Not Like a Cup of Joe
“It works in a very select area of the brain called the hypothalamus, which regulates among other things sleep and wakefulness,” Wyatt said. “And because it doesn’t work in widespread areas of the brain, it seems to have a much cleaner side-effect profile, not producing nervousness or tremulousness or shakiness that other stimulants can.”
There are some side effects, including headaches, nausea, infection, possible nervousness, anxiety and insomnia. But patients would see a limited number of those effects at one time, and they are actually less than the effects of caffeine.
Dodds thought that the pill would have effects similar to caffeine, but she was surprised.
Wakefulness with Provigil
Dexedrine has been the standard treatment for narcolepsy, and it has had military applications as well: the United States Air Force supplied it to most air crews during the Persian Gulf War… Dexedrine interferes with normal sleep, leaving its users feeling hung over when they awaken. This so-called sleep inertia often prompts the user to take more pills, and a vicious cycle ensues. Provigil preserves normal “sleep architecture.”…
Even as sleep disorders increase, firms are pushing their employees to disrupt their normal sleep patterns in order to provide services around the clock. Mentions that this may provide competitive advantages. The capability to resist the mental and physiological effects of sleep deprivation will fundamentally change current military concepts of “operational tempo” and contemporary orders of battle for the military services…
Provigil Therapy for Apathy
A 78-year-old man with dementia and depression was also experiencing apathy that did not respond to antidepressants including escitalopram, a selective serotonin-reuptake inhibitor (SSRI). Escitalopram was discontinued and Provigil, a novel vigilance-promoting agent pharmacologically distinct from stimulants, was used to successfully treat the apathy.
The dosage regimen was initiated at 50 mg and titrated to 200 mg/day over 4 weeks. Apathy was assessed using the Apathy Evaluation Scale developed specifically to identify apathy and also to differentiate this from depression.
Apathy, a common behavioral problem, is often mistaken for depression; however, apathy differs from depression in symptomatology, clinical presentation, and treatment options. SSRIs, a common treatment for depression, are known to cause or increase apathy.
A placebo-controlled trial of Provigil
Comprehensive drug use data (urine specimens and self-report) and other health and psychosocial data were collected weekly during treatment and research interviews at baseline, week 10 and week 22.
Treatment retention and medication adherence were equivalent between groups. There were no differences in methamphetamine abstinence, craving or severity of dependence. Medication-compliant subjects tended to provide more methamphetamine-negative urine samples over the 10-week treatment period (P = 0.07). Outcomes were better for methamphetamine-dependent subjects with no other substance dependence and those who accessed counselling. There were statistically significant reductions in systolic blood pressure (P = 0.03) and weight gain (P = 0.05) in Provigil-compliant subjects compared to placebo. There were no medication-related serious adverse events. Adverse events were generally mild and consistent with known pharmacological effects.