Provigil

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ERMudPhud

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Anybody tried it or know anybody who has? It is now FDA approved to treat something called "Shift work sleep disorder" which sounds a lot like what I go through every few weeks. My current regimen after a string of night shifts is to take a short nap, then stay up all day no matter how hard it is, then take some benadryl before going to sleep. I have to take the benadryl because even if I've been awake all day my clock is still set for night shifts and I often get a "second wind" just as I am going to sleep and then stare at the ceiling for a few hours. The benadryl work fine but leaves me feeling a bit groggy for the first few hours the next morning. If the Provigil works as advertised it sounds great. Take one in the morning after your last night shift and stay awake all day without feeling like crap and then go to sleep normally that night. Supposedly few side effects with none of the notorious amphetamine nastiness. Any thoughts on my urge to experience better living through chemistry?
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All I know is that DARPA did a lot of research on it, to help soldiers. If a soldier could stay awake 40 hours, sleep 8-10, wake up with no hangover, and go at it again, that functionally doubles or triples your army's availability.

I asked a sleep-fellow trained neurologist about it two years ago, and he (for the time) said that it wasn't best, since it was only approved for narcolepsy. Now, I think it's a great idea.
 
I think it's a solid little drug. I've got friends who have used it for everything from narcolepsy to chronic fatigue to simply being an intern. I'm sure there's some horrific side effects and, as a fellow physician, wouldn't recommend that you take it to simply "live better through chemistry"... but I know people who have and they don't have complaints.

As a non-tangential aside - we just sent a survey out to your RDs asking them to forward it to you. Another resident and I are working on a study looking at EM Residents' use of drugs to help with shift-work circ. rhythm adjustment. If you get a chance, please fill that puppy out - it'll help us out and you could get some cash. I'm not going to put the webpage up here because I don't want other people filling it out - but your RD should have gotten the e-mail.
 
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I thought that was your name on that thing. I filled it out.

I'm sure there's some horrific side effects
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Yes, like the acute urinary retention I saw in a gomertose old lady last month who had just started it.

C
 
Provigil is FDA-approved for Shift Work Sleep Disorder (SWSD) (i.e. people like us).
 
It has some interesting possibilities for helping you re-adjust post nights when you're trying to re-adjust for days but are still inclined to sleep all day and stay up the night before work. In the lower effective doses, it seems to be pretty "clean".

My own feeling is that barring the occasional cup or two of coffee, it is inappropriate to be using medication to stay awake at a job which requires clear decision-making ability. While newer drugs like this one are not classicly physically addictive, there is certainly a propensity to become addicted to this drug from the psychological and behavioral standpoint, and I've heard of a case or to in EM people. If you're having these sorts of problems, you need to step back and take a look at the big picture and figure out what's wrong with your schedule.

jawurheemd said:
Provigil is FDA-approved for Shift Work Sleep Disorder (SWSD) (i.e. people like us).
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srlondon said:
My own feeling is that barring the occasional cup or two of coffee, it is inappropriate to be using medication to stay awake at a job which requires clear decision-making ability. While newer drugs like this one are not classicly physically addictive, there is certainly a propensity to become addicted to this drug from the psychological and behavioral standpoint, and I've heard of a case or to in EM people. If you're having these sorts of problems, you need to step back and take a look at the big picture and figure out what's wrong with your schedule.
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For the record, I am 100% completely addicted to my morning coffee. Behaviorally and psychologically.

--Funkless
 
My intentions if I ever try Provigil were to reset my clock 1 or 2 times per months after a string of nights 24 hours before going back to my day job grinding up lab mice. I would be way uncomfortable taking it to stay awake for an ER shift
 
funkless said:
For the record, I am 100% completely addicted to my morning coffee. Behaviorally and psychologically.

--Funkless
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For the record, I am 100% completely addicted to my morning coffee, my mid-morning coffee, my noon coffee, my afternoon coffee, and my early evening coffee.
 
ERMudPhud said:
Anybody tried it or know anybody who has? It is now FDA approved to treat something called "Shift work sleep disorder" which sounds a lot like what I go through every few weeks. My current regimen after a string of night shifts is to take a short nap, then stay up all day no matter how hard it is, then take some benadryl before going to sleep. I have to take the benadryl because even if I've been awake all day my clock is still set for night shifts and I often get a "second wind" just as I am going to sleep and then stare at the ceiling for a few hours. The benadryl work fine but leaves me feeling a bit groggy for the first few hours the next morning. If the Provigil works as advertised it sounds great. Take one in the morning after your last night shift and stay awake all day without feeling like crap and then go to sleep normally that night. Supposedly few side effects with none of the notorious amphetamine nastiness. Any thoughts on my urge to experience better living through chemistry?
Click to expand...

I've never heard of Provigil before...I assume it has a long-lasting effect since you say you can just take one and be set all day, but how does it compare for your level of awakeness compared to a drug like caffeine? I know with caffeine I can take it and feel awake, yet my mind is still sleeping. I wonder if this drug can get around that problem.
 
leviathan said:
I've never heard of Provigil before...I assume it has a long-lasting effect since you say you can just take one and be set all day, but how does it compare for your level of awakeness compared to a drug like caffeine? I know with caffeine I can take it and feel awake, yet my mind is still sleeping. I wonder if this drug can get around that problem.
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Try going to the Provigil website

http://www.provigil.com

They state on this web site that:
  • Provigil is the first and only wake-promoting agent
  • Consistently improves wakefulness
  • No effect on sleep when sleep is desired
  • Generally well tolerated, with a proven safety profile
  • Promotes wakefulness without generalized CNS stimulation
 
jawurheemd said:
Try going to the Provigil website

http://www.provigil.com

They state on this web site that:
  • Provigil is the first and only wake-promoting agent
  • Consistently improves wakefulness
  • No effect on sleep when sleep is desired
  • Generally well tolerated, with a proven safety profile
  • Promotes wakefulness without generalized CNS stimulation
Click to expand...

Thanks for the link, though I tend to be cautious about information I receive off the company's own webpage.
 
leviathan said:
Thanks for the link, though I tend to be cautious about information I receive off the company's own webpage.
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Err, well......

I mistakenly took a provigil when I was reaching for an Ambien (shouldn't mix drugs in a container, even when they DONT LOOK ALIKE. So, after an hour or two of not falling asleep I discovered the mistake, and took the Ambien. Went to sleep fine, slept 7 hours, woke up fine.

Both Provigil and Ambien are :thumbup: :thumbup:

Just try for more than an hour or two between doses of them
 
Hi. Can you guys think of any deleterious effects of taking Provigil to "reset" after a string of night shifts if you already take Ritalin to treat ADD? Any synergistic problems or anything?

Thanks!
 
A couple of weeks ago I had an absolutely brutal weekend. Possibly the worst string of nights I've ever worked with the worst night coming at the end. As I was getting ready to go home I realized I was so whipped that I was going to be completely nonfunctional at home. I really wanted to stay up for the day and play with my kids and then get a normal nights sleep Sunday night before going back to lab on monday morning so I took 200mg of provigil. It was a very weird feeling. I was fine all day, as if I had had a decent nights sleep the night before. I didn't feel jittery, nauseous, or have a headache like I get when I am trying to stay up with caffeine. Even weirder was that if wasn't doing anything and just laid down on the couch it was pretty easy to doze off but if I was up doing anything at all, even just playing with the kids, I felt alert. I felt maybe slightly more manic than my normal manic self and I would never want to work while on the drug since I worry it would affect my judgment but as a way to stay up after your last night shift it worked as advertised. Finally, around 11:00 pm I went to bed and slept like a log.
 
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