Posted by mike99 on February 26, 2006, at 15:44:04
In reply to Re: provigil discussion, posted by mike99 on February 26, 2006, at 15:28:14
Since it increases plasma epinephrine and norephinephrine, and I'm guessing also direct NE release from sympathetics to the heart.Don't know if anyone really cares about this, so if not please ignore this, but I am very sensitive to sympathomimetics.
I'm hoping provigil may be an alternative since it has less effects on the cardiovascular system. Yet it does seem to have definite sympathomimetic activity.
I've heard of people often combining sympathomimetics with beta blockers to counter the cardiovascular effects. My understanding is this has the potential for "unopposed beta blockade"--where beta receptors are blocked out of proportion with alpha receptors and that this can be very dangerous.
For example, in the ER someone with a cocaine or amphetamine OD should never be treated with a beta blocker solely, but rather a mixed alpha/beta antagonist such as labetalol or carvedilol. This is my understanding.
I don't think many docs are even aware of this.
Anyhow, I am digressing but would be interested in anyone who's switched to provigil due to stimulant intolerance or combined it with an alpha or beta blocker.
Cheers.
poster:mike99
thread:612884
URL: http://www.dr-bob.org/babble/20060219/msgs/613513.html