![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by rocky2 on September 24, 2008, at 11:03:53
i started adrafinil 6 days ago at 600mg a day, but i really havnt noticed anything from it and i feel just as depressed and tired as i allways do like i havnt taken anything at all, is this something i should be worried about? i heard that it is suppose to have some effect straight away
Posted by Nadezda on September 24, 2008, at 13:22:52
In reply to Adrafinil not working, posted by rocky2 on September 24, 2008, at 11:03:53
I've heard that adrafinil doesn't work that well, or at all, for a lot of people. Provigil (modafinil) is a more potent and effective drug--also more expensive, unfortunately.
Nadezda
Posted by bleauberry on September 24, 2008, at 16:43:36
In reply to Adrafinil not working, posted by rocky2 on September 24, 2008, at 11:03:53
> i started adrafinil 6 days ago at 600mg a day, but i really havnt noticed anything from it and i feel just as depressed and tired as i allways do like i havnt taken anything at all, is this something i should be worried about? i heard that it is suppose to have some effect straight away
I have used Adrafinil several times and can offer some things to think about.Some people do get an immediate response and some do not.
Most people respond to either adrafinil or modafinil but not both.
Even if there is an immediate response, it is not usually the real therapeutic reaction of it. That takes weeks and months to happen. People become more talkative, more active, regain interest in things, and think sharper, with each one of these things happening one at a time gradually over weeks. The true therapeutic effect is actually as slow as most antidepressants.
Every time I restarted it I had a particular pattern. Immediate boost in energy, too hyper, uncomfortable, but with a pronounced antidepressant effect which allowed me to endure the uptightness. Then it all faded in just a couple days and I didn't feel anything. I figured the drug was worthless and had already pooped out. But I kept taking it anyway, trying to keep faith that what I read about it needing time was true. About a month later, after not thinking about it the whole time, I realized I had indeed become interested in things. Quite interested actually. Remarkable anti-anhedonia effect. I was more talkative, more comfortable in a crowd, relaxed and yet energetic. It had all crept up on me in a subtle gradual way that I didn't notice at first. Probably the only side effect was I could get exhausted easily if I overdid it.
But as you know, mileage varies. These days adrafinil, modafinil, or wellbutrin are my absolute worst drugs. They rapidly send me into a deathly deep depression. I have been diagnosed with mercury toxicity from amalgam fillings, so things have obviously changed. Adrafinil used to be a good friend, but mercury and lead messed it up.
You could try going down to just 300mg a day, to save money. Just take it everyday like a vitamin, even if you don't feel anything from it. Then see in about 6 weeks where you are at. The reason I say 300mg is because in my experience that is enough to do some good. 600mg and 900mg, though commonly prescribed doses, can be more than needed and waste your money. Or since you are already at 600mg and fine with it, just stay there. If you don't see any benefit in 6 weeks, then ditch it and switch to modafinil instead.
Posted by rocky2 on September 25, 2008, at 10:53:00
In reply to Re: Adrafinil not working, posted by bleauberry on September 24, 2008, at 16:43:36
> > i started adrafinil 6 days ago at 600mg a day, but i really havnt noticed anything from it and i feel just as depressed and tired as i allways do like i havnt taken anything at all, is this something i should be worried about? i heard that it is suppose to have some effect straight away
>
>
> I have used Adrafinil several times and can offer some things to think about.
>
> Some people do get an immediate response and some do not.
>
> Most people respond to either adrafinil or modafinil but not both.
>
> Even if there is an immediate response, it is not usually the real therapeutic reaction of it. That takes weeks and months to happen. People become more talkative, more active, regain interest in things, and think sharper, with each one of these things happening one at a time gradually over weeks. The true therapeutic effect is actually as slow as most antidepressants.
>
> Every time I restarted it I had a particular pattern. Immediate boost in energy, too hyper, uncomfortable, but with a pronounced antidepressant effect which allowed me to endure the uptightness. Then it all faded in just a couple days and I didn't feel anything. I figured the drug was worthless and had already pooped out. But I kept taking it anyway, trying to keep faith that what I read about it needing time was true. About a month later, after not thinking about it the whole time, I realized I had indeed become interested in things. Quite interested actually. Remarkable anti-anhedonia effect. I was more talkative, more comfortable in a crowd, relaxed and yet energetic. It had all crept up on me in a subtle gradual way that I didn't notice at first. Probably the only side effect was I could get exhausted easily if I overdid it.
>
> But as you know, mileage varies. These days adrafinil, modafinil, or wellbutrin are my absolute worst drugs. They rapidly send me into a deathly deep depression. I have been diagnosed with mercury toxicity from amalgam fillings, so things have obviously changed. Adrafinil used to be a good friend, but mercury and lead messed it up.
>
> You could try going down to just 300mg a day, to save money. Just take it everyday like a vitamin, even if you don't feel anything from it. Then see in about 6 weeks where you are at. The reason I say 300mg is because in my experience that is enough to do some good. 600mg and 900mg, though commonly prescribed doses, can be more than needed and waste your money. Or since you are already at 600mg and fine with it, just stay there. If you don't see any benefit in 6 weeks, then ditch it and switch to modafinil instead.
>hi thanks for your advice, you obviously know alot about this kinda stuff, i think i'll just carry on taking it and see what happens, though i cant switch to modafinil as i would have to pay for it myself and it costs too much, do you know alot about amisulpride too, i was on that 2 years ago and it really helped for the first couple of days, but then it seemed to stop working and things like anhedonia became worse, could that be the prolactin effect? and do you think that if i tried it again with a prolactin inhibitor that might solve the problem
Posted by bleauberry on September 25, 2008, at 19:28:39
In reply to Re: Adrafinil not working, posted by rocky2 on September 25, 2008, at 10:53:00
>
> hi thanks for your advice, you obviously know alot about this kinda stuff, i think i'll just carry on taking it and see what happens, though i cant switch to modafinil as i would have to pay for it myself and it costs too much, do you know alot about amisulpride too, i was on that 2 years ago and it really helped for the first couple of days, but then it seemed to stop working and things like anhedonia became worse, could that be the prolactin effect? and do you think that if i tried it again with a prolactin inhibitor that might solve the problemFunny you should mention amisulpride. The two weeks I was on amisulpride+adrafinil combination were really good. Fast acting and amazing. The prolactin thing really got me though. I could not have sex to save my life.
I'm not in good shape right now so don't want to go hunt for them, but I do recall see a couple things on pubmed where anti-prolactin things like pramipexole or bromocriptine or cabergoline were added to amisulpride. They did work for prolactin, and amazingly did not ruin the good effects of amisulpride. Dopamine agonist + dopamine antagonist. Doesn't make sense on paper, but it worked.
You might try amisulpride+adrafinil. Or if in a month adrafinil doesn't kick in a bit, try amisulpride. This time though keep the dose lower. If you were on 50mg, make it 25mg. If you were on 25mg, make it 12.5mg.
Posted by Dr. Bob on September 27, 2008, at 18:24:35
In reply to Adrafinil not working, posted by rocky2 on September 24, 2008, at 11:03:53
Posted by Tony P on September 27, 2008, at 21:53:28
In reply to Adrafinil not working, posted by rocky2 on September 24, 2008, at 11:03:53
> i started adrafinil 6 days ago at 600mg a day, but i really havnt noticed anything from it and i feel just as depressed and tired as i allways do like i havnt taken anything at all, is this something i should be worried about? i heard that it is suppose to have some effect straight away
================================================
It works "straight away" compared to your average A/D which takes two to 8 weeks to really kick in. It certainly works the same day you take it, if it's going to work for you at all. But it's quite slow and gradual compared to, say, pure stimulants (or an aspirin).I have taken Adrafinil & Modafinil a fair bit, and one of the things I find is you have to kind of work with them. E.g., just as the manufacturers claim, they don't prevent sleep, I've taken 2 Adrafinil, lain down with a book and promptly fallen asleep for 6 hours! On the other hand, if I take them (either one, or both in combination) and am deliberately active, I really feel the stimulation - I'm more active, cheerful, chatty and creative. YMMV.
Adrafinil is definitely s-l-o-w to work -- up to 3 hours before it really peaks, so you may just not be noticing the effect. Or you may require a higher dose; some people take 1200 mg/day regularly (but not all at once!) & I've occasionally taken 1800 mg (6 tabs) with no ill effects.
If you're not already a coffee drinker, try a little coffee or strong tea at the same time -- I find they have a synergistic effect with these meds; I've read that coffee boosts dopamine, whcih is the most often neglected of the Big Three in A/D therapy.
I suffer from alternating insomnia & hypersomnia, and sleep apnea, so these 2 meds have helped me a lot. I have to be careful, though, as I'm BP III inclined & can easily slip into all-night hypomania, which just perpetuates the cycle.
I find that Adrafinil & Modafinil also work quite well in combination (half as much of each, of course, e.g. 100 mg Modafinil plus 300 mg Adrafinil, or half that if you're sensitive to stimulants). A. is gentler, slower to work (it's partly metabolized into M.), lasts longer & is maybe a tad less edgy than M. So the combination gives me both a quick boost and a longer lasting, milder effect.
TP
Posted by rocky2 on September 28, 2008, at 6:41:19
In reply to Re: Adrafinil not working, posted by bleauberry on September 25, 2008, at 19:28:39
>
> >
> > hi thanks for your advice, you obviously know alot about this kinda stuff, i think i'll just carry on taking it and see what happens, though i cant switch to modafinil as i would have to pay for it myself and it costs too much, do you know alot about amisulpride too, i was on that 2 years ago and it really helped for the first couple of days, but then it seemed to stop working and things like anhedonia became worse, could that be the prolactin effect? and do you think that if i tried it again with a prolactin inhibitor that might solve the problem
>
> Funny you should mention amisulpride. The two weeks I was on amisulpride+adrafinil combination were really good. Fast acting and amazing. The prolactin thing really got me though. I could not have sex to save my life.
>
> I'm not in good shape right now so don't want to go hunt for them, but I do recall see a couple things on pubmed where anti-prolactin things like pramipexole or bromocriptine or cabergoline were added to amisulpride. They did work for prolactin, and amazingly did not ruin the good effects of amisulpride. Dopamine agonist + dopamine antagonist. Doesn't make sense on paper, but it worked.
>
> You might try amisulpride+adrafinil. Or if in a month adrafinil doesn't kick in a bit, try amisulpride. This time though keep the dose lower. If you were on 50mg, make it 25mg. If you were on 25mg, make it 12.5mg.
>
>
thanks, i was just thinking that cos i heard prolactin is around to clean out dopamine, and if theres too much prolactin that might counter the effects of amisulpride, but im not sure i dont really know much about this kinda stuffim sorry to hear your not in good shape, i hope you feel better soon
Posted by rocky2 on September 28, 2008, at 6:59:29
In reply to Re: Adrafinil not working » rocky2, posted by Tony P on September 27, 2008, at 21:53:28
> > i started adrafinil 6 days ago at 600mg a day, but i really havnt noticed anything from it and i feel just as depressed and tired as i allways do like i havnt taken anything at all, is this something i should be worried about? i heard that it is suppose to have some effect straight away
> ================================================
> It works "straight away" compared to your average A/D which takes two to 8 weeks to really kick in. It certainly works the same day you take it, if it's going to work for you at all. But it's quite slow and gradual compared to, say, pure stimulants (or an aspirin).
>
> I have taken Adrafinil & Modafinil a fair bit, and one of the things I find is you have to kind of work with them. E.g., just as the manufacturers claim, they don't prevent sleep, I've taken 2 Adrafinil, lain down with a book and promptly fallen asleep for 6 hours! On the other hand, if I take them (either one, or both in combination) and am deliberately active, I really feel the stimulation - I'm more active, cheerful, chatty and creative. YMMV.
>
> Adrafinil is definitely s-l-o-w to work -- up to 3 hours before it really peaks, so you may just not be noticing the effect. Or you may require a higher dose; some people take 1200 mg/day regularly (but not all at once!) & I've occasionally taken 1800 mg (6 tabs) with no ill effects.
>
> If you're not already a coffee drinker, try a little coffee or strong tea at the same time -- I find they have a synergistic effect with these meds; I've read that coffee boosts dopamine, whcih is the most often neglected of the Big Three in A/D therapy.
>
> I suffer from alternating insomnia & hypersomnia, and sleep apnea, so these 2 meds have helped me a lot. I have to be careful, though, as I'm BP III inclined & can easily slip into all-night hypomania, which just perpetuates the cycle.
>
> I find that Adrafinil & Modafinil also work quite well in combination (half as much of each, of course, e.g. 100 mg Modafinil plus 300 mg Adrafinil, or half that if you're sensitive to stimulants). A. is gentler, slower to work (it's partly metabolized into M.), lasts longer & is maybe a tad less edgy than M. So the combination gives me both a quick boost and a longer lasting, milder effect.
>
> TPthanks for your advice, so if its going to work it would be having an effect by now? thats not good as im kinda running out of options and i really thought this would help
Posted by Sigismund on September 28, 2008, at 19:45:32
In reply to Adrafinil not working, posted by rocky2 on September 24, 2008, at 11:03:53
They are 300mg tablets?
If so, you are only taking 2 a day.
There was a time I took 6 a day without ill effect.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.