US Brand Name: Provigil
Generic Name: modafinil
Provigil (modafinil). Provigil is one weird drug. Its primary function is to promote wakefulness in people with narcolepsy, but it is being prescribed off-label for just about everything. It is approaching Neurontin (gabapentin) in the snake oil sweepstakes. At least the people at Pfizer know how Neurontin works and what it does. Provigil is a true mystery. Other than binding to a few dopamine sites in the brain, but not releasing any more dopamine like amphetamines do, the good folks at Cephalon haven’t published (for the 2002 edition of the PDR) just how the hell Provigil does its magic, because they didn’t know! They do know that monkeys like it as much as cocaine. The IAAF still doesn’t know if it’s stimulating enough to affect an athlete’s performance, and who better to know about drugs than a sports federation, right? They plan on banning it next year. The World Anti-Doping Association has just banned it. Even though it doesn’t do jack shit for an athlete’s performance, except maybe in the biathlon. Anyway, Kelli White mentions how it helped her with narcolepsy in this article. I found it to be moderately useful for ADD and to counter the lethargy induced by my Topamax-Neurontin-Risperdal-lorazepam cocktail. I’d have enough concentration, focus and wakefulness to have a bit of a life until about 3:00 or 4:00 p.m. Then it was time to just watch Buffy and eat a reheated supper until the meds caught up with me and he fell asleep in front of the TV around 8:00 p.m. Believe me, it was a vast improvement. At least the food got made, the bills got paid and the dishes got washed. I was most grateful for having that much of a life every day thanks to Provigil. Through experimentation I found that 200 mg first thing in the morning worked best. Any more got me wired and vaguely hypomanic, and hypomania is a potential side effect for the bipolar. Taking extra in the afternoon or dividing the dose to take some in the afternoon just made me hyperaware of how god damn tired I was. Provigil has been found effective as a treatment for ADD for children in studies. According to my doctor, it works best for ADD if sleep disruption or brain injuries are involved. Why, just like me and Mouse!
Mouse finds it to be better much better than Ritalin but less effective than Adderall. She only takes it if her Adderall prescription is screwed up and she runs out. I found Provigil to have the mildest of antidepressant effects, although it is prescribed off-label as an antidepressant. Some people are finding it best when taken in a cocktail with other antidepressants, so maybe that dopamine action is just the boost their other antidepressants need. If the lethargy of mood stabilizers is just too much to bear, and believe us, we know about it being too much to deal with, Provigil is an option to discuss with your doctor. If you get samples, get a prescription right away. I found Provigil to be one of those drugs that if you stop taking it and start again it is less effective, although Mouse doesn’t have such issues. I did great on samples of 100 mg, but then when I got a prescription for it and got it filled from Canada it took 200 mg to achieve the same effects, and nothing else changed in my cocktail. Some meds are just like that. Headache and nausea are really common side effects, but I didn’t experience them. However, I have since had to start taking Provigil again, combining it with Strattera (atomoxetine) for ADD. This time 100mg of Provigil combined with 40mg of Strattera is most effective for concentration, focus and dealing with the lethargy, although I do get the headaches now and then.
Freakiest rare side effects: hallucinations and flatulence.
Initial dose is 100-200 mg in the morning and may be increased to 400 mg either as a single dose in the morning or divided into two doses. Doses above 400 mg are not recommended for anyone who does not have narcolepsy. Provigil is rated for doses up to 600 mg a day.
Provigil’s half-life is 15 hours. I used to buy this med as Alertec from Canada, but the FDA or DEA rescheduled it right in the middle of my order being processed, which really hosed things. Anyway, no more purchases from overseas. For non-narcolepsy usage, the monthly cost is about $120-$330. For narcolepsy that can go up to around $500. Cephalon.