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PostPosted: Thu Aug 04, 2016 7:44 am 
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I have been on Suboxone for several years now and I am doing really well on that program. Before I started on Suboxone I was taking Provigil which I didn't abuse. It was given to me to help me stay awake because all my medications make incredibly me sleepy. Well it ended up it also helped me with my depression dramatically. I know its a controlled substance, (amphetimine....sp?) Well needless to say I had to give up the Provigil when I started on the Suboxone program. 5 years later my depression was just getting worse with no improvement.....no matter what I tried. So I fought like hell to start back on the Provigil. I finally won that battle and my Suboxone Dr. started to prescribe it me. Yeah!! I was just curious if anyone else is taking Provigil or the sister drug Nuvigil and Suboxone at the same time? If so, how they are doing on it with the Suboxone? I am just curious. Thank you!!!

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PostPosted: Thu Aug 04, 2016 6:12 pm 
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This is just my practice, not from a guideline or any nationally recognized source. (actually I am not aware of any)
If you have had a sleep study and evaluation by a sleep medicine specialist and they will be monitoring and following I would probably concur. From a PCP without any testing or consultation I would not.
I am a minimalist, if 'all your medications' are making you sleepy, then I would try to assist you in weaning off of them, not add to the list.
I assume you were being hyperbolic when you said you 'fought like hell.' I get self referrals from other practices because of a falling out or disagreement about treatment.
Provigil is a Schedule 4, one notch down from Suboxone and two down from amphetamine and opiates, so it is not considered in the same class as amphetamine (for now)
I'm curious too if others are on it and what it is being used for...


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PostPosted: Thu Aug 04, 2016 7:14 pm 
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It is NOT amphetamine. I don't know the drug well in regard to mechanism of action, but I prescribe it now and then for people who have daytime sleepiness that is not caused by sleep apnea.

There were rumors in my part of the country that it worked like the drug in the movie 'Limitless'... and I suddenly had many people asking for it. I can assure people that it does NOT work in that way. It blocks sleep-- and that's all it does. There have been a couple studies looking at it for ADD, and it is NOT as effective as amphetamine for those symptoms. Some people lack attention because of a tendency to fall asleep easily... and it helps those people by keeping them awake.

I don't think it has much abuse potential, and the schedule IV status is probably appropriate. I have not used it to treat depression, but if it happens to work for you, I don't see any problem combining it with buprenorphine. I don't know if I'm a minimalist... but I respect that philosophy, and I think most people are overprescribed to a large degree. But I see the med as relatively safe, and when I've prescribed it, patients have not had problems with needing early refills-- as they often do with benzos or amphetamines. My main problem with prescribing it is that it is VERY expensive, and so I always feel a bit irresponsible for adding so much to healthcare costs-- for a rather limited benefit.


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PostPosted: Thu Aug 04, 2016 7:57 pm 
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My sub dr misinformed me then. I did have a sleep study done and all was normal. I can't just ween off medications that I take for my heart failure and depression. Anyways I was just curious. Thanks for the input

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PostPosted: Thu Aug 04, 2016 8:14 pm 
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I hope I wasn't misunderstood... if it helps your depression, I don't see how it would be harmful. Hopefully your doc will see it that way!


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PostPosted: Fri Aug 05, 2016 10:00 am 
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Thank you! :D :D

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PostPosted: Sun Aug 07, 2016 8:35 pm 
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It sucks really because I probably need Provigil. I fight sleep constantly and have for years. I have trouble memorizing things and paying attention due to excessive daytime sleepiness. However, I am switching to a new doctor for my subs and I doubt he would prescribe it to me. He will already be prescribing subs and Prozac. But it is a shame because I DO probably need something like that because nothing else works!


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PostPosted: Sun Aug 07, 2016 8:37 pm 
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BTW, I think Nuvigil and Provigil are considered stimulants.


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PostPosted: Tue Aug 09, 2016 9:30 am 
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You are right they are stimulants. I am like you. Foggy headed, no memory of things, days running together....etc. I would go to meetings and nod off. I was afraid they would think I was on something! My husband came to the meetings with me to keep me awake.

I had to fight for it. My sub Dr. sent me for a sleep study and it was normal. I kept telling her my problems. She said if my cardiologist, (I have congestive heart failure), said it was safe for me to take then she would consider it. I got a letter from him saying it ok and she still wouldn't prescribe for it. I had other Dr.'s say it was ok and after several months she finally started me on it. It has made all the difference in the world. I take it around noon so it doesn't wear off by the time I have to go to evening meetings.

Don't give up. We as addicts have to fight harder for medications that could help us because we ARE addicts. I agreed to a pill count occasionally. That was the only way she would do it.

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