Provigil - what does it do?

[myfriend]

My friend with MS (just diagnosed) is suffering unbearable fatigue and finally her neurologist agreed to consider prescribing something for her, probably Provigil. She wanted to know:
1) What will the effect be - will the fatigue disappear or just abate? Will she be able to function, unlike now when she basically sleeps all day?
2) What side effects do most people have?

Thanks

[Sara Angela]

My neuro. gave me some samples. I took one Sunday. I didn't feel differently. Although, right now I'm not have the severe fatigue.

Wouldn't hurt to get a sample to try.

Sara

[22cyclist]

It is a stimulant. She needs to take it in the morning as to not disrupt sleep at night, it is quite like caffeine, only better.

It might make her shaky, or it may have no effect at all. It should help with cog-fog. I take it and it just helps me stay more alert and need less naps.

It should take effect immediately, or the day she takes it.

Good luck.
lisa

[Tonya499]

Provigil works like a stimulant but also increases hypothalamic histamine a. It's kind of an anti-antihistamine or opposite of Benadryl. I take it for central sleep apnea that is not completely treated with CPAP and oxygen. It works well but I still take naps. I certainly can't function without it.

[LL60]

myfriend,

What a great friend to do research for her. You can look it up to find out exactly how it works. But just to share my own experience with it: I take provigal and ritalin. I take the ritalin on the weekends to get my "chores" done. I take provigal during the week. It doesn't seem to work quite as the ritalin, but there is no crashing from it at the end of the day, it seems to just gradually wear off. And I get sort of a "I'm on drugs" feeling with the ritalin, but not with the provigal.

I do daily brain games on the computer and am trying to notice and it SEEMS like I do better with them on the days taking provigal than on the days taking ritalin.

Neither one does much more than just helps with the fatigue. It takes a lot to get though the days. And my normal has had to change quite a bit.

Let us know how she does okay.

[Westgrl]

I take Provigil. I was having a lot of issues at work. Trouble concentrating, foggy head, lack of motivation, practically dozing off at my desk.

The first time I took it, I took a whole pill in the morning, felt like I had way too much coffee. I found advice on the board here that some started out with half a dose. Now I take 1/2 a dose first thing in the morning & the other around 11am, sometimes 10am if I am really fatigued.

It doesn't make it disappear for me. It just makes it more manageable. I can concentrate at work, I'm more motivated, and feel more like my old self.

Everyone is different, some don't handle these meds well, and others, like myself, have found relief with them. Just like some swear by supplements but I had bad side effects with them. The only way to tell is to give it a try.

Good luck to your friend!

[myfriend]

Thanks for the responses (and the compliments). My friend's doctor ended up prescribing Amantidine. She took it yesterday and today and it had no effect. She's pretty upset about that. If Amantidine didn't help, might Provigil be more effective, or is it either both work or neither?

[JerryD]

Tell your friend that 'speed' pills will work and should work, because the drug company that makes them works hard to prove that they do. The Provigil made me very 'hyper' but did not stave off the fatigue. Like drinking too many coffees.
Vitamin B-12 and B complex, that I buy OTC, work so much better for me, and no Rx.
I suggest your friend get his/her vitamin D, B-12 and magnesium levels checked and fix them. And hormones play a big part in this fatigue problem, too. Check this stuff out on-line. You Tube some of these topics. Magnesium deficiency, vitamin D deficiency, B-12 deficiency.
There is so much out there, and your specialist, unless a trained naturopath, doesn't know enough about them to be helpful. Mine doesn't, which is why I consult a naturopath (MD), also. Good luck

[MSer102]

My doctor started me on amantadine. It didn't help my fatigue at all it just made me feel weird. So I switched to provigil and it worked much better to keep me awake and alert. Occasionally it made me feel a little speedy but usually I felt fine and only was aware of it if I didn't take it.

My doctor told me that each drug helps about half the people who take it and doesn't help the other half. If one drug doesn't help then the other one might. That was true for me. So if amantadine doesn't help your friend provigil might. If provigil doesn't help there are other medicines like ritalin that might. So your friend shouldn't give up but should keep asking her doctor to try different medicines until she finds one that works.

[myfriend]

Thanks, I'll tell her that. Thing is, her doctor is not being very helpful or forthcoming when it comes to information or prescribing medications. He pretty much said he won't be offering her anything else for the time being.

[newbie but goodie]

Myfriend, is she getting these prescriptions from her PCP or neuro? A neuro or MS Specialist may be more forthcoming and/or willing to work with her regarding her fatigue than a PCP. If it is her neuro I would say consider seeing someone else. Symptom management is nothing to sneeze at in managing MS. We deserve to be as functional and comfortable as we can be.

[Bob698]

I've had an RX for Amatadine for a while now. It doesn't work over night. Its best to give it a week before trying to decide if its working or if your friend might need to take more or if a stronger RX is called for.
Its usually the first rung on the RX ladder, so let your friend know that her Dr. is probably being cautious.

I can tell you that Amantadine did wonders for me. It just took most of the fatigue away, there's no jitters or dependancy issues like with stimulants.

There are negatives for me, though. The main issue in my case is that Amantadine will cause constipation. There's also a bit of a social stigma since nosey people can google Amantadine and find its usually RX'd as an anti-bacterial med for people who have Hep C.

Your friend should understand that its RX'd for MS fatigue because it provides a "side effect" with MS patients that the Drs. don't understand yet. Meaning, it knocks down the fatigue but they really don't know why.

Its also pretty benign in terms of how it reacts with us. Most MS meds carry more of a trade-off in terms of things that could go wrong later on.

[newbie but goodie]

I'm not sure most people would ever find that hep c connection. Amantadine is not a first line treatment for it and isn't all that effective. It is primarily an antiviral to treat influenza a and is commonly used for Parkinson's. If you google amantadine the Ms society is thesecond thing on the page.

Iwouldnt worry about that but I do agree it takes a few days to see fullresults sometimes. I take it and love it.

[myfriend]

Thank you all so much for your responses. They were very helpful.

It seems like the Amantadine is starting to have an effect. Unfortunately, the effect it's having seems to be that my friend can't sleep at night. Is it possible that the Amantadine starts working only at night if she takes it at 8 AM?