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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by pbjc on January 25, 2004, at 18:00:27
My pdoc wants to switch me from Ritalin to Provigil. I'm skeptical. I've been taking Ritalin for 8 years at daily doses between 60-80 mg per day. Ritalin helps me focus and concentrate and actually acomplish things that otherwise would languish. I'm diagnosed with Bipolar II and am on, what I consider to be, a lot of meds: 160 mg Celexa, 2 mg Risperdal, 300 mg Topamax, 1975 mg lithium, 200 mg Geodon plus 2 different sleep meds.
I don't want to just be "awake" on Provigil, I want to continue to be able to acomplish tasks as I currently do on Ritalin. My pdoc values my input and I'd like to be able to discuss this with her if I could get some input from those who have had any experience in this area. I have tried Dexedrine and Adderall in the past and neither of these meds gave me the same response I receive with Ritalin.
Thanks,
Philip
Posted by scott-d-o on January 25, 2004, at 20:51:14
In reply to Provigil vs. Ritalin, posted by pbjc on January 25, 2004, at 18:00:27
> My pdoc wants to switch me from Ritalin to Provigil. I'm skeptical. I've been taking Ritalin for 8 years at daily doses between 60-80 mg per day. Ritalin helps me focus and concentrate and actually acomplish things that otherwise would languish. I'm diagnosed with Bipolar II and am on, what I consider to be, a lot of meds: 160 mg Celexa, 2 mg Risperdal, 300 mg Topamax, 1975 mg lithium, 200 mg Geodon plus 2 different sleep meds.
>
> I don't want to just be "awake" on Provigil, I want to continue to be able to acomplish tasks as I currently do on Ritalin. My pdoc values my input and I'd like to be able to discuss this with her if I could get some input from those who have had any experience in this area. I have tried Dexedrine and Adderall in the past and neither of these meds gave me the same response I receive with Ritalin.
>
> Thanks,
> PhilipI agree with you.. I suppose he is concerned you are abusing your ritalin? thou this seems a little odd after 8 years.. perhaps you should inquire exactly *why* he wishes you to switch to provigil.
they really aren't similar at all and I doubt provigil would work as well for you.. provigil is primarily noradrenergic while ritalin is a potent DRI. provigil may have some indirect affect on dopamine, since it's glutaminergic, but when I took it I really couldn't discern any affects at all from it.
scott
Posted by pbjc on January 26, 2004, at 16:45:19
In reply to Re: Provigil vs. Ritalin, posted by scott-d-o on January 25, 2004, at 20:51:14
>perhaps you should inquire exactly *why* he wishes you to switch to provigil.
> scott
Scott - My pdoc thinks it might have some mood brightening effect for me as well as helping me get out of bed in the mornings, which I struggle with, but the Ritalin has been working just fine for me in that regard. She has had some of her other patients respond well, and now I think she wants to let me test drive Provigil also. It is just that I've been stable for quite a while now and I really don't want to derail it by taking away a med that we know works for me and throwing one in the mix that doesn't even work on the same neurotransmitter. I'm also afraid I'll lose my ability to focus and concentrate that I get with the Ritalin.
Philip
Posted by scott-d-o on January 26, 2004, at 17:34:52
In reply to Re: Provigil vs. Ritalin » scott-d-o, posted by pbjc on January 26, 2004, at 16:45:19
> Scott - My pdoc thinks it might have some mood brightening effect for me as well as helping me m solution for this problem.get out of bed in the mornings, which I struggle with, but the Ritalin has been working just fine for me in that regard. She has had some of her other patients respond well, and now I think she wants to let me test drive Provigil also. It is just that I've been stable for quite a while now and I really don't want to derail it by taking away a med that we know works for me and throwing one in the mix that doesn't even work on the same neurotransmitter. I'm also afraid I'll lose my ability to focus and concentrate that I get with the Ritalin.
>
> Philip
>Well, I don't think there is any drug that makes you want to get out of bed in the morning, since you can't really take medication while you're sleeping so it kicks in when you wake up ;-). I think GHB might be the only drug that could work for this since at first it helps you go to sleep by suppressing dopamine but then you get a dopamine kick hours later, I'm not sure how long the drug stays in your system thou. GHB just recently got approved under the brand name Xyrem.
If you stop the Ritalin abruptly and go on Provigil, in all likelyhood you will get very depressed as well as losing your focus, etc. Honestly, I have tried both of the meds in question and Ritalin is much more likely to have positive effects on mood, unfortunatly, I also felt "on edge" at 1/8th the dose you are taking. I'm now doing much better on Dexedrine spansules which have been great for me so far but I still have the same problem as you with not wanting to get up in the morning; I constantly miss classes. Usually I turn off my alarm unconciously even if I have to walk across the room and then I feel like sh*t when I wake up and it's 2:00 in the afternoon. In fact, I used to have insomnia & this problem. Klonopin took care of my insomnia but I still can not get up in the morning and will just oversleep for like 15 hrs if I feel like it.
This is the advice my pdoc gave me today on this and I think it makes sense so maybe it will work for you. I don't know if you exercise or not, but I currently workout (weights & cardio) every other day in the evenings, he advised that I should attempt to change my workouts to the morning, instead. Of course it will be difficult for the first week or so but he says eventually your body learns that it needs energy in the morning.
I've always heard that if you workout less than 3 hrs before you go to bed that this causes insomnia, so I guess it makes sense that it could work the other way around. I think I am going to try at least moving the cardio to the mornings; I think if I can get through the first couple weeks, which I'm sure will be hell, this might be a good long-term solution for this problem.
scott
Posted by Ame Sans Vie on January 26, 2004, at 23:55:40
In reply to Provigil vs. Ritalin, posted by pbjc on January 25, 2004, at 18:00:27
Provigil is (quite literally, in my experience) prescription ecstasy, if taken in higher-than-recommended doses. I currently take 60mg Adderall XR daily, but I don't think I've ever felt as wonderful as I did when I used to take 1,000mg of Provigil each morning. High doses like this can cause hypertension, but if your heart can handle 60-80mg of Ritalin, Provigil will be a cakewalk. There are only two problems: 1) convincing a doctor to prescribe 250% of the maximum recommended FDA dose, and 2) doses that high can cause wicked headaches... that's why I had to stop taking it. Other than that though, I feel that it is a *very* underrated medication if used in adequate doses. And of course there's the benefit of once-daily dosing with 'round-the-clock effect and no resultant insomnia. I'm sure the stuff would be sold on the street in large doses such as this if it weren't for the fact that it's so hideously expensive.... just my two cents.
Posted by scott-d-o on January 27, 2004, at 15:16:02
In reply to Re: Provigil vs. Ritalin » pbjc, posted by Ame Sans Vie on January 26, 2004, at 23:55:40
> Provigil is (quite literally, in my experience) prescription ecstasy, if taken in higher-than-recommended doses. I currently take 60mg Adderall XR daily, but I don't think I've ever felt as wonderful as I did when I used to take 1,000mg of Provigil each morning. High doses like this can cause hypertension, but if your heart can handle 60-80mg of Ritalin, Provigil will be a cakewalk. There are only two problems: 1) convincing a doctor to prescribe 250% of the maximum recommended FDA dose, and 2) doses that high can cause wicked headaches... that's why I had to stop taking it. Other than that though, I feel that it is a *very* underrated medication if used in adequate doses. And of course there's the benefit of once-daily dosing with 'round-the-clock effect and no resultant insomnia. I'm sure the stuff would be sold on the street in large doses such as this if it weren't for the fact that it's so hideously expensive.... just my two cents.
hah, it's funny your the first person I've ever heard even suggest that modafinil has abuse potential.. I suppose no one else has dared to take doses that high. what does the "high" feel like compared to amphetamines? Seems like it would cause a sh*tload of anxiety, assuming modafinil really does work thru glutamate release and/or noradrenergic means. Hmm.. I wonder if they same "high" could be achieved with adrafinil, it's not as expensive, but liver complications may become an issue.
scott
Posted by Ame Sans Vie on January 27, 2004, at 17:45:44
In reply to provigil ecstasy?!?, posted by scott-d-o on January 27, 2004, at 15:16:02
The Provigil high was not at all uncomfortable, and this is coming from someone who is trembling like crazy with anxiety with a small dose of Ritalin. I compared it to MDMA (methylenedioxymethylamphetamine) as that's a drug more people are familiar with, but truthfully it felt *exactly* like its chemical cousin, MDE (methylenedioxyethylamphetamine) -- known on the streets as "Eve" (MDA [methylenedioxyamphetamine] is "Adam"). I used to have a pure source of powder MDE, which I actually preferred over MDMA. But don't just take my word for it -- I gave Provigil to four friends of mine one night who all enjoy the occasional tab of XTC and they were absolutely astounded.
In case you're not familiar with MDE's effects, versus those of MDMA, here's something I came across that describes it to a T:
"The effects were very similar in direction and tone to MDMA, but with much less physical body pleasure, less memory disruption, less unbridled euphoria, less need/desire to talk talk talk, feeling more quiet, very positive mood, pleasant but consistent warm body vibration / trembling. Made for an excellent chance to connect, much like with MDMA, but without the strong negative effects generally experienced both during and after MDMA."
Of course, a dose of MDE has a duration of action of about 8 hours start to finish, while the Provigil high is a 24-hour thing.
My conclusion -- at least in higher doses, there's *much* more to modafinil than meets the eye.
Posted by theo on January 27, 2004, at 20:01:20
In reply to Re: provigil ecstasy?!? » scott-d-o, posted by Ame Sans Vie on January 27, 2004, at 17:45:44
It is the number 1 common side. I never have headaches and when I took 100mg, about 12 hours later had a pounding headache that lasted a couple of days. Anyone else experience severe headaches from Provigil?
Posted by University on November 4, 2005, at 0:05:05
In reply to Re: provigil ecstasy?!? » scott-d-o, posted by Ame Sans Vie on January 27, 2004, at 17:45:44
For me, Provigil--even at just 100mg--induced euphoria, feelings of well-being, energy/stimulation, and hyperphagia... But its prohibitive cost for those without narcolepsy diagnoses (at that time--now, many insurers will accept other diagnoses) ended my stint with this drug. I've been on methyphenidate ever since. But I have been DX'd with sleep apnea, so I have a shot at coverage now...
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