![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by becksA on April 10, 2006, at 8:42:40
I have ADD, and I also have severe social anxiety disorder. I'm on a ridiculously high dosage of klonopin, which helps to a GREAT extent. In fact, my anxiety is finally almost completely gone on 14mg daily, split into 3 doses. However my ADD is quite bad as well. I am very scatterbrained and without a stimulant of any kind, I've never been able to get ANYTHING done. I'm trying to finish school, and when I don't take my aderal I cannot even open up my notebook let alone write a paper. The reason I don't take aderal or other stims is because even the slightest amount (even on 14mg of klonopin makes my anxiety return).
I know Provigil has been getting so-so reviews at best when it comes to ADD, but we're going to try it anyway, but I'm afraid of the possible side effects, as I've been told it will take a coupel weeks to start feeling it anyway. Will I notice an increase in anxiety? What else can I expect? I know obviously to take it in the morning, but staying up late is the4 least of my worries.
(I'm also on 1250 daily of depakote for possible cyclothemia, and if anything, just as an added anti-anxiolitic).
Thanks.
Posted by gardenergirl on April 10, 2006, at 15:38:53
In reply to nervous to start provigil...., posted by becksA on April 10, 2006, at 8:42:40
Hi,
I've been on 200 mg Provigil for about 3 weeks now. I've noticed a decrease in binge eating and in impulsivity, which is good. These effects showed up fairly quickly, even at 100 mg. I have mild ADHD, and I added Provigil to address my inattention and hopefully augment my antidepressants.The only negative effect I've had, which I posted about above, but no one seemed to notice, is that if I get too much caffeine, I feel overstimulated. It's not as bad as akithisia, but it did make it hard to relax and my anxiety increased that day.
So definitely limit caffeine until you know how the Provigil will affect you.
Good luck!
gg
Posted by Racer on April 10, 2006, at 22:10:53
In reply to Re: nervous to start provigil.... » becksA, posted by gardenergirl on April 10, 2006, at 15:38:53
I had good luck with Provigil, and if Dexedrine doesn't work out for me, I may go back on it.
For me, caffeine was an issue, and I had a few headaches at first, but honestly -- I don't think I ever slept better in my life! Truly, taking Provigil got my sleep schedule on track for the first time ever. (Although I did usually need a nap during the day, but still slept great at night.)
Again, this is only me, but I did have some trouble with anxiety at first. Once I figured out, though, that I was better off taking a split dose, that stopped. In fact, I think I was more confident on it, because I felt better and felt better about myself.
After a couple of years, though, I thought it was increasing my depression, so I stopped. I'm not quite as sure now, whether or not it really had anything to do with the Provigil, which is why we're thinking we may try it again if the Dexedrine doesn't want to play nice for me.
For what it's worth, Adderall can increase depression. Could be it's not the stimulant that wants to cozy up with you. I'd be all in favor and pretty gung ho to say try Provigil, but if it doesn't work out, maybe another stimulant?
Good luck. And remember: if Provigil doesn't work out, you can always stop taking it...
Posted by mike99 on April 11, 2006, at 12:27:24
In reply to Re: nervous to start provigil.... » becksA, posted by gardenergirl on April 10, 2006, at 15:38:53
> Hi,
Hey gg,
mike here...
> I've been on 200 mg Provigil for about 3 weeks now. I've noticed a decrease in binge eating and in impulsivity, which is good. These effects showed up fairly quickly, even at 100 mg.
May I ask if you started at 100 mg and how soon you notice effects?
>> I have mild ADHD, and I added Provigil to address my inattention
Have you noticed any improvement in attention? If so, might you be able to rate this improvement on a 1-10 scale?
>>and hopefully augment my antidepressants.
and how about this department?
> The only negative effect I've had, which I posted about above, but no one seemed to notice,I did... I always read your provigil posts ;)
>>is that if I get too much caffeine, I feel overstimulated. It's not as bad as akithisia, but it did make it hard to relax and my anxiety increased that day.May I ask if you have resolved this with decreasing/eliminating caffeine?
One last question I have, gg (I promise), is whether you would describe any sort of calming effect as often seem w/ the stimulants.
Hope it doesn't feel like I'm interrogating you with all these questions...feel free to answer any or none... i'm just very interested in your experience.
rock on,
mike
Posted by gardenergirl on April 11, 2006, at 14:58:58
In reply to Re: nervous to start provigil.... » gardenergirl, posted by mike99 on April 11, 2006, at 12:27:24
Hi Mike,
This is attempt two at replying. Explore pooped out and ate my last reply. Aaargh.> May I ask if you started at 100 mg and how soon you notice effects?
I started with 100 mg for about 3 weeks. I noticed the reduction in binge eating within about 10 days. This effect seems to be waning some, though. :( At 200 mg, I noticed decreased impulsivity fairly quickly.
>
> Have you noticed any improvement in attention? If so, might you be able to rate this improvement on a 1-10 scale?Rating it might be tough. I would have originally said not much improvement in this area, but after thinking about it, I think maybe about a 4. I'm much more able to pay attention to my husband when he's talking to me (lol) than before. I used to have to ask him to repeat stuff within minutes because what he said would fly right out of my head. This seems to be better even when there are distractions like the TV. Of course I'm also doing less multi-tasking, which helps, too. But then again, perhaps the Provigil is providing me with some inner stimulation so that I don't feel the need to multi-task and thus can better attend to what I'm doing?
>
> >>and hopefully augment my antidepressants.
>
> and how about this department?I think it's helping. It certainly helps to get me out of bed in the a.m., which is extremely difficult when I'm depressed. My husband notes I'm laughing more and isolating myself less. Still have down times, but they seem shorter and more directly linked to a specific thing versus occuring seemingly randomly.
>
> > The only negative effect I've had, which I posted about above, but no one seemed to notice,
>
> I did... I always read your provigil posts ;)Thanks. I was feeling a bit invisible with that post. :)
>
>
> >>is that if I get too much caffeine, I feel overstimulated. It's not as bad as akithisia, but it did make it hard to relax and my anxiety increased that day.
>
> May I ask if you have resolved this with decreasing/eliminating caffeine?Absolutely. I've decreased it, but not eliminated it. One cup of coffee in the a.m. and perhaps a diet coke in the p.m. Of course, since I am used to drinking about 4 diet cokes, I need to find a suitable substitute. Water would be a good choice, but ehhh--not my favorite beverage.
>
> One last question I have, gg (I promise), is whether you would describe any sort of calming effect as often seem w/ the stimulants.I think for me there's a bit of a fine line between calming and overstimulated. If I'm too stimulated, anxiety increases. As far as feeling calmer otherwise, I can't say. I'm making gains in therapy, too. It's too hard to parse out what might be helping me with being less emotionally reactive. But overall I am doing better. :)
>
> Hope it doesn't feel like I'm interrogating you with all these questions...feel free to answer any or none... i'm just very interested in your experience.I appreciate the dialog. And I have some questions for you. :)
Did you make a decision yet about Provigil or some other stim?
And do you or have you done anything behaviorally to cope with ADHD that you found particularly helpful? I know I should go through the stuff I used to give the clients I diagnosed with ADHD and apply it to myself. :D Easier said than done, of course. I know I need more structure in my day, so any tips you have about better managing multiple demands and being productive with ADHD would be welcome.
Take care,
gg
Posted by gardenergirl on April 11, 2006, at 15:00:12
In reply to Re: nervous to start provigil.... » mike99, posted by gardenergirl on April 11, 2006, at 14:58:58
I might try splitting my dose. Maybe 100 mg when I get up and the other 100 mg early afternoon. Racer did this for a total of 150 mg and found this more effective.
gg
Posted by mike99 on April 11, 2006, at 16:35:12
In reply to Re: nervous to start provigil.... » mike99, posted by gardenergirl on April 11, 2006, at 14:58:58
> Hi Mike,
> This is attempt two at replying. Explore pooped out and ate my last reply. Aaargh.I hate that!
>
> Did you make a decision yet about Provigil or some other stim?I've decided I'm defintely not going to take a stim such as ritalin or any amphetamine.
Provigil...still ambivalent. I'm seeing a cardiologist next week to discuss the possibility. This may sound extreme but then I have had extreme reactions to stimulating meds. I am erring on the side of caution caution caution. This is taking a lot of patience to proceed this way but I would not feel comfortable doing it any other way.
> And do you or have you done anything behaviorally to cope with ADHD that you found particularly helpful?
I've virtually eliminated alcohol. Exercise. List making. Breaking things down and prioritizing, catergorizing, summarizing, repetition repetition, etc.. when I'm reading and so forth---I think a lot of the behavioral compensations I've made over the years have become second nature, so I'm sure I'm missing some, but will post any more if I can think of them.
Meditation is one thing I've tried several times but never stuck with.
>> I know I should go through the stuff I used to give the clients I diagnosed with ADHD and apply it to myself.
Are you a psychologist? I honestly think I've probably maxed out on any beneficial behavioral strategies-- minus biofeedback, but that's unproven and expensive. But I am always open to new suggestions.
Posted by bimini on April 11, 2006, at 20:25:14
In reply to nervous to start provigil...., posted by becksA on April 10, 2006, at 8:42:40
I was prescribed high dosage of Provigil(400mg) and Concerta(72mg) for symptoms caused by brain injury. Anxiety, depression, delusion, hallucination, disociation, gaps, memory holes, attention, sequencing problems, motor coordination ...I didn't wake up from a dreamlike existence with feet and hands that I don't feel are mine.
Concerta did make me jittery in spurts but along with Provigil helped with cognitive functions more than the effect of the medication. It gave me opportunity to train compensation tools.
Provigil (when I was taking it with Concerta) gave me a dip of energy at about 3-4 hours after taking it about 8am. Each noon I was ready to take a nap in my lunch preceeded by a bunch of yawn attacks. 1/2 hour later I was feeling great again. Dosage of 400mg Provigil didn't have any more effect than 200mg then.
Concerta raised my blood pressure to stage2 and had to quit it.
Now am taking Lamictal with Provigil. Raising the dose of Provigil this time had the opposite effect. Higher the dose less jitters. No yawn attacks, no napping in soups.
I feel a huge difference between 200mg, 300mg and 400mg this time.
bimini
Posted by gardenergirl on April 12, 2006, at 15:22:25
In reply to Re: nervous to start provigil.... » gardenergirl, posted by mike99 on April 11, 2006, at 16:35:12
>> Provigil...still ambivalent. I'm seeing a cardiologist next week to discuss the possibility. This may sound extreme but then I have had extreme reactions to stimulating meds. I am erring on the side of caution caution caution. This is taking a lot of patience to proceed this way but I would not feel comfortable doing it any other way.
That sounds wise. I hope the appt. goes well.
>
> I've virtually eliminated alcohol. Exercise. List making. Breaking things down and prioritizing,That's a big weak area for me.
>>I think a lot of the behavioral compensations I've made over the years have become second nature, so I'm sure I'm missing some, but will post any more if I can think of them.
Thanks.
>
>
> Are you a psychologist?In training. I'm near the end of my training and finding it difficult to do my dissertation.
Thanks for your input!gg
Posted by vicksnow on April 14, 2006, at 18:09:51
In reply to nervous to start provigil...., posted by becksA on April 10, 2006, at 8:42:40
provigil caused me to have extreme anxiety for about 3 days. rapid heartbeat, i couldn't sleep. it was absolute hell but i survived it. then took it for a while ...it stopped working and i started to get tired again even after taking the full dose of provigil. but be forwarned of the first 3 days. they were living hell for me.
Posted by gardenergirl on April 14, 2006, at 23:02:13
In reply to Re: nervous to start provigil...., posted by vicksnow on April 14, 2006, at 18:09:51
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.