Another medication can be added to the Plaquenil that may help with fatigue and joint pain, the first one I would want to try is mepacrine/quinacrine. Many will report the combination is energizing and helps with multiple symptoms of lupus.
My doctors I've gone to do not seem to want to prescribe it for some reason.... Not sure why but I've asked twice and been turned down twice without any reason given!
The doctors here also do not like to prescribe Provigil for a few different reasons. One, it is very expensive and many insurance plans will not cover it unless used for the officially licensed use (narcolepsy). Two, it has not been found to be *that* effective in the majority of people especially if you compare it to a jolt of caffeine it does about the same thing. And third, long term daily use could have side effects and could possibly make lupus worse in that you may not listen to your body's message to rest as much as you should.
Personally, I would not use Provigil daily even if I had the option. I would reserve it for rare/special occasions. But I am conservative in medicine use, and am now able to rest/lie down as needed by and large.
