Thanks Grumpcat, your explanation is very helpful. I can't wait to get prescription !
GrumpyCat said:
Just reading the info on provigil, it sounds like it might be worth a try. If the first dose of the day lasts into the afternoon, and begins to wear off at that time, it might last until bedtime. Remember, there will still be drug left in your system at that afternoon time.
Half-life is explained like this. If the dose is 1000mg and the half life is 15 hours, then in 15 hours you will still have 500mg left in your system. After 30 hours, your will have 250mg, and so on. I picked a doses that was easy to divide, I have no idea what the dosing is for provigil.
My rheumy wouldn't prescrib e Provigil or adderral - he said to see my GP. My GP was great and we decided to start with Provigil, although she doesn't think it is going to help me enough. She said if the Provigil doesn't work then she will prescribe adderall. I'm not keenn on taking adderall because I'm concerned about it getting me through the entire day and about having trouble sleeping.
The Provigil generic cost $200 so I'm using the mail pharmacy program and will get it next week. Meanwhile I slept 18 hours yesterday !
Frances, I was on MTX for 7 months and now that I am off it I can honestly say it made fatigue way worse! I felt like I was packing around 10lb weights for the first months. We added Sulfa and I had a slight energy increase. I switched over to Avara and have had much better results. No nausea, big energy increase and very little side effects (mouth issues) that have been reduced with a reduction in Sulfa and an increase in folic acid. With this switch I have also noticed big changes in my mental state, less depression and more optimistic about the future as my functioning life had really improved, less pain and no flares now for two months. Good luck!!
Frances said:
Thanks to everyone on this forum I was REALLY prepared and felt empowered to have a my fatigue discussion with my rheumy - who has been an amazing doc. I have never explained my fatigue issue clearly and how it affects my life.
I even brought my Mommy to share her observations and we met before and worked out a plan for the discussion. I had a type written several page briefing I read him.
The discussion went EXTREMELY well. It was a real productive very long discussion between the three of us. He asked me about my ideas first and this is what I said:
1. Try MTX again, but injectable, because I couldn't tolerate it before
2. Try Savella (thanks Grumpycat) a med used to help fibro fatigue
3. Try Arava
He asked me what I thought about taking a lower dose of MTX along with a med to help with the side effects - Leucovorin. And meanwhile, he told me to research the following drugs (because he knows I like to research everything):
1. Provigil
2. Nuvigil
3. Adderall
He said to try the MTX for at least a month. And to make an app't in 2 months.
First Dose MTX RESULTS Last Friday
I took 5mg Friday night (previous dose was 10 mg). No nausea, felt fine, but i slept 18 hours Friday to Saturday night and slept most of Sunday . So, I'm not going to take anymore MTX and will research the other meds.
Another bout of coma sleep yesterday.
slept 18 hours yesterday and 14 hours today. I'm sure the change in weather here caused it. It snowed/sleeted and the temperature dropped drastically.
I'm calling my rheumy to get an app't asap. I'm not waiting 2 months.
Iām new here. I have not been diagnosed with PsA, however my new Orthopedic Surgeon suspects it. I have a 18+ year history of knee pain and lesions on my scalp and legs, negative for RF factors and CRPs.
I did want to give you my experience if both Provigil and Adderall, even though your post is an older one. I am diagnosed with severe sleep apnea and have used a CPAP machine for 4+ year. I am also diagnosed with Hypersomnia, residual to my sleep apnea.
I tried Provigil for a few months, starting at 200mg as needed a few times a week, then 200mg daily, and finally 200mg twice daily. The Provigil was great initially to keep me awake and alert. It did not provide any extra energy. As I progressed through the increased dosages, the effects would best when increasing dosage and taper after a few weeks. It did stop working after about a month of 200ng twice a day. I was still awake, but tired and not alert. The side effects for me included a low grade 24 hour headache, it was worth bearing with the headache to stay awake. When it stopped working I was switched to Adderall. Also, while on Provigil I did have daily migraines and nental fog in the morning, not from the Provigil.
I was started on Adderall XR 20mg twice a day. I felt good in the morning awake and a little extra energy, I crashed and napped 5 hours after taking it. It did do wonders for my knee pain, around 50 percent of the pain was gone. I was increased up to 30mg twice a day (20mg extended releade + 10 mg instant release). It makes me feel almost normal and my quality if life has drastically imprived. It keeps me awake most of the day, with an occasional nap. It also reduces my knee pain by about 80 percent, but no one can explain to me how.
Try the Provigil first. Some a lot of people it works wonders. Everyone is different. If it doesnāt work, donāt be scared of the Adderall. I was a bit apprehensive when the doctor mentioned it to me, even at a point of trying almost anything to stay awake.This Adderall is not as bad as I thought. The worst part of taking the Provigil was the headaches. The worst part if taking the Adderall is cutting out the caffiene. At least now I am an awake, decaf coffee drinker whose knees donāt hurt as bad. Adderall can increase your blood pressure and there are some negatives to using it. My blood pressure has actually decreased. It did decrease to a point of hypotension. My hyoptention was a result of an abnormal drug interaction, a Pharmacist should be useful to ensure to interactions donāt occur. Please discuss with your doctor, my experience is unique to me.
If you or anyone else have any specific questions please ask. I am just starting down this road and will ask my share as I work through the diagnosis or dismissal of PsA