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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by SarahB on June 9, 2000, at 17:11:15
Hello, again, everyone. Been a busy summer so I haven't had much time to post at all. If anyone remembers me, I am ADD and on Adderall, 30mgs a day-split dose, not too many other problems with life besides that. I was wondering about the doses of Adderall and what ppl here are taking. I started on 10mgs and I am now up to 30 and it seems that I may have to go up again. This has been over a span of about 6-7 months. I have an appt with my shrink next Friday to discuss this and maybe add an AD to the mix. (some of the old ways of thinking and a bit of depression are creeping in)(marriage aint all it's cracked up to be) Anyway, if anyone else here is on Adderall, I would love to know what your dose is and how long it worked, what you started at... Yada, yada... Thanks everyone for your input! Also, what is a good AD to mix with Adderall, I have tried Prozac, zoloft, effexor, and elavil years ago. The only one that really worked was Elavil, but I can't handle the sedative affect anymore. Thanks everyone!! Karen (in Denver), how is the adderall working for you, haven't been keeping up??
Posted by CarolAnn on June 10, 2000, at 9:41:10
In reply to Adderall, posted by SarahB on June 9, 2000, at 17:11:15
Sarah, I'm on 30mgs. Adderall split into three doses per day. My experience is that after the first two months, the effect has been much less noticeable. My doctor said that this is normal, you don't actually feel that 'lift', but the Adderall is still working. He will not let me go any higher in dose. You might want to try Wellbutrin, it is supposed to help with ADD, so it might be a good supplement to your Adderall. FYI though, some people don't get any real help from Wellbutrin, even though it is supposed to be an "activating" drug, it did nothing for me and I could REALLY use the energy! It is definitly worth a try though, because it does work for a lot of depressed and ADD people. Good luck! CarolAnn
Posted by JudithC on June 10, 2000, at 11:09:41
In reply to Re: Adderall » SarahB, posted by CarolAnn on June 10, 2000, at 9:41:10
> Sarah, I'm on 30mgs. Adderall split into three doses per day. My experience is that after the first two months, the effect has been much less noticeable. My doctor said that this is normal, you don't actually feel that 'lift', but the Adderall is still working. He will not let me go any higher in dose. You might want to try Wellbutrin, it is supposed to help with ADD, so it might be a good supplement to your Adderall. FYI though, some people don't get any real help from Wellbutrin, even though it is supposed to be an "activating" drug, it did nothing for me and I could REALLY use the energy! It is definitly worth a try though, because it does work for a lot of depressed and ADD people. Good luck! CarolAnn
I,too,take up to 30 milligrams of Adderall daily and it certainly gives me a "lift" in order to get going physically. And,Adderall also helps me to focus....to concentrate upon reading so that my thoughts are not so scattered.
Posted by KarenB on June 10, 2000, at 13:20:03
In reply to Adderall, posted by SarahB on June 9, 2000, at 17:11:15
Hi Sarah,
I am on Adderall, 20 mg before getting out of bed and 5-10mg five hours later. When do you take your 3 doses?
Look at the thread (just archived) from 6/8 and 6/9/00 entitled somebody please help..." by Lazukars. At the bottom, I added two posts about Provigil, which is a drug for Narcolepsy being tested for ADD use. Another guy, Rick is taking it with Klonopin and something else and says it creates motivation as well as energy. I think that is what I am lacking.
I faxed some articles to my doc and hope to give it a try soon. The Adderall gives me energy BUT I still feel "sleepy" in the afternoon (although I couldn't sleep if I tried) and have low level depression. Doc added Buspar for this and it is working "OK" but not as well as I would like. I have the advantage (or disadvantage, depending on how you see it) of having taken medication that REALLY worked and now it's hard to settle for just OK. The one that really worked? Not available in the US and now discontinued. Oh well... I'm not giving up until I feel well again.
Karen
Posted by JohnL on June 10, 2000, at 18:05:53
In reply to Re: Adderall/Provigil?, posted by KarenB on June 10, 2000, at 13:20:03
I'm on my second day of Provigil instead of its ancestor Adrafinil. So far so good. It's definitely got more pep to it than Adrafinil. For anyone needing energy and/or motivation and/or pep, Provigil certainly can do that. I hope I'm not speaking too soon because I'm only on day 2. But so far I feel lots of energy and motivation with only a mild revved up feeling. Contrary to Ritalin or Adderall which made me very uncomfortably revved up.
I think in the future we will see Provigil used more than it is now. It's still fairly new. But I suspect it will end up being used for a wide array of things, including melancholic depression, ADD, and who knows what else.
I started with a super low dose just to feel it out. That was 50mg. So far that seems to be just fine. I don't feel any need or desire to go any higher at this time.
But one huge drawback...if you don't have insurance, it can be expensive. My copay was $20, as it always is. No big deal. But I looked at the small print to see what the retail price actually is that my insurance company has to pay. Oh my goodness. $367 for 90 pills? Yikes!
JohnL
Posted by michael on June 11, 2000, at 16:33:55
In reply to Re: Adderall/Provigil?, posted by JohnL on June 10, 2000, at 18:05:53
hey JohnL.,
As time goes by, I'd be very interested in any insights you might be able to provide in terms of comparison, similarities, contrasts of the provigill to the adrafinil.
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...
Regardless, I'd definitely be interested in any of your thoughts on the matter. Good Luck! michael
btw - did the effects of the adrafanil begin to wain, or is the switch more of an insurance play? I apologize if I'm being too nosey. For me, it's definitely not as dramatic an effect as it was the first week - but it is still significantly better with it than w/o it. btw - this is the first stim i've tried - unless you count effedrine...
> I'm on my second day of Provigil instead of its ancestor Adrafinil. So far so good. It's definitely got more pep to it than Adrafinil. For anyone needing energy and/or motivation and/or pep, Provigil certainly can do that. I hope I'm not speaking too soon because I'm only on day 2. But so far I feel lots of energy and motivation with only a mild revved up feeling. Contrary to Ritalin or Adderall which made me very uncomfortably revved up.
>
> I think in the future we will see Provigil used more than it is now. It's still fairly new. But I suspect it will end up being used for a wide array of things, including melancholic depression, ADD, and who knows what else.
>
> I started with a super low dose just to feel it out. That was 50mg. So far that seems to be just fine. I don't feel any need or desire to go any higher at this time.
>
> But one huge drawback...if you don't have insurance, it can be expensive. My copay was $20, as it always is. No big deal. But I looked at the small print to see what the retail price actually is that my insurance company has to pay. Oh my goodness. $367 for 90 pills? Yikes!
> JohnL
Posted by SarahB on June 12, 2000, at 0:04:27
In reply to Re: Adderall/Provigil? » JohnL , posted by michael on June 11, 2000, at 16:33:55
Checked my drug formulary... it's not on it, so I am certainly not gonna pay that! Thank you, anyway!
Posted by Lynne on June 12, 2000, at 4:26:08
In reply to Re: Adderall/Provigil?, posted by JohnL on June 10, 2000, at 18:05:53
> I'm on my second day of Provigil instead of its ancestor Adrafinil. So far so good. It's definitely got more pep to it than Adrafinil. For anyone needing energy and/or motivation and/or pep, Provigil certainly can do that. I hope I'm not speaking too soon because I'm only on day 2. But so far I feel lots of energy and motivation with only a mild revved up feeling. Contrary to Ritalin or Adderall which made me very uncomfortably revved up.
>
> I think in the future we will see Provigil used more than it is now. It's still fairly new. But I suspect it will end up being used for a wide array of things, including melancholic depression, ADD, and who knows what else.
>
> I started with a super low dose just to feel it out. That was 50mg. So far that seems to be just fine. I don't feel any need or desire to go any higher at this time.
>
> But one huge drawback...if you don't have insurance, it can be expensive. My copay was $20, as it always is. No big deal. But I looked at the small print to see what the retail price actually is that my insurance company has to pay. Oh my goodness. $367 for 90 pills? Yikes!
> JohnLHi JohnL,
Was is the name of the book by DR. Jensen and where do I purchase it? I am very interested to see how you think the Provigil is compared to Adafinil.
Thanks,
Lynne
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
-----------------------------------------------
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
Posted by JohnL on June 13, 2000, at 2:58:31
In reply to Re: Adderall/Provigil? » JohnL , posted by Lynne on June 12, 2000, at 4:26:08
> Was is the name of the book by DR. Jensen and where do I purchase it? I am very interested to see how you think the Provigil is compared to Adafinil.
>
> Thanks,
> LynneLynne,
The book is The Successful Treatment of Brain Chemical Imbalance. It actually has the appearance more of a workbook than a book. Softcover. Large like a notebook. Author Dr Martin Jensen. I've seen it at online book stores, at the local walk-in book stores (though it's sold out whenever I check), or directly from the publisher. Go to www.drjensen.com to order it directly.I like Adrafinil tons better than Provigil. To my body and my chemistry, it is a much smoother, nicer, gentler, more effective treatment.
JohnL
Posted by Malcom on April 14, 2001, at 10:56:21
In reply to Re: Adderall/Provigil? » JohnL , posted by Lynne on June 12, 2000, at 4:26:08
Yeah, Provigil can be pretty expensive. I just payed $139.00 for 15 200mg pills. I am splitting them and taking 100mg each day in the morning. Although it helps improve attention and fatigue, it doesn't always last that long and it has some negative side effects. For instance, after it wore off yesterday, I felt very tired, unmotivated and irritable. Then later, I felt very nauseaus. Also, my attention was probably a little worse than normal when it wore off. This is better than Adderall though, because when Adderall wore off, my inattetion would be outrageously bad. One thing I have noticed with Provigil is that my attention will sometimes be improved even though I subjectively feel as though the drug has worn off. But today is only day four. I've been told that the only thing to do is to keep trying medications until one is found that works. But so far, I've tried 7 different medications in 9 different combinations and I've only responded to four of these, and of these, three actually makes things worse overall. Its not that they don't provide benefical effects sometimes, its just that they provide more negative effects than beneficial ones. Does anyone know if Provigil can be combined with anything else? For me, Dexedrine, Adderall and sustained release Ritalin only worked in combination with Zoloft. So I was wondering if Provigil might work better in combination with something else.
> > I'm on my second day of Provigil instead of its ancestor Adrafinil. So far so good. It's definitely got more pep to it than Adrafinil. For anyone needing energy and/or motivation and/or pep, Provigil certainly can do that. I hope I'm not speaking too soon because I'm only on day 2. But so far I feel lots of energy and motivation with only a mild revved up feeling. Contrary to Ritalin or Adderall which made me very uncomfortably revved up.
> >
> > I think in the future we will see Provigil used more than it is now. It's still fairly new. But I suspect it will end up being used for a wide array of things, including melancholic depression, ADD, and who knows what else.
> >
> > I started with a super low dose just to feel it out. That was 50mg. So far that seems to be just fine. I don't feel any need or desire to go any higher at this time.
> >
> > But one huge drawback...if you don't have insurance, it can be expensive. My copay was $20, as it always is. No big deal. But I looked at the small print to see what the retail price actually is that my insurance company has to pay. Oh my goodness. $367 for 90 pills? Yikes!
> > JohnL
>
> Hi JohnL,
>
> Was is the name of the book by DR. Jensen and where do I purchase it? I am very interested to see how you think the Provigil is compared to Adafinil.
>
> Thanks,
> Lynne
Posted by vlvtelvis on April 14, 2001, at 16:27:05
In reply to Re: Adderall/Provigil?, posted by Malcom on April 14, 2001, at 10:56:21
I tried taking 100mgs in the AM and found that it made me feel real mellow. I definatly lost some kind of a mental "edge" I had otherwise. Could it have been interacting with a SSRI?
> Yeah, Provigil can be pretty expensive. I just payed $139.00 for 15 200mg pills. I am splitting them and taking 100mg each day in the morning. Although it helps improve attention and fatigue, it doesn't always last that long and it has some negative side effects. For instance, after it wore off yesterday, I felt very tired, unmotivated and irritable. Then later, I felt very nauseaus. Also, my attention was probably a little worse than normal when it wore off. This is better than Adderall though, because when Adderall wore off, my inattetion would be outrageously bad. One thing I have noticed with Provigil is that my attention will sometimes be improved even though I subjectively feel as though the drug has worn off. But today is only day four. I've been told that the only thing to do is to keep trying medications until one is found that works. But so far, I've tried 7 different medications in 9 different combinations and I've only responded to four of these, and of these, three actually makes things worse overall. Its not that they don't provide benefical effects sometimes, its just that they provide more negative effects than beneficial ones. Does anyone know if Provigil can be combined with anything else? For me, Dexedrine, Adderall and sustained release Ritalin only worked in combination with Zoloft. So I was wondering if Provigil might work better in combination with something else.
>
> > > I'm on my second day of Provigil instead of its ancestor Adrafinil. So far so good. It's definitely got more pep to it than Adrafinil. For anyone needing energy and/or motivation and/or pep, Provigil certainly can do that. I hope I'm not speaking too soon because I'm only on day 2. But so far I feel lots of energy and motivation with only a mild revved up feeling. Contrary to Ritalin or Adderall which made me very uncomfortably revved up.
> > >
> > > I think in the future we will see Provigil used more than it is now. It's still fairly new. But I suspect it will end up being used for a wide array of things, including melancholic depression, ADD, and who knows what else.
> > >
> > > I started with a super low dose just to feel it out. That was 50mg. So far that seems to be just fine. I don't feel any need or desire to go any higher at this time.
> > >
> > > But one huge drawback...if you don't have insurance, it can be expensive. My copay was $20, as it always is. No big deal. But I looked at the small print to see what the retail price actually is that my insurance company has to pay. Oh my goodness. $367 for 90 pills? Yikes!
> > > JohnL
> >
> > Hi JohnL,
> >
> > Was is the name of the book by DR. Jensen and where do I purchase it? I am very interested to see how you think the Provigil is compared to Adafinil.
> >
> > Thanks,
> > Lynne
Posted by cole on April 15, 2001, at 19:19:31
In reply to Re: Provigil: anyone else feel stoned on it?, posted by vlvtelvis on April 14, 2001, at 16:27:05
> I tried taking 100mgs in the AM and found that it made me feel real mellow. I definatly lost some kind of a mental "edge" I had otherwise. Could it have been interacting with a SSRI?
I had the same response, total brain lag, just out of it. I was awake but totally zonked. It never got any better. I tried it with remeron, but I honestly don't think it was the combo that made me feel that way, i think it has something to do with the way it effects the dopamine levels because wellbutrin made me feel the same way, and I took wellburtin alone. Just my take. ritalin is way better for me.
cole
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