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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by owl on November 17, 2000, at 12:38:50
Hello,
I'm trying to find info on the use of Provigil (a med for narcolepsy, and sometimes used for ADHD) and it's potential for treatment of BP. Especially when sedation and lack of focus/concentration are side effects of other BP meds. Does anyone have any info on this?
Thanks!
Owl
Posted by SLS on November 17, 2000, at 21:34:56
In reply to provigil for bipolar disorder, posted by owl on November 17, 2000, at 12:38:50
> Hello,
> I'm trying to find info on the use of Provigil (a med for narcolepsy, and sometimes used for ADHD) and it's potential for treatment of BP. Especially when sedation and lack of focus/concentration are side effects of other BP meds. Does anyone have any info on this?
> Thanks!
> OwlRecent studies sponsored by the drug manufacturer have indicated that Provigil is not effective for ADD or AD/HD. However, Provigil does seem to help some people with both major depression and bipolar depression when combined with a standard antidepressant.
If you search the archives over the last six months, you will find a few threads regarding Provigil, and many regarding its sister drug, adrafinil (Olmifon).
Check out this link. It is an abstract from Medline.
modafinil = Provigil
Posted by danf on November 18, 2000, at 4:15:22
In reply to provigil for bipolar disorder, posted by owl on November 17, 2000, at 12:38:50
One thing to always keep in mind is that lack of focus /concentration is often a sign of inadequate treatment, not a med side effect.
This can be difficult to sort out. Many of the older anti-psychotics had this effect & also a parallel sedation effect as dosages were increased.
Many of the newer APs & ADs do not have this increase in sedation & confusion as the dose increases.
If you have a problem with focus /concentration, you need to discuss this carefully with your treating doc to try & determine the cause. Then modify your med regimen accordingly.
Posted by KarenK on November 22, 2000, at 10:50:52
In reply to provigil for bipolar disorder, posted by owl on November 17, 2000, at 12:38:50
Hi Owl,
Provigil is used on a short term basis to straighten out your sleep cycle, a big problem in bipolar. Since it is classified as an amphetamine, I would think it put you at risk of triggering a manic episode if used on a regular basis. Just my 2 cents.
KarenK
Posted by Rick on November 24, 2000, at 21:10:18
In reply to Lack of focus/concentration, posted by danf on November 18, 2000, at 4:15:22
Since all new prescription stimulants for 40 years were amphetamines, I can see how folks might jump to the conclusion that Provigil is as well.
But in fact Provigil is NOT an amphetamine. Indeed, that's one of its biggest benefits in many cases. Provigil usually has substantially fewer side effects and a lot less abuse potential than amphetamines, so it is much less stringently controlled by the FDA. Provigil is a Class IV substance like a benzo, vs. the amphetamine-based drugs, which fall into the much more restrictive Class II.
Regarding Provigil's lack of proven efficacy in ADD, it's important not to conclude that this means it's not stimulating for others. (Indeed, Provigil's official designation is for excessive daytime sleepiness due to narcolepsy. Hmm...do all narcoleptics by definition have ADD?)
Low-dose (100 mg/day) Provigil has helped me so much in terms of alertness (without adding nervousness or anxiety), wakefulness, motivation, enthusiasm, and sociability. Frankly, I wasn't expecting or hoping for anything more than a reduction in fatigue, but it turned out to provide that and lots more. I initially added Provigil when the Serzone that was added to my Klonopin regimen (for social anxiety) zoned me out...sleepy and blase. But now it's part of my daily regimen. (BTW, I was already a bit low on the motivation scale even before the Serzone.)
It's been at least four months now, with no sign of poop-out. The first few days often produce mild euphoria, which is basically a short-lived, pleasant side effect. I sometimes think peole who cite super-quick Provigil poop-out were actually reacting to the rapid disappearance of the quick-onset euphoria.
Finally, regarding safety in bipolar disorder, take another look at the small study Scott linked to above, in which Provigil was very successful in jump-starting AD's. While the small sample size and lack of placebo-control should be considered, you'll note that the responders included people with bipolar depression.
Rick
----
> Hi Owl,
>
> Provigil is used on a short term basis to straighten out your sleep cycle, a big problem in bipolar. Since it is classified as an amphetamine, I would think it put you at risk of triggering a manic episode if used on a regular basis. Just my 2 cents.
>
> KarenK
-----
> One thing to always keep in mind is that lack of focus /concentration is often a sign of inadequate treatment, not a med side effect.
>
> This can be difficult to sort out. Many of the older anti-psychotics had this effect & also a parallel sedation effect as dosages were increased.
>
> Many of the newer APs & ADs do not have this increase in sedation & confusion as the dose increases.
>
> If you have a problem with focus /concentration, you need to discuss this carefully with your treating doc to try & determine the cause. Then modify your med regimen accordingly.
Posted by Rick on November 24, 2000, at 21:39:29
In reply to Re: Lack of focus/concentration, posted by Rick on November 24, 2000, at 21:10:18
I should've pointed out that the last paragraph in my post was basically repeating what Scott already said regarding the Provigil AD-augmentation study. I thought it was worth repeating. (OK, OK, I just didn't read carefully!! I do have an excuse, but it's too lame to share.)
------
> Since all new prescription stimulants for 40 years were amphetamines, I can see how folks might jump to the conclusion that Provigil is as well.
>
> But in fact Provigil is NOT an amphetamine. Indeed, that's one of its biggest benefits in many cases. Provigil usually has substantially fewer side effects and a lot less abuse potential than amphetamines, so it is much less stringently controlled by the FDA. Provigil is a Class IV substance like a benzo, vs. the amphetamine-based drugs, which fall into the much more restrictive Class II.
>
> Regarding Provigil's lack of proven efficacy in ADD, it's important not to conclude that this means it's not stimulating for others. (Indeed, Provigil's official designation is for excessive daytime sleepiness due to narcolepsy. Hmm...do all narcoleptics by definition have ADD?)
>
> Low-dose (100 mg/day) Provigil has helped me so much in terms of alertness (without adding nervousness or anxiety), wakefulness, motivation, enthusiasm, and sociability. Frankly, I wasn't expecting or hoping for anything more than a reduction in fatigue, but it turned out to provide that and lots more. I initially added Provigil when the Serzone that was added to my Klonopin regimen (for social anxiety) zoned me out...sleepy and blase. But now it's part of my daily regimen. (BTW, I was already a bit low on the motivation scale even before the Serzone.)
>
> It's been at least four months now, with no sign of poop-out. The first few days often produce mild euphoria, which is basically a short-lived, pleasant side effect. I sometimes think peole who cite super-quick Provigil poop-out were actually reacting to the rapid disappearance of the quick-onset euphoria.
>
> Finally, regarding safety in bipolar disorder, take another look at the small study Scott linked to above, in which Provigil was very successful in jump-starting AD's. While the small sample size and lack of placebo-control should be considered, you'll note that the responders included people with bipolar depression.
>
> Rick
>
> ----
> > Hi Owl,
> >
> > Provigil is used on a short term basis to straighten out your sleep cycle, a big problem in bipolar. Since it is classified as an amphetamine, I would think it put you at risk of triggering a manic episode if used on a regular basis. Just my 2 cents.
> >
> > KarenK
>
>
> -----
> > One thing to always keep in mind is that lack of focus /concentration is often a sign of inadequate treatment, not a med side effect.
> >
> > This can be difficult to sort out. Many of the older anti-psychotics had this effect & also a parallel sedation effect as dosages were increased.
> >
> > Many of the newer APs & ADs do not have this increase in sedation & confusion as the dose increases.
> >
> > If you have a problem with focus /concentration, you need to discuss this carefully with your treating doc to try & determine the cause. Then modify your med regimen accordingly.
Posted by SLS on November 25, 2000, at 17:32:41
In reply to Redundancy Alert! (Provigil bipolar), posted by Rick on November 24, 2000, at 21:39:29
NO POST ALERT!
Just another dose of redundancy:
> I should've pointed out that the last paragraph in my post was basically repeating what Scott already said regarding the Provigil AD-augmentation study. I thought it was worth repeating. (OK, OK, I just didn't read carefully!! I do have an excuse, but it's too lame to share.)
> ------
> > Since all new prescription stimulants for 40 years were amphetamines, I can see how folks might jump to the conclusion that Provigil is as well.
> >
> > But in fact Provigil is NOT an amphetamine. Indeed, that's one of its biggest benefits in many cases. Provigil usually has substantially fewer side effects and a lot less abuse potential than amphetamines, so it is much less stringently controlled by the FDA. Provigil is a Class IV substance like a benzo, vs. the amphetamine-based drugs, which fall into the much more restrictive Class II.
> >
> > Regarding Provigil's lack of proven efficacy in ADD, it's important not to conclude that this means it's not stimulating for others. (Indeed, Provigil's official designation is for excessive daytime sleepiness due to narcolepsy. Hmm...do all narcoleptics by definition have ADD?)
> >
> > Low-dose (100 mg/day) Provigil has helped me so much in terms of alertness (without adding nervousness or anxiety), wakefulness, motivation, enthusiasm, and sociability. Frankly, I wasn't expecting or hoping for anything more than a reduction in fatigue, but it turned out to provide that and lots more. I initially added Provigil when the Serzone that was added to my Klonopin regimen (for social anxiety) zoned me out...sleepy and blase. But now it's part of my daily regimen. (BTW, I was already a bit low on the motivation scale even before the Serzone.)
> >
> > It's been at least four months now, with no sign of poop-out. The first few days often produce mild euphoria, which is basically a short-lived, pleasant side effect. I sometimes think peole who cite super-quick Provigil poop-out were actually reacting to the rapid disappearance of the quick-onset euphoria.
> >
> > Finally, regarding safety in bipolar disorder, take another look at the small study Scott linked to above, in which Provigil was very successful in jump-starting AD's. While the small sample size and lack of placebo-control should be considered, you'll note that the responders included people with bipolar depression.
> >
> > Rick
> >
> > ----
> > > Hi Owl,
> > >
> > > Provigil is used on a short term basis to straighten out your sleep cycle, a big problem in bipolar. Since it is classified as an amphetamine, I would think it put you at risk of triggering a manic episode if used on a regular basis. Just my 2 cents.
> > >
> > > KarenK
> >
> >
> > -----
> > > One thing to always keep in mind is that lack of focus /concentration is often a sign of inadequate treatment, not a med side effect.
> > >
> > > This can be difficult to sort out. Many of the older anti-psychotics had this effect & also a parallel sedation effect as dosages were increased.
> > >
> > > Many of the newer APs & ADs do not have this increase in sedation & confusion as the dose increases.
> > >
> > > If you have a problem with focus /concentration, you need to discuss this carefully with your treating doc to try & determine the cause. Then modify your med regimen accordingly.
Posted by Rick on November 25, 2000, at 19:03:01
In reply to Re: Redundancy Alert! - Phew, you had me worried! » Rick, posted by SLS on November 25, 2000, at 17:32:41
YOU might call what you submitted a redundacy, but Kellogg's and General Mills would call it the headline of their dreams. I *would* miss my Grape Nuts, though.
> NO POST ALERT!
>
> Just another dose of redundancy:
This is the end of the thread.
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