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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 Jonathan_NC on June 1, 2007, at 20:43:12
Hello,
I am taking the following medications in the morning for atypical depression and social anxiety:
200 mg Lamictal
37.5 mg Effexor XR (just started a week ago)
300 mg Wellbutrin XL
100 mg Provigil (just started today)I thought Provigil would be the 'magic' pill to help me out of this perpetual funk, but it didn't have any effect today. I didn't take my .25mg Klonopin this morning because I didn't want to negate the effect of Provigil. Am I right in thinking this?
For those of you who are educated in these drug interactions, or have personal experience with them, can anyone tell me if the drugs in my cocktail are canceling each other out? Is there anything dangerous about this mix? I do trust my psychiatrist, but I would like a second opinion from all of you.
Thank you so much. I wish you all well,
Jonathan
Posted by Phillipa on June 1, 2007, at 22:00:36
In reply to Drugs counteracting each other? Provigil and more, posted by Jonathan_NC on June 1, 2007, at 20:43:12
I'd be climbing the walls with anxiety as so many stimulants. Love Phillipa
Posted by KayeBaby on June 1, 2007, at 23:15:13
In reply to Re: Drugs counteracting each other? Provigil and more » Jonathan_NC, posted by Phillipa on June 1, 2007, at 22:00:36
100mg is a low dose. I think 200 is average to start so don't worry. Try 200 tomorrow.
Klonopin put me into a zombie funk. I would avoid or minimize it. It has a very long half life-like 30 hrs.
For me, provigil was a mood brightener and I could stay awake on it but it did not feel stimulating per se. It worked well for me at first then not so good. But I'm like that and it takes a fire to make me actually feel stimulated.
Take Care,
Kaye
Posted by EERRIICC on June 2, 2007, at 13:45:33
In reply to Drugs counteracting each other? Provigil and more, posted by Jonathan_NC on June 1, 2007, at 20:43:12
Don't alter you're Klonipin dose, I doubt it will make any difference.
Provigil may need to be raised to a higher dose 200...400...600mg before it works decently. It is a very interesting drug, don't give up on it easily...augment and adjust it's dosages and such.
Posted by LlurpsieNoodle on June 2, 2007, at 16:53:50
In reply to Drugs counteracting each other? Provigil and more, posted by Jonathan_NC on June 1, 2007, at 20:43:12
Hi J,
Wow! sounds a lot like MY cocktail. Like you I respect and trust my pdoc (psychopharm doc) so I guess we'll just have to trust them.
>
> I am taking the following medications in the morning for atypical depression and social anxiety:
>
> 200 mg Lamictal300 for me
> 37.5 mg Effexor XR (just started a week ago)
> 300 mg Wellbutrin XL
> 100 mg Provigil (just started today)200 for me.
Also geodon 180mg and klonopin .5mg
> I thought Provigil would be the 'magic' pill to help me out of this perpetual funk, but it didn't have any effect today. I didn't take my .25mg Klonopin this morning because I didn't want to negate the effect of Provigil. Am I right in thinking this?
>
> For those of you who are educated in these drug interactions, or have personal experience with them, can anyone tell me if the drugs in my cocktail are canceling each other out? Is there anything dangerous about this mix? I do trust my psychiatrist, but I would like a second opinion from all of you.For about 5 mos I took a cocktail of cymbalta (similar in many ways to effexor) provigil 200mg and seroquel. I got great results from that. It is my experience that the provigil cancelled the sedation I was experiencing from cymbalta (and now geodon). I found that it had far fewer side effects than coffee. It didn't give me jitters, and didn't seem to be addictive in the way that coffee is (NeEd MoRe!!!).
Now, supposedly the effexor is supposed to be good for anxiety. Well, cymbalta didn't do CRAP for my anxiety, finally I got the go ahead to take klonopin. You take a very low dose of klonopin. If you don't notice any sedation, keep taking it. Especially if it's prescribed. If you still feel sedated (sleeping too much, nodding off at inappropriate times) you should ask your pdoc if 200mg provigil is not more appropriate. Also consider the time of day when you take your anti-depressants. The ones that are more stimulating- take those in the am or during the day. Take the sleepy-making ones at night.
>
> Thank you so much. I wish you all well,
> JonathanI wish you well too. Remember that everyone's body is different. The more questions you ask, the more you will learn.
As far as dangerous side effects- ask your pdoc, but I cannot see any reason for bodily harm. However there may be a psychological effect of taking a lot of pills. You may feel "sicker" or worry more about your symptoms and about your doctor's competence. Hang in there,
-Ll
Posted by stargazer2 on June 2, 2007, at 17:59:11
In reply to Re: Drugs counteracting each other? Provigil and more » Jonathan_NC, posted by Phillipa on June 1, 2007, at 22:00:36
None of the meds he is taking are stimulants,per se and many people with depression need the AD's like Wellbutrin for energy and Provigil for wakefulness, but they're not considered stimulants. And Lamictal is a mood stabalizer, not a stimulant.
I think all of them in combination are useful and not exactly working aginst one another.
What is officially your diagnosis? Depression with anhedonia, Atypical Depression, Treatment resistant depression? Just curious...Stargazer
Posted by Phillipa on June 2, 2007, at 20:01:26
In reply to Re: Drugs counteracting each other? Provigil and more » Jonathan_NC, posted by Phillipa on June 1, 2007, at 22:00:36
Stargazer I know that wellbutrin is not a stimulant but that's what it did to me at l50mg a week later ended up in the hospital as the pdoc thourht I was manic couldn't sit still running around so they took me off it right away and I was fine. Love Phillipa
Posted by Jonathan_NC on June 4, 2007, at 19:02:11
In reply to Re: Drugs counteracting each other? Provigil and m » Jonathan_NC, posted by LlurpsieNoodle on June 2, 2007, at 16:53:50
I want to thank you all for your wonderful responses. Surprisingly, I haven't noticed any stimulating effect from Provigil, even at 200mg.
Does anyone who has social anxiety feel like if they were more content they wouldn't be so anxious in public? That's how I feel.
On another topic, when I listed all the drugs I'm on, I was kind of taken aback. I need to consolidate and consider generic drugs, as I'll be off health insurance at the end of the month. I'm sure many of you have encountered this dilemma and have spoken about it on the this board. Provigil is probably not something I'll continue at $7-$10 per 200mg. Wellbutrin and Klonopin are generic, fortunately. No luck on Lamictal or Effexor. Any other generics recommended for dysthymia and/or social anxiety? I'll probably repost this as a new thread if I don't get any responses.
Thank you again for your kind responses. I wish all of you wellness and happiness, and look forward to knowing you better.
Jonathan
Posted by F00TBALL on June 11, 2007, at 7:28:59
In reply to No Provigil effect, and generic alternatives, posted by Jonathan_NC on June 4, 2007, at 19:02:11
Sometimes people have to go up to 400MG to get results from it. But if your insurance won't cover it, it's probably not a realistic option for you.
This is the end of the thread.
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