Fatigue: Provigil vs. Adderall

[crm1209]

I've taken provigil once in the past and I recently talked with my rheumatologist about trying it again. He mentioned adderall as a possible alternative. Do any of you know about the relative pros and cons of these two medications -- any reason why one might be better than the other, particularly for SLE fatigue?

Renee

[peonyprincess]

I do not know the pros and cons of these medications as I personally do not take them, however, my friend that has MS used to take Provigil and her physician took her off of it about a year ago and placed her on Adderall. My friend likes the Adderall better and doesn't feel as drugged. I am sure her doc had his reasons. Ask your physician why he would chose one over the other. You may also want to check with your insurance company to see if they will cover the expense. They might pay better on one over the other. Arrgghhhh.....so many questions and hoops we have to jump thru just to make us feel better. SO AGGRAVATING!!!!



Nancy

[crm1209]

Great suggestions, Nancy -- thank you! You're right, it takes a lot of effort to sort things out. I'm learning to be quite the hoop-jumper!

Renee

[raggedyann1]

Renee,

Adderall is much cheaper than provigil. Adderall is a medication for ADHD and provigil is a medication for Narcolepsy. There have been various discussions in the past on this board about taking provigil or not but I don't believe there has ever been a discussion about Adderall. Personally giving me more energy could end up making my lupus flare up. So it is not an option that I have decided to explore.

Take care,
karen

[crm1209]

Karen,

Thanks for the tip on th $$$! I didn't realize there was a cost difference. I'm hoping to be able to take the edge off the fatigue and improve my stamina and ability to concentrate as the prednisone is tapered. I'm determined to go down to a lower pred. dose, so I'll have to try stuff to manage the pain and fatigue. In the past, I've gotten so sick that I can barely leave the bed (like so many other here, I'm sure you can relate). I'm still working -- although I have to pace myself -- and I really want to be able to continue to work. I'm afraid I won't be able to if I can't manage the symptoms when the pred. dose gets below a certain point (in the past that's been around 10 mg.).

I guess I'll just have to take it as it comes; if the taper (and the other medication adjustments we're trying) causes problems, I'll probably end up with rituxan.

Thanks again for the info -- if I end up trying Adderall, I'll post about it.

Renee

[lisade]

Hi,

I realize that all people respond to medications differently so please do not base your decision to take any medications on my reaction I just want to let you know what happened to me.

A couple years ago my rheumy gave me Provigil to try because I was so tired and trying to work full time. I took it for about a week then went into a terrible flare that I have been unable to get out of.

I will never again try any of these medications for fatigue, nor will my rhuemy reccomend them for me. He does tell me that he has patients that have responded very well to them.

Please remember each person responds differently and there are people on these boards that have reported great benefits from provigil.

Just my story.

[crm1209]

Lisa,

Thank you for alerting me to what happened to you -- it sounds terrible. I also appreciate your pointing out that your experience may be different from mine. It may be, but I would not have thought about the possibility of the medication itself causing problems if you and Karen had not written. Thank you for the time and for caring enough to sharing your experience.

Renee

[jujubean]

Hi!

I just wanted to write bc I do take Adderall. I take 40 mg a day and I take it for fatigue and depression. I also take an antidepressant with it, amongst various other meds. It does help me a great deal. When I don't take it for a day I just sleep all day long. I do have trouble getting to sleep at night though and am afraid that my insomnia is probably most likely made worse by the adderall. However, I've had pretty severe problems with insomnia before starting the adderall. I started out at 20 mg and didn't feel that did anything for me so my pysch upped it to 40. I've been on it for about a year. I don't know what kind of insurance you have but my copay for it is $40 a month. That is sometimes very hard for me to afford but I can't go without it now. I wouldn't be able to function.

As everyone has already stated, we all react differently to meds and so you really don't know if something will help you until you try it but I wanted to at least tell you my experience with adderall. My dr never mentioned the other med, but part of the reason he put me on the adderall was as I said also for my depression and the adderall itself is supposed to augment my antidepressant too. Anyway, I hope this info helps you some and I wish you the best of luck. It's awful to have to struggle with this debilitating fatigue in our day to day lives. I also work fulltime and don't think I would be able to without the meds.

[crm1209]

Thanks for the info, Jujubean.

I took Provigil for about 3 weeks a year or so ago and it helped; when I saw my rheumatologist last week, he gave me some samples to try. Unfortunately, I've been on a higher-than-usual pred. dose now, so the fatigue is not as much as an issue. When we taper down to a lower dose, I know the fatigue will kick in. Then I'll post about the provigil -- especially if it seems to cause other symptoms to worsen. I don't recall that happening before, but I also simply may not have made the connection.

I have taken ambien on occasion when I couldn't sleep (usually because of prednisone). It works well, but is probably not indicated for long-term use. Flexeril (for fibro) and some antidepressants (e.g., trazodone) semm also to be fairly commonly used to help with sleep problems. Have you tried any of those?

It's nice to know that some folks are able to manage the symptoms and keep working in spite of the difficulties of this disease. It's sometimes so overwhelming just to keep going, but during the brief periods that I feel more "well" I don't want to stop working. During the longer, more difficult times, it's all I can do to hold on and try not to make permanent decisions (like quitting my job!). After 4 years, I feel like I am just now beginning to cope more effectively. Of course, the first 3 years were spent not knowing what was wrong, whether it was degenerative, disabling, deadly, etc. (all the usual fears that predate the diagnosis)! Who knows what the next few years will bring....

Thanks again for responding to the post,

Renee

[jujubean]

Hi! And thank you for your suggestions.

unfortunately, I have tried many different things also. I've taken ambien before but suddenly had a very severe reaction to it, so that's out. I also take Nortriptyline (for depression) but I've heard that it is often used for fibro pain and insomnia. I take 50 mg a day which is the max allowed per the level of it in my blood, too much can cause heart problems etc... I also have taken Flexeril, tramadol, and vicadin for fibro. I was just recently switched from those to Zanaflex and a higher dose vicadin. I also take Plaq.

Anyway, I just wanted to write and thank you for your thoughtfulness and suggestions. My best wishes to you.