View Full Version : Provigil vs. Dexedrine for ADD inattentive type


Triana
02-06-06, 08:25 PM
Anyone want to comment on experience with Provigil vs. Dexedrine for ADD inattentive type? Any effect on depression?
I am disorganized, procrastinate and can't get motivated!
Thanks. Have yet to try a drug for ADD, only depression and nothing has seemed to work for depression!

Fast Talker
03-18-06, 09:15 PM
Triana:

Hello there. This is coming from an experienced ADHD paitent. I started of with Dexidrine, and all that did was alter my moods in such a way that I didn't even like myself. I had no appatite at all, and I felt as if something was pushing me from behind. It is a hard feeling to describe. But Modafinil...(Provigil) That is a different story. I took that and there was instantly a new me. I am even reading books on research chemistry now, because that is what I want to do. I am going to be 30 in May and I don't want to wait too long before I do something about a talent that will go to waste. As for the Dex. VS. The Provigil. I have already picked. And the provigil won 100 fold! Hope that this works for the rest of you. Thanks for reading.

Shannon. "Fast Talker"

Jackinbox
03-19-06, 07:18 PM
What dosage of Provigil are you using? Do you take it one or two times a day?

Fast Talker
03-19-06, 09:39 PM
Oh, I am sorry there. I take 100mg 2ce daily. Of the Provigil. The Dexedrine did not do well at all for me. So far things are great. There are no feelings of paranoia or that you are actually drugged. Smooth easy goin' stimulant. I am not depressed anymore, my house is in amaizing condition. I am so much easier to approach. Deffinetly worth the ty. Sorry about leaving out half of the answers to your questions. Thanks for reading.

Fast Talker Shannon.

Fast Talker. Shannon.

tadfish
04-30-06, 09:25 AM
Has anyone combined the 2
i i am on dexies and ritalin and am trying modafinil.
what is it like when you combine amphetamines with modafinil for somebody with ADHD

Fast Talker
05-01-06, 10:10 AM
Hello there:

I am currently taking modafinil with dexidrine also. My doctor said that it would be fine to add an amphetamine safely with the modafinil. If I am having bADD day, I will take a dexidrine with the modafinil. I only do it when I am really having severe ADHD symptoms. That I am lucky for, I don't have a lot of bADD days since I started the modafinil. However, getting back on track here...(:o Maybe I should have taken a Dexidrine today?...) The dose for my modafinil is 200mg in the morning and 200mg in the afternoon. My psychiatrist has increased my dose because I had seen a major decline in myself. I was talking incesently I was impulsive, (:( I actually acted upon an old ADDiction 3 weeks ago:o :( ) I was intrusive to the max. I was cutting everybody off in conversations. And by the time that all these symptoms were hitting me 100 fold, I didn't realize it myself... Which is really strange for me since I have started the modafinil. I have been able to see my bADD days and do something about it. But not this time. So, I have asked all my family and friends, especially my husband, to tell me if I am not noticing what I am doing. That is when I will take a Dexidrine. I have used Ritalin with modafinil too but found that it created a REALLY bad case of dysphoria and paranoia. And all that I took was a 20mg Long Acting Ritalin. The Dexidrine is good. It is a 5mg Quick Release tablet. I just take one with my morning dose and if I feel I need the Dexidrine with my afternoon dose, I will take another Dexidrine. However, I can't do this every day because if I take Dexidrine everyday, I will rage out and be very paranoid. But taking Dexidrine once in a while is an ok thing for me. Thanks for reading.


Fast Talker. ;) :)

Matt S.
05-09-06, 09:49 AM
modafanil or whatever it is called (provigil??) did not help me at all but ive been on a wallop of dexedrine for a long time and that helps but i wish there was something healthier and more "PC" than dexedrine between the 1 month supply, the reputation and the side effects of the crappier generic brand not to mention the junkie attitude i hate dexedrine but it is the ONLY adhd medication that helps me at all and i have to deal with it

NICEEE
06-12-07, 04:25 PM
if you really have inattentive ADD (prefrontal hypoactivity) and you have been checked through an EEG machine and went through diet changes and detoxifications to further confirm your ADD, provigil will make your ADD and consquential atypical ADD depression several times worse. You will feel like you need to sleep it off and the more you try to fall asleep the more your head inflates and tenses up and doesn't let you fall asleep. It torturingly won't let you fall asleep. That is what happened at 12pm to me after i left my neurologist's office.

In one week i will be put on ADDERALL and have no idea how i am going to survive up to that point. Because i also have narcolepsy and waiting for xyrem in the mail.

Right now i am writing about this to stimulate myself from not falling asleep. If i fall asleep right now i will sleep for 4 hours and will still barely get up after such a long nap. I sleep 8-9 hours every night, healthy diet, no sugar or colors, vitamins, jog every morning, but still have an almost irrisistable urge to fall asleep right now.


But if you have more of a inconsistent sleep/depression/diet problem, then the provigil might just work for you to wake you up have you do your sh*t instead of having yourself fooling around with your friends or your computer and not discipling yourself to go to sleep early and then be depressed of your poor decision making.

JR1973
06-13-07, 10:33 AM
Provigil seems to be some kind of 'snake oil' med because nobody really knows how it works. I kind of curious about it myself. A long acting form for ADD was sent to the FDA but got shot down so that won't be out anytime soon.
My doctor says it really doesn't work too well for ADD but it does wake you up. Insurance will fight you to hell and back trying to get it approved too. It's supposed to be Un-Godly expensive.

I look forward to reading about everyone's input on it though. I'm currently on Adderall XR but I am also being treated for Sleep Apnea (I use a Bi-Pap machine) so I wonder if adding Provigil into the mix might help even more?

J

Nocturnal
06-13-07, 09:13 PM
My doc said if you can get a certified sleep doc to prescribe you the Modanifil then you should be able to get your insurance to cover it. It is supposed to be prescribed for sleep problems such as narcolepsy and maybe even sleep apnea with it having an adverse affect on your wakeful state.

Main thing is though you get the script through some type of certified sleep specialist.

JR1973
06-14-07, 09:58 AM
Just got back from my monthly visit from my Neurologist. She gave me free samples of Provigil, enough to cover 2 weeks worth. She also said I'll have to do another sleep study, but this one will be some kind of daytime test, to give them enough ammo to try and get Provigil approved through insurance.

Provigil is approved for excessive daytime sleepiness, OSA (Obstructive Sleep Apnea, and Narcolepsy).

J

jealibeanz
06-15-07, 07:34 AM
I take 400 mg Provigil. I agree, it doesn't help with concentration all that much, but does keep you awake, which is certainly a plus when you're attempting to concentrate. Most people are pretty tired and sleep deprived in this country. Provigil gives you a little "leg up" on this problem.

As far as insurance coverage goes, it seems to vary greatly.

My former plan (a division of BC/BS), required no prior authorization for stimulants or Provigil. My current plan requires no prior authorization for Provigil, but does for Ritalin. To approve Ritalin, my doc submits my dx as narcolepsy.

I know many plans do require prior authorization, but this usually can be done by having the physician submit an "acceptable" diagnosis. I don't think most require sleep studies. Some, but not more.

A lot of experts don't regard sleep studies as a wonderful diagnostic tool because it's not indicative of how the patient sleeps normally at home.

JR1973
06-15-07, 09:50 AM
I agree with jealibenz about Provigil. Yesterday I took 100mg 2x during the day. Didn't really do much. Today I started with 200mg in the AM followed with my Adderall XR 30mg. The provigil does help make you alert or awake I guess but doesn't do anything for attention. It's kinda wierd. It's a stimulant but not a stimulant I guess.
Ditto about the sleep studies. I've had two over the last 5 years. It's hard to sleep when you are in some strange place with a couple dozen wires stuck to you and such. My last one was probably as close to accurate as possible because that is when I went from cpap to bipap and has made a huge difference. My doc thinks the reason my adderall xr doesn't seem to work too long is that its supplementing for sleep deprivation from over the years. She thinks what I think as well rested and normal is probably only about 50% when compared to a normal non-sleep apnea person.


Jealibenz: Do you take any other ADD meds with your provigil?

J

PleinSoleil
06-18-07, 09:04 PM
if you really have inattentive ADD (prefrontal hypoactivity) and you have been checked through an EEG machine and went through diet changes and detoxifications to further confirm your ADD, provigil will make your ADD and consquential atypical ADD depression several times worse. You will feel like you need to sleep it off and the more you try to fall asleep the more your head inflates and tenses up and doesn't let you fall asleep. It torturingly won't let you fall asleep. That is what happened at 12pm to me after i left my neurologist's office.I completely disagree. I am a textbook case of inattentive ADD which I know with certainty is not related to my diet (I eat almost no sugar, nothing artificial, and am very conscious of the effects that carbohydrates have on my faculties). Provigil has helped my ability to focus beyond measure--to such an extent that I have to this point shelled out $400/mo to remain on it. I don't think it is helpful to say "if you have X, then Y will not help you." Everyone is effected differently. (And, for the record, I combine Provigil with Strattera; I have also combined Strattera with ritalin and adderall, and I know the difference in effects.)

I do agree COMPLETELY that Provigil will not only destroy your ability to sleep but can make attempts to sleep deeply unsettling (in my case, I vivid waking nightmares the minute I would drift off.) The solution: I take it in the morning and have never had a problem going to sleep. Because Provigil does wear off in the afternoon and I find the sleep effects disturbing, I take a 10mg ritalin in the late afternoon to give me a booster until the night.

The point is, any of these drugs could work for anyone. You don't know until you try them.

jealibeanz
06-18-07, 10:57 PM
if you really have inattentive ADD (prefrontal hypoactivity) and you have been checked through an EEG machine and went through diet changes and detoxifications to further confirm your ADD, provigil will make your ADD and consquential atypical ADD depression several times worse. You will feel like you need to sleep it off and the more you try to fall asleep the more your head inflates and tenses up and doesn't let you fall asleep. It torturingly won't let you fall asleep. That is what happened at 12pm to me after i left my neurologist's office.

In one week i will be put on ADDERALL and have no idea how i am going to survive up to that point. Because i also have narcolepsy and waiting for xyrem in the mail.

Right now i am writing about this to stimulate myself from not falling asleep. If i fall asleep right now i will sleep for 4 hours and will still barely get up after such a long nap. I sleep 8-9 hours every night, healthy diet, no sugar or colors, vitamins, jog every morning, but still have an almost irrisistable urge to fall asleep right now.


But if you have more of a inconsistent sleep/depression/diet problem, then the provigil might just work for you to wake you up have you do your sh*t instead of having yourself fooling around with your friends or your computer and not discipling yourself to go to sleep early and then be depressed of your poor decision making.
ADHD is a psychiatric diagnosis. It is based on symptoms.

There are no physical diagnostic criterion. Many clinicians do believe that a large percentage of people with ADHD have a form of dysfuction in the prefrontal cortex, but it's not a "rule". It's fairly well accepted that the disorder can be due to genetics or physical or psychological trauma. Although "attention" is believed to be largely controlled in the prefrontal region, there are many other factors that are likely to be involved.

I don't agree with telling someone definitively that Provigil will make ADHD and depression worse. Everybody reacts differently to medications. Personally, I've had a good experience with it and it's lessened my ADHD symptoms and lifts my mood.

In fact, there are doctors and researchers who believe Provigil can lessen ADHD and depressive symptoms. Many use it as off-label treatment.

It was very very close to being approved as a pediatric ADHD medication, prescribed at fairly high doses. The only reason the FDA didn't approve it was because there was an incident of one child developing Steven-Johnson Syndrome, which the researchers believed to be unrelated to the medication, or at least a extremely rare reaction. I'm surprised that completely dropped the project instead of completing subsequent studies regarding its safety.

While eating well and exercising is a good idea for health reasons, there's never been any conclusive evidence that sugar or dyes are the cause of ADHD. Sure, it's a theory, but not one with a great deal of evidence. If eliminating such substances results in major improvements, there may be underlying health issues, like food/chemical allergies or insulin resistence.

That's nice that you have decided to eliminate sugar and dyes from your diet, that you exercise, and that you have good sleep hygiene. Your tone is elluding to the fact that you believe anyone who doesn't practice the same habits is to be looked down upon for not caring for themselves. It's not necessary, nor is your comment about the poster "fooling around with friends and the computer, lacking discipline, and making poor decisions."

Everybody does the best they can do at all times. Think about it. Even when making a "poor" decision, you can always justify it with a reason. That's how life works and how people behave.

It sounds as if you are projecting your own thoughts, feelings, and worries onto the poster. That's uncalled for.

jealibeanz
06-18-07, 11:00 PM
BTW, Provigil's patent expires soon. I'm not sure when, but I believe it's within 2007. This is why the company has created "Nuvigil", its isomer.

ventyourpain2k5
06-18-07, 11:13 PM
You are 5 years off.

jealibeanz
06-19-07, 05:52 AM
You are 5 years off.
Oh, right, I forgot there was a change with Provigil's patent. It was supposed to expire in November 2007, but Cephalon negotiated (payed) the companies who were planning on producing a generic version to hold off until 2012.

Anyhow, Nuvigil has been approved and the reason why it was submitted was because Provigil's patent should have expired this year.

There has been some speculation that this event may cause the price of Provigil to drop, especially because insurance companies will want to negotiate its cost to be less than Nuvigil. It also might help to lower to copay for those with insurance or to be covered by those who don't already allow it on their formulary. Even though Nuvigil is made by the same company, its release means that Provigil is no longer a novel drug it a class of its own.

johnatmls
06-21-09, 10:26 PM
I was unable to fill dexedrine script, I was completely out, it was Friday and the doctor was out until Monday. I remembered that I received samples of Nuvigil(Armodofinil) by Cephalon, Inc. I have been taking large doses to see if it could replace dextroamphetamine 30mg BID and it has worked exceptionally well. It has allowed me to focus and concentrate without causing severe changes to my personality. It has not caused the tensing of all my muscles, it has not caused hyper-manic episodes, it has not caused severe anxiety, it has not caused hyper sexuality, it does not seem like a drug you would abuse, It just seems good. I have been looking for something like this for 30 years now, I may have found a drug that allows me to keep my personality, allows me to focus, and yet does not cause any obsessive behavior like the other C-II stimulants. It is much better than Adderal and Ritilin. This is the best medication I have experienced, I just hope it works out.:)

nzkiwi
07-11-09, 03:06 AM
Honestly, the fda probably told cephalon to hold off gaining approval for provigil and wait for nuvigil. Bring nuvigil to market and we will approve that for adhd. Makes better business sense for Cephalon. Why gain fda approval for provigil for adhd when it will be off patent soon.

You wait and see. I'll put a lot of money on nuvigil gaining fda approval for adhd.

I know this sound conspiracy like, but the fda spends as much time looking out for the financial wellbeing of these pharma companies as they do us citizens. Which I feel is completely wrong.

For example the fda allows companies to isolate isomers and re-patent the medicine. All this does is extending patents and line the pockets of the pharmaceutical companies. This is one of the many reasons our health care system in the most costly in the world.

Take lexapro, their is no compelling evidence that it is any more effective than celexa, yet many doctors will prescribe lexapro over celexa.

Note: Provigil was recently showen to block the re-uptake of dopamine in the same areas of the brain that methylphenidate and amphetamines do. Probably the one thing that make provigil less addictive is its longer half life.

ryanchappell
08-08-09, 07:01 PM
The trial and vote to disapprove the ADHD version of modifinal seems a little fishy.

The rash turned out to be benign and the ideal excuse for the panel, who at least one member admitted to holding Shire (Adderall, Vyvanse patent holder) shares.

They said that the trials said it was effective in around 50% of children. That is significant! Especially the way doctors have you try one med after another, and play with doses, until it works.

There are some patients that it would work for that can't take the other drugs, kind of like the way strattera is being used. Also, it could be used for breaks from amphetamines, and is proven to help withdrawals in much harder, abused drugs, and still provide relief for many patients of actual ADHD symptoms.

Sleepiness and fatigue are major symptoms in ADHD-p inattentive, and and Provigil or Nuvigil would "erase" a lot of this where amphs just delay it, and make sleeping it off more difficult.

I bet if shire had the modifinal patent it would have been approved.

dololly
08-08-09, 07:36 PM
I take Provigil..I love the results! The down part is that Provigil is prescribed not only for ADD, but for helping you stay awake (ie people who just fall asleep). I would recommend you take it first thing in the morning. You may have problems with sleep, but maybe if you take a sleeping med, it will help you go to sleep.

nzkiwi
08-11-09, 05:43 AM
Unfortunately Provigil has orphan drug status.

An orphan drug is a pharmaceutical agent (http://www.addforums.com/wiki/Medication) that has been developed specifically to treat a rare medical condition, the condition itself being referred to as an orphan disease (http://www.addforums.com/wiki/Rare_disease). The assignment of orphan status to a disease and to any drugs developed to treat it is a matter of public policy (http://www.addforums.com/wiki/Public_policy_(law)) in many countries, and has resulted in medical breakthroughs that would not have otherwise been achieved due to the economics of drug research and development (http://www.addforums.com/wiki/Medical_research).

I think what this means is, the company is given extra patent protection under the law and is allowed to charge outrageous prices for the drug.

The problem I see with this is: 1) Narcolepsy isn't that uncommon, as clinicians are recognising the disorder more frequently. 2) A large percentage of Provigil sales are off-label. 3) Provigil has expanded indications, including sleep-shift disorder and so on.

My point is, it's unfortunate the price of the drug is so high as many people could benefit from ModafiniL. These pharmaceutical companies are making record profits, meanwhileThe government lets these companies hide behind patent protections.

Gonga
09-13-09, 10:52 AM
Just found out about provigil in the last week, and lo and behold a day later I find out a friend of mine (not ADD) had some in his cupboard as he was using it to get extra work done.

I've been taking it for 3 days and I notice a massive difference in staying focused on single tasks, silly stuff where usually I would be gone and staring in to space a minute or two in starting something. I know its just the first few days, but I intend to order some. (Its just not worth waiting months and months for a decent UK doctor to finally refer me, tried that already)

The last few days I have felt as close to normal as I imagine it to be. I still manage to sleep okay, and there is no "high" of any note, despite a slight feeling that I am more "on the ball" than usual.

From what I am reading this could well be what I have been hoping would come along, I don't see to many side effects being spoken of if its taken sensibly.

And even at the cost online, right now it seems like a steal considering what everyday life can be like sometimes.

handschar
12-17-09, 01:20 AM
Interesting thread. I have had experience with both Adderall and Provigil separately. Both worked well for a period. However, tolerance, particularly with the latter, became noticeable relatively quickly. I would say, within a handful of weeks.

After a period of experimenting with OTC alternatives (without success), I have once again begun a regimen of Provigil, 100mg tid. I am going to query my physician regarding the possibility of reducing the Provigil to 100mg bid, and adding either Adderall or Dexedrine, at a yet undetermined dose, in place of the third 100mg dose of Provigil. This, I hope, will not only reduce the cost I incur on a monthly basis, but will extend the efficacy of both.

I am not a medical professional. Thus I hope to not make a fool of myself by even asking what I am about to ask. But I will nonetheless. :) Considering that eugeroics and amphetamines have two different—though apparently not entirely distinct according to recent literature—modes of function, is there any indication by those knowledgeable on the subject, of the potential for synergy between any two compounds of the eugeroic and amphetamine classes presently prescribed for the treatment of ADHD?

With that, I will conclude my first 'real' post on the forum. The first post was a response to a thread regarding forum members' occupations. :)

MishaMisha123
08-25-12, 12:51 AM
I have inattentive form of ADD with a diagnosis of Primary Idiopathic Hypersomnia. I take 2 x 200mg Provigil daily. This did not make depression worse and has kept me awake. Attention is slightly better, since I don't need to sleep all the time. The biggest thing this did for me is keep me awake during the day. Without it, I would sleep my life away, and that seemed to be a major source of my depression, since I didn't want to do ANYTHING due to tiredness. I can still fall asleep, no problem, at night, and can even take a nap during the day, which isn't as necessary as it was before Provigil. I didn't notice any additional difference with Ritalin or Aderall.

Yes, dealing with insurance companies is a nightmare with Provigil, as it is difficult enough for my ADD brain to keep up with normal daily tasks, let alone deal with the insurance company every time I get a new prescription. I've been taking it for years, have done the night and daytime sleep study, received the hypersomnia diagnosis, and we still have to play the ridiculous "prior authorization" game with every new prescription. My diagnosing doctor retired and now I have to deal with a new one that will only write a prescription every 6 months. He says "that's how I was raised", which translates to "I need you to show up every 6 months, so I can see you for 2 minutes to make more money". This means I have to see him every 5 months, since I can count on the insurance company to jerk me around for at least a month with each prescription, playing the "we never received the fax" game.

Sheesh, time to walk away...this is frustrating me just talking about it. :rolleyes:

Good luck!

MishaMisha123
08-25-12, 01:26 AM
Oh, and forgot to mention the cost: 1500 for 3 months (180). :(

hollywood
08-25-12, 10:50 PM
Cost me 30 bucks

Mr.Addams
09-17-12, 07:42 PM
I tried modafinil for a month. I was prescribed it for hypersomnia. It made my overwhelming tiredness much, much worse.

I'm on dexamphetamine now, which works well for keeping me awake, not always well for tiredness/sleepiness though.

I am considering combining both, as the beneficial effects of modafinil in regard to motivation/cognitive are very alluring.