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Provigil


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Has anyone any experience with this drug?  Has anyone used it for better mental focus?  If so, at what dosage?  Would it work well in ADHD as an alternative to the schedule 2 drugs available now?   I don't believe there are generics.  I believe it is quite expensive.   Thanks.

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At present time I would personally not use any pharmaceutical for neuroenhancement .. Provigil/Adderall etc   I would consider using them if I had a health problem where the medication was well studied as a potential therapy. Too much unknown with medications of that type. Especially long term cognitive and personality/behavior concerns. I am sure you are not asking for practice/patient care but if you are please consider using a more reputable source. 

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I'm changing my tune on schedule II and III stimulants. I think they are way overused and pts with no real medical problem just keep coming back for years to get their Adderall refills. I've seen people on 60 or even 80mg per day!!! It makes me uncomfortable having my DEA attached to these refills.

 

I think "ADHD" is one of the most overused/abused diagnoses in family practice. It's just a license for legal speed.

 

 

But as to Provigil, it's not commonly used, and I'm not really sure why. I know it has been used in the military for some time with pilots and ground soldiers. Personally I would not be comfortable using any scheduled stimulant for "mental focus" (enhancement)...that's just asking for an addiction.

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Medicine has developed tools to make some every day tasks a bit quicker/easier ... sleep, studying, alertness during work, sexual arousal/libido well into later years.   Where do we draw the line ?  Should we draw a line ? More and more is becoming medicalized as technology advances and pharmaceutical companies apply their strength and clinicians can be overwhelmed/confused by it all. I also wonder what role insurance should be play in these health issues. I started wondering recently if in the next ten years you will have a new form of medicine called amenity medicine or something like that which does not accept insurance and is focused on these lifestyle enhancers.

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I started wondering recently if in the next ten years you will have a new form of medicine called amenity medicine or something like that which does not accept insurance and is focused on these lifestyle enhancers.

 

There already is....it's called "anti-aging" medicine. AKA for-profit lifestyle enhancement.

 

It's tough to draw a hard line. Take testosterone for example. I'm a big proponent...but I tell patients this is mostly a quality of life issue and not a true medical need. There are also a thousand cash practices out there that will tell you otherwise, and the prescribing thresholds vary widely between providers. There is big money in lifestyle enhancement. People will pay to feel good, and it's easy to tease out a medical "need". The question is, of course, at what point does improving quality of life become irresponsible. 

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Provigil should be prescribed for narcolepsy, shift work sleep disorder, or suboptimally treated obstructive sleep apnea. Disorders of "wakefulness" - not "I need a pick me up." I have also prescribed it for fatigue related to Parkinson's disease. It needs to be monitored carefully

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I wouldn't think that Provigil would help with focus on a non-sleep-deprived individual anyhow.  It doesn't really act like a stimulant.  It shuts down the sleep center.

 

I carried this when I was in the military for the guys I looked after.  They hated it....because it did nothing to enhance performance (which is what they all assumed it would do)...just made them not want to sleep.

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I know there is a stigma for prescribing these types of medications due to the risk of addiction in some people, but I have to say that there is so much stigma that my provider wouldn't write me any scripts. I have been complaining for years about always feeling tired, taking naps daily, etc and I finally decided to go to a sleep center before I start PA school. My PCP always told me it was because I was in college and didn't take me seriously. Well, they did find that I DO have a sleep disorder, but told me "well, being on a more set schedule in school should help"... really?! This is after I have already tried a variety of home remedies that my doctor recommended - more vitamin Bs, extra vitamins etc.

 

It is a little frustrating that people are reluctant to give medicine to someone with no history of addiction, never has taken narcotics, etc. Plus im 26 years old, not an 18 year old. 

 

I know ADHD is misdiagnosed a lot and I agree that people are getting scripts for Adderall who do not have ADHD, but this thread about Provigil hit home to me personally because I actually do have a sleep disorder, but my doctor is someone who doesn't like to prescribe medications - not a bad thing since I am a big fan of preventative medicine, but frustrating when the insomnia doctor has diagnosed sleep disorders after sleep studies.

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No, the sleep specialist is the one who said, "Well, school will have a more set schedule that should help". I asked if there was something they could give me since I've tried everything that my doctor told me. After finding a sleep disorder, I was pretty surprised at the apprehension to prescribe medication. I think at 26, the problem isn't going away - especially when I will be continuing to work in the hospital setting with "swing shifts", but what do I know?! ;)

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It is a little frustrating that people are reluctant to give medicine to someone with no history of addiction, never has taken narcotics, etc. Plus im 26 years old, not an 18 year old. 

 

I know ADHD is misdiagnosed a lot and I agree that people are getting scripts for Adderall who do not have ADHD, but this thread about Provigil hit home to me personally because I actually do have a sleep disorder, but my doctor is someone who doesn't like to prescribe medications - not a bad thing since I am a big fan of preventative medicine, but frustrating when the insomnia doctor has diagnosed sleep disorders after sleep studies.

 

I can see your frustration, but prescribing scheduled drugs is a lot like being a cop. After a while you just start to suspect everyone asking for them is an addict or malingerer until proven otherwise. It's not fair really, but when you have a DEA license it will make more sense. 

 

Sorry to stray away from the OP, I'll shut up now.

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