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Medical Forum / General / General / April 2007Provigil - what kind of doctor do I need to find?
For the last ten years, actually for as long as I can remember, I have been sleepy all the time during the days but I can't work a third shift job because I need to be able to work when most places of business, especially libraries, are open. I read about Provigil on the Internet and it sounds like an ideal remedy but when I mentioned it to one of the doctors at my HMO, an ethnic family practice doctor with probably little experience in sleep related disorders, she said she had never heard of Provigil and would not prescribe something she knows little about. Is that ignorance or what? An intelligent caring doctor would look it up on Medline, check current review literature, then decide if a patient's suggestion is a valid one. Okay. I think I made it clear my HMO doctor is no good when it comes to treating a specialty disorder so I thought I'd check the newsgroups. What kind of doctor do you think would be most likely to recommend Provigil and what do I say to be convincing. I am sure that saying coffee and caffeine beverages irritate my stomach would sound kind of lame (although true) so what else can I say to make a point? Oh, and I posted to this group (alt.support.depression.manic) because when I searched the newsgroups for Provigil this was the first group where I got a hit. I cross-posted to sci.med, and sci.med.pharmacy also because those are the first NGs I would have thought of right off the top of my head. Thanks. Jan On 3/2/07 8:50 AM, in article 1172854224.491901.180760@h3g2000cwc.googlegroups.com, "Jan" <c3derp0nd@gmail.com> wrote: > For the last ten years, actually for as long as I can remember, I have > been sleepy all the time during the days but I can't work a third [quoted text clipped - 24 lines] > > Jan I have been prescribed modafinil (Provigil) by a psychiatrist. I personally did not find it superior to caffeine in any way. It costs at least an order of magnitude more. There may be no significance, but doses for modafinil and caffeine seem to be pretty much the same, 100 to 200mg. There is a significant probability that you have an underlying condition. In my case, I was also sleepy all the time and had difficulty concentrating. After much pestering, my primary care physician order MRI of my head. It disclosed normal pressure hydrocephalus which contributed to poor gait and poor concentration. That problem was relieved with shunt surgery. The sleepiness showed up again. Doctors did not seem to take me seriously when I complained about orthostatic hypotension symptoms. After searching through the internet, I was able to see a neurologist who did take me seriously. She called the problem functional dysautonomia. Unfortunately, my impression is that minor things can can be done for relief of the problem. I am not suggesting that your problems are the same as mine. My point is to be persistent in a quest for help. Find physicians working on problems similar to yours. No matter how much professional medical help you need, you are your own best advocate. This gets me to my peeve about Medicare. Medicare does not pay physicians enough for the use of their brains. They make income by doing things (procedures) to you. AFIK there is no legal way for me to supplement payments to physicians beyond Medicare payments. Instead, I keep on going back short visits that do not get to the root of my problems. I do not think this charade is cost or medically effective. Bill -- Fermez le Bush--about two years to go. >On 3/2/07 8:50 AM, in article >1172854224.491901.180760@h3g2000cwc.googlegroups.com, "Jan" [quoted text clipped - 33 lines] >of magnitude more. There may be no significance, but doses for modafinil and >caffeine seem to be pretty much the same, 100 to 200mg. Interesting. The Air Force has adopted Provigil for pilots on long missions in preference to meth, probably because it has less side effects like unwanted aggression leading to poor judgment. >There is a significant probability that you have an underlying condition. In >my case, I was also sleepy all the time and had difficulty concentrating. [quoted text clipped - 22 lines] >Bill >-- Fermez le Bush--about two years to go. On Mar 2, 4:14 pm, On the Road to Damascus <my.life.starts....@REMOVETHISgmail.com> wrote: > On Fri, 02 Mar 2007 10:33:10 -0800, Salmon Egg > [quoted text clipped - 71 lines] > > - Show quoted text - Yes, I read about it's use by the military. Unfortunately I'm not a vet so that route isn't available to me. It's a shame the government is so down on medicines that promote alertness. I often think, "if I were the monarch of the land," but the truth is I'd probably suck at it because the majority of people don't think like me and the result of my ordinances would probably be total societal disorder. It's people like me whom in 1965 were thinking we'd all be riding in hovercrafts by the year 2000. And the reality of it is when I go to certain parts of town in the year 2007 it still looks like 1920. So where are all the smart drugs OMNI magazine reported in 1980 that by the year 2000 we'd all be able to control our psyche round the clock with any number of exotic designer drugs? Truth be known the government would probably suppress them even if they existed. Jan (grumpy old sourpuss suffering from the probable delusion that things can and should be different) >On Mar 2, 4:14 pm, On the Road to Damascus ><my.life.starts....@REMOVETHISgmail.com> wrote: [quoted text clipped - 90 lines] >Jan (grumpy old sourpuss suffering from the probable delusion that >things can and should be different) Be glad you're not a vet. Try calling some local pharmacies and asking them what doctors are prescribing Provigil. That's not exactly top secret information although the pharmacist may think it a strange request so you might have to call around. Doctors tend to have favorite medicines that they prescribe so it's no use going to one who isn't known to prescribe what you want. If you've done your research you already know what symptoms to complain of...lack of energy, difficulty making decisions, apathy, etc... I've already got my doctor picked out, I just got to get off my butt and make an appointment...public mental health doctors don't like prescribing stuff like that. On 3/3/07 12:28 AM, in article mubiu2d67bpnaoc77gat6550s0dnc5cd3i@4ax.com, > I've already got my doctor picked out, I just got to get off my butt > and make an appointment...public mental health doctors don't like > prescribing stuff like that. Even after reading the drug inserts, I do not understand what the big deal is about Provigil. I would like to know why it is superior to caffeine. Why are some physicians loathe to describe it. Other than it is an expensive and scheduled drug, what is the big deal? Bill -- Fermez le Bush--about two years to go. >Even after reading the drug inserts, I do not understand what the big deal >is about Provigil. Well, it's amphetamine-like. >Why are some physicians loathe to describe it. They tend prescribe what they know and they feel qualified to prescribe. >Other than it is an expensive and >scheduled drug, what is the big deal? You've figured out the two bugaboos of Provigil. > On 3/3/07 12:28 AM, in article mubiu2d67bpnaoc77gat6550s0dnc5cd3i@4ax.com, > [quoted text clipped - 11 lines] > Bill > -- Fermez le Bush--about two years to go. Just another stimulant. You named the 2 main reasons physicians don't want to use it. The 3rd reason is all the dopers that pester them day and night to get it because they saw an add on TV or the internet and think it will "help" them between meth runs.  Signature"I'm quite positive [former White House associate counsel Vince] Foster was murdered," Sarah McClendon 1995 appearance on Diane Rehm's syndicated radio show. > > On 3/3/07 12:28 AM, in article mubiu2d67bpnaoc77gat6550s0dnc5c...@4ax.com, > [quoted text clipped - 26 lines] > > - Show quoted text - Well some people feel like they need speed or anything like it but if they say so they are afraid people will categorize them just like they do with meth heads. I am in this category. I need something to counter my constant sleepiness. I just participated in a sleep study test and the doctor was able to document that I haven't been making stuff up all these years just to get ahold of some stimilants. They said I have sleep apnea and restless legs and this makes it hard for me to get a good night's sleep even if I think I have been asleep all night. They said I don't go under deeply enough to get any deep REM sleep and this probably is the reason I feel sleepy all the time. Until the sleep study test I didn't have any idea why I'm always sleepy. I just knew that stimulants make me feel alert enough to get a day's work done in a day's time. Why are some people so quick to call people druggies when they have no idea what makes a person crave the medications they crave just to feel somewhat normal? Just because some people are just out for kicks doesn't mean we all are. in re: news:1173116812_12723@sp6iad.superfeed.net The reason that it's so expensive is that it's the first stimulant that doesn't have the "spillover effect," tremor, distorted thinking, nervousness, et cetera, associated with all of the commonly-used stimulants. As far as I know, it is the first truly effective stimulant unrelated to amphetamines or caffeine. It is truly, dramatically effective. I took it until my pdoc ran out of samples. It augmented my antidepressant dramatically. It virtually eliminated the apathy that is the result of brain damage among individuals who have suffered from multiple severe clinical depressions. It virtually eliminated the cognitive distortions resulting from my depressions and the medications used to treat them: dysnomia, paraphasia, stammering, excessive daytime sleepiness and other indeterminate problems. My apathy, "amotivational syndrome," is extreme enough to rob me of any motivation whatsoever, I'm very intelligent but my cognitive distortions make me feel like an idiot. I thought that it was a life-saver. To say that it isn't superior to caffeine or amphetamines is pure, unadulterated, b*llsh*t. --- ? The Earth is one country. > Okay. I think I made it clear my HMO doctor is no good when it comes > to treating a specialty disorder so I thought I'd check the > newsgroups. What kind of doctor do you think would be most likely to > recommend Provigil and what do I say to be convincing. I am sure that > saying coffee and caffeine beverages irritate my stomach would sound > kind of lame (although true) so what else can I say to make a point? You need to be seen by an ENT or other doctor with a specialty in sleep disorders. You may have sleep apnea, a very common sleep disorder, or another problem. No doctor in his/her right mind will prescribe Provigil without testing to determine what is causing the problem and if it is the appropriate drug to treat it (or if drugs are needed at all). Signature"Did Father shoot him? I will eat Grandfather for dinner." - Helen Keller, on learning of the death of her grandfather email: aripee at inanna . com >> Okay. I think I made it clear my HMO doctor is no good when it comes >> to treating a specialty disorder so I thought I'd check the [quoted text clipped - 8 lines] >without testing to determine what is causing the problem and if it is >the appropriate drug to treat it (or if drugs are needed at all). Show me a psychiatrist in his/her right mind. in re: news:1172854224.491901.180760@h3g2000cwc.googlegroups.com The company that manufactures it extended its patent by adding a new "Indication for use." It was originally only indicated for use in the treatment of narcolepsy, but now it's also indicated for the treatment of "Shift-related sleep disorder." A doctor who has worked with sleep disorders will prescribe it, but your HMO will almost certainly NOT pay for it because it's one of the most expensive pharmaceuticals that I've encoutered. The indications for use should read " for the treatment of persons with prodigious incomes suffering from (whatever)." --- ? The Earth is one country. On 4/11/07 10:10 PM, in article gbjTh.320026$8a4.269270@fe03.news.easynews.com, "kooljerk" > The company that manufactures it extended its patent by adding a new > "Indication for use." How long can such an extension last? I know that if a variation of the drug is being developed there are special rules that allow extension for about 1-1/2 or 2 years. For example when a drug is converted into and extended release form. Bill -- Fermez le Bush--about two years to go. in re: news:C24314A7.6F3BE%salmonegg@sbcglobal.net The FDA is, for all intents and purposes, a wholly owned subsidiary of "Big Pharma," the multinational pharmaceutical companies. They are consistently among the most profitable industries in this country. --- ? The Earth is one country. |
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