able to get up to 150 mg Provigil during my previous trial, and I'd like to try 200 mg, since although I am feeling noticeably more awake, I still don't feel fully awake (maybe two-thirds awake, as opposed to half-awake or less when unmedicated). I also feel less of a drop-off later in the day, compared to Ritalin LA, due to Provigil's longer half-life. But I still feel unable to do much of anything after 4 pm, and that is a substantial limitation.
I think increasing the morning dose, rather than taking split doses, would be better for me. I think if I took 100 mg at noon I would have serious insomnia problems. I wouldn't be up all night, but when I go below eight hours of sleep, I start feeling sleep debt issues, and since narcolepsy *is* sleep debt, it compounds the problem and was the reason (besides the weird side effects) that I did a very slow titration last year.
Buspirone has no withdrawal syndrome whatsoever. I went from 30 mg to 0 in two days, and felt no ill effects. It does seem to help me with sleep-wake transitions (i.e. it helps with the hypnagogic hallucinations, which are less of an issue with 100 mg nortriptyline anyway, and also helps me wake up feeling less groggy).