Goes Running For The Shelter Of The Pilots Little helper
December 27, 2008 4:44 PM   Subscribe

The Provigil Debate Continues On. Previously
posted by Xurando (53 comments total) 21 users marked this as a favorite

 
I have literally crippling anxiety disorder and an inability to focus, and this drug seems like just the thing for me. Someone else can have my creativity, I don't need it, at least not for the next two years. I've been thinking of taking this drug (or getting an ADD diagnosis) for some time. This is my new year's resolution.
posted by By The Grace of God at 4:54 PM on December 27, 2008


By the way, if anybody has any anecdotes about getting a dx/taking Provigil in the UK, please memail me or post in here (if that's not considered a derail).
posted by By The Grace of God at 4:59 PM on December 27, 2008


Here is a reason not to skimp on sleep with the aid of drugs.
posted by Artifice_Eternity at 4:59 PM on December 27, 2008


Personally, I've found Provigil to be a pretty big disappointment. First time or two I took it, it was great; felt like I'd gotten the best night of sleep ever. After that, though, the effects diminished substantially, to the point where I'd getting drowsy late at night just a few hours after taking it, the same as I might expect if I hadn't taken anything at all. I do ingest massive amounts of caffeine throughout the day, though, so it could be just that I need a much stronger dose. Still -- not quite the wonder drug it's touted as. And for the price, I'm really not sure it's any better than plain old coffee.
posted by decoherence at 5:03 PM on December 27, 2008


I'm torn on this. This sounds fantastic in many ways, but also worries me in one. It's yet one more way to become more productive and profitable members of society, stripped of the flaws and failings that prevent us from being total automatons.

On one hand, I can see a lot of people benefiting from being able to work more for their families, or actually having the energy and time to get that degree that'll finally facilitate upward social movement.

On the other hand, it seems we're so obsessed with societal acceptance of success that we're willing to becoming less of what we naturally are to reach a means whose real value I'd question, and this drug is one more way to get there.
posted by spiderskull at 5:04 PM on December 27, 2008 [2 favorites]


I have literally crippling anxiety disorder and an inability to focus

One common side effect of Provigil is anxiety.
posted by availablelight at 5:05 PM on December 27, 2008


In this case, the tradeoff involves creativity. Some of my friends who relied on crushed Ritalin during college used to joke about how the drugs were great for late-night cramming sessions, but that they seemed to suppress any kind of originality. In other words, increased focus came at the expense of the imagination. It makes perfect sense that such a cognitive trade-off would exist. Paying attention to a particular task - like writing an article - requires the brain to ignore all sorts of seemingly unrelated thoughts and stimuli bubbling up from below. (The unconscious brain is full of potential distractions.)

It seems like this could be solved by cycling in and out. Right now I'm doing a lot of studying. it would be helpful if I could be more focused. It's very interesting material (linear algebra) and as I study I keep getting inspired and my mind will go off on a tear imagining stuff based on what I'm reading, then it will start to wander to other things, and so on. That's nice and fun but it does make learning take longer.

On the other hand, obviously at some point you want to apply the stuff you've learned, but if you were taking brain drugs, you could cycle in and out. Take them when you need to study, and go off them when you need to be creative. Although I wonder how long the effects last.

I bet there are drugs that could actually increase creativity also. Certainly psychedelics make you feel more creative, having all kinds of insights.

Also, I don't think Provigil is comparable to stuff like Ritalin. It just makes you feel more awake and alert without the drowsiness of caffeine. (i.e. caffeine makes you more alert and not a sleep, but you still feel, like, stretched out or something. That's my experience anyway)

Some of these reports about taking modafindel/provigil sound a lot like the placebo effect as well. I mean, the story about the guy sitting down and writing a paper after reading a book about string theory, I'm sure that could have happened with a sugar pill if he thought it was brain-boost 2000 or whatever.
posted by delmoi at 5:15 PM on December 27, 2008


Just a wee dab of speed...
posted by Artw at 5:21 PM on December 27, 2008


PROVIGIL is approved to improve wakefulness in adults who experience excessive sleepiness (ES)...

Thank you for directing my attention to these articles. Now I know there's a name for what I have, and that I'm not just "lazy" or "love to take naps." I'm a victim poster child of ES!
posted by not_on_display at 5:23 PM on December 27, 2008 [2 favorites]


n_o_d, paired with some self-diagnosed Asperger's, it'll be a wonder you can function at all.
posted by maxwelton at 5:31 PM on December 27, 2008


I can't speak to the off-label uses of Provigil. I take on-label (is that a term?), for fatigue induced by multiple sclerosis. Before Provigil my life was severely limited by regular episodes of incapacitating fatigue and accompanying brain fog. It's the reason I decided not to pursue medical school, for example.

Since I started taking Provigil, fatigue simply hasn't been a problem. I still often feel scattered and distracted, and I still drink coffee, but I'm basically functional.

In my experience, Provigil has far fewer side-effects than caffeine. As a stimulant, it is somewhat disappointing. It doesn't make me feel buzzed or high or high-energy. It's much less entertaining than coffee, for example. But it also doesn't cause jitters the way coffee does. It just makes me not feel wiped out.

I have a friend --- a coworker --- who had even worse fatigue than I ever did. For several years he slept about eighteen hours a day. Needless to say, this was a great disruption to his life. I say "coworker" but he worked from home and only about ten hours a week. He started taking Provigil a couple of months ago and basically, poof, his fatigue went away. He's functioning much more like a normal person again.

I mention all this for context, just so people realize that Provigil is not only about creating ubermenschen. Hey, I wish it gave me a state of hyperfocus that effectively raised my IQ by a couple of dozen points. I could use it. I've been tempted to layer Aderal or some such on top of Provigil because I still feel like I'm not nearly as focused and effective as I could and should be. But, basically, for whatever reason, I don't get any of that from Provigil. Because of that, I've long been skeptical of reports that it does anything for concentration at all. But I guess it's all relative, and for people who don't have fatigue issues, it really does give them a different kind of boost.
posted by alms at 5:45 PM on December 27, 2008 [6 favorites]


We've been through all this before, in the early sixties, when an impressive array of scientists and professors (and conservative magazine editors like Henry Luce) were touting the mind expanding benefits of LSD. If you weren't there, you wouldn't know how benign this drug was made to sound (this was well before the hippie era), and how anyone with reservations was made to sound stodgy and calvinist. And so everyone took it. And what we all found out is that it didn't open your mind. It made you a crazy person. It gave you temporary psychosis. This may be what this new generation of drugs is doing: unbalancing your mind; making you nuts. Of course, you won't feel like a nut. You'll feel like you've finally got it all together. As G.K. Chesterton said, the insane are not unreasonable, "the madman is the man who has lost everything but his reason."
posted by shambles at 5:53 PM on December 27, 2008 [1 favorite]


And what we all found out is that it didn't open your mind. It made you a crazy person.

I wouldn't agree with that.
posted by specialfriend at 6:06 PM on December 27, 2008 [11 favorites]


It made you a crazy person. It gave you temporary psychosis.

Right, temporary. So?

This may be what this new generation of drugs is doing: unbalancing your mind; making you nuts.

Omg, something MAY cause something BAD!? We'd better ban it right away. After all, if one thing is metaphorically like some other thing, and furthermore you can imagine something bad might happen, that proves that the first thing is bad!

In other news, tomatos and nicotine are both nightshades! That means they're like eachother! That means tomatoes might cause cancer! We should ban them right away! No one wants cancer!
posted by delmoi at 6:07 PM on December 27, 2008 [2 favorites]


Provigil may have some unknown long-term effects, but comparing it to LSD is hyperbole. LSD gives you kaleidoscopic hallucinations and extremely distorted internal and external perceptions. Provigil is a stimulant like speed, but none of the addicting euphoria.
posted by justkevin at 6:11 PM on December 27, 2008


And so everyone took it. And what we all found out is that it didn't open your mind. It made you a crazy person.

So glad you're here to speak for ALL of us...
posted by hermitosis at 6:12 PM on December 27, 2008


At 42, I get more creative (and less able to focus) every day. This is perhaps the first drug I might consider dabbling with -- not full time, but when I need to put my head down and get something done. As a photographer and artist, I need my foggy headed time to think and ponder. But when I need to execute (some software development tasks, for example) quickly and precisely, perhaps a little pill might do the trick.

I've always wanted the internal mechanism for controlling mental states that Iain Banks put in his Culture novels. Is this the first step for us?

Worth some consideration, at least. And, uh, losing a few pounds might be nice.
posted by seanmpuckett at 6:24 PM on December 27, 2008


Omg, something MAY cause something BAD!? We'd better ban it right away.

Stop strawmaning other peoples' opinions into "OMG we want to ban it!" hyperbole. It's completely reasonable to say "We don't know the long-term side-effects of this drug. Therefore, people who can function well without it and probably don't need it should be think carefully before taking it."
posted by Solon and Thanks at 6:28 PM on December 27, 2008 [4 favorites]


Stop strawmaning other peoples' opinions into "OMG we want to ban it!" hyperbole.

You are aware that these drugs actually are banned at the moment, right? At least for people without a legitimate medical need.
posted by delmoi at 6:31 PM on December 27, 2008 [1 favorite]


I was under the influence that non-chronic-medication for long-lasting-underlying-medical-condition use of modafinil was best when you take it when you need it instead of relying on it everyday.

For example, you've been up 16 hours working your ass off and need to put in another 8 to make a deadline, then you take a hit rather than taking it every day so you can work 22 hours out of every 24.

Like almost everything else (LSD included), there's a point of diminishing returns. Modafinil can temporarily reset the feelings of sleepiness, but it seems like it's mostly just getting rid of the acute symptoms without dealing with any of the other aspects of tiredness which only real rest can allow your body to deal with.
posted by porpoise at 6:33 PM on December 27, 2008


I (usually) take 200mg of it daily for idiopathic hypersomnia. It works, in that I feel far less sleepy. I've noticed no side effects.

Regarding anxiety, I have struggled on and off for years from anxiety and depression, and modafinil has been very helpful to me in that regard, since not being sleepy all the time makes lifestyle change--the only real effective treatment for it--significantly easier. Whether or not it induces anxiety in itself, I can't say for sure, but if it does, it's less of a problem for that reason. I find that it definitely exacerbates the anxiety-inducing effects of caffeine, so I try to avoid caffeine while on it. It acts as a mild anti-depressant, which is fortunate since it interacts badly with SSRIs, or vice versa; the antidepressant effects work, but for me, the sleepiness is actually worse on SSRI plus modafinil than it is on neither, or possibly it's just harder to resist. Modafinil and alcohol give me an interesting interaction, possibly desirable for relaxation but not good for socializing: it makes me go limp, like a rag doll or a puppet with its strings cut. Not so much so that I can't move, but moving becomes a noticeably effortful process, and of course this comes with sleepiness too.

Partly because it's expensive, partly because I don't like being on a drug all the time, partly because I suspect that I really do, for some reason, need more sleep than normal, I go off it when I can. I've not noticed any withdrawal, or downer of mood, but my desire for 9 or 10 hours of sleep and two-hour afternoon naps returns in full.

Because the effect of the drug seems to last around 15-16 hours, if I take it in the morning at about 7am, by 11pm I feel very sleepy again. If I need or want to stay up late at night for a party or a red-eye flight or something, delaying the dose 'til early afternoon just as the "nap time" urge hits seems to work, and I can stay up 'til 4am or so. With the next day's dose at 7-ish, I can function all day, but definitely need a full night's sleep that next night.

I've taken to ordering it from some Indian online pharmacy, because I can get 50 x 200mg pills for $80 from them, as opposed to 60 x 100mg pills for $200 locally. I've noticed no difference in the effect.
posted by aeschenkarnos at 6:40 PM on December 27, 2008 [2 favorites]


I took it once and rather enjoyed it. No euphoria,kept me awake and alert for hours and was able to sleep after with no problems.
posted by empath at 7:14 PM on December 27, 2008


I wouldn't even say that LSD makes you temporarily a crazy person. I did some of my calc III homework on my first LSD outing, and it was straightforward and error-free in the light of day. At least in the sense of being able to continue with abstract reasoning, I haven't found hallucinogens to affect sanity, although there's a slight distraction effect from the visuals. There's more to sanity than symbol manipulation, of course, but I rarely hear about individuals in the midst of a psychotic break being able to finish their math homework.

I suspect that, were the various LDL-cholesterol, plaque-scouring drugs come to the fore, I would worry less about the calcium deposition during sleep deprivation. I've toyed with the idea of purchasing both modafinil and anafranil to see precisely what the fuss is about. I sleep a bit more than I like, no matter how I manipulate various levels of caffeine (or lack thereof) and exercise; spending one-third of my life drooling and unresponsive just seems like a bit of a waste.
posted by adipocere at 7:21 PM on December 27, 2008


Shambles, I think you're on the wrong side of history with regards to LSD. Once the hysteria of the 1960's subsides, our society will begin taking a more rational approach to understanding psychedelics. The trend is clear. We're already seeing it with the wave of pro-marijuana legislation, much to the chagrin of of the drug-war old guard. (In Massachusetts, decriminalization of marijuana got a higher margin of victory than Barack Obama did.)

Meanwhile, many more people are willing to speak publicly of the positive impact that LSD had on their lives. Despite the positive impact Provigil has had on my life, I'd put it a distant second to LSD.
posted by alms at 7:37 PM on December 27, 2008 [1 favorite]


This is really much ado over nothing. Is there any debate about whether or not people should drink coffee? There is, but people are pretty much free to make up their own minds about it. The only reason people are debating this is because it comes in pill form.

As the personal anecdotes here make clear, The Johann Hari article was just a sensationalist bit of fluff from a guy who makes his living writing pot-stirring articles. The arguments that people will feel forced to use it to compete would only be valid if people felt compelled to drink coffee today. Since it's prescribed, I think the possible side-effect issue can be handled the way all adverse drug events are handled.

The larger issue is the prevailing attitude that it's OK to fix an abnormal physiology, but not to enhance an normal one. Maybe the way things are now, where it's not too hard to get, but you do have to make an effort, is just enough. However, if you'd like to try a fairly benign nootropic, you can just order piracetam from Amazon.
posted by Mr. Gunn at 8:21 PM on December 27, 2008


When caffeine wears off, I get *very* testy and obnoxious--even small amounts. I'd probably have to sell all my handguns if I ever took Provigil. If I owned any.
posted by mecran01 at 8:26 PM on December 27, 2008


You are aware that these drugs actually are banned at the moment, right? At least for people without a legitimate medical need.

Your response to shambles characterized him as saying the medication should be OMG banned. I didn't see him saying that, though perhaps he does feel that way.

Furthermore, it's a prescription medication. Is that really the same thing as being banned? You had to change the definition of banned in your quoted reply to reflect that it is only banned for people without a prescription for it.
posted by Solon and Thanks at 8:31 PM on December 27, 2008


I was under the influence that

Paging Dr. Freud, Dr. Sigmund Freud.
posted by Horace Rumpole at 8:34 PM on December 27, 2008


Solon and Thanks: Furthermore, it's a prescription medication. Is that really the same thing as being banned?

In the US, the same's true of cocaine and meth.
posted by daksya at 8:36 PM on December 27, 2008


I've been taking 100-150mg of Provigil every morning for two and a half years now to treat excessive sleepiness caused by a different drug. (The low dosage is due to a well-documented personal sensitivity to psycho-pharmaceuticals)

The upside is that yes, it's an effective sleep-blocker - not unlike a 16-hour-duration caffeine without the jittery feeling. It has had, in my experience, a quite noticeable positive impact on general cognition speed and especially memory. In particular, my memory for numbers (already in the 99th percentile before taking Provigil) has gone clear off the charts. I find myself pointing out stuff like the scoring pattern in a game of Ping-Pong I'm playing exactly mirroring one I played two weeks ago (or mirroring yesterday's in reverse). In response to a co-worker's offhanded question about high-priority bugs I rattled off the six-digit ID numbers for the ten highest-priority bugs on my current project without even thinking about it (this type of stuff has prompted some stares). Other areas of memory - names, dates, trivia from random Wikipedia articles - have experienced marked improvement although nothing so dramatic.

This past August I stopped taking Provigil cold-turkey for six weeks, and found that the majority of the general memory boost appears to now be permanent (gross neurotopological changes now set in stone?), but the increase in general cognition speed and the greatly enhanced short/mid-term memory for numbers stopped within a day or two of the Provigil.

Other upsides include it being an effective appetite suppressant, and while I wouldn't go so far as to call it a mild anti-depressant, the birds do seem to sing a little sweeter.

It's definitely helped me stay focused and on-task, but at cost to my creativity. I can't really evaluate the magnitude of the latter because I don't know whether or to what degree it's being compensated for by the increased cognition speed.

Here's where the other shoe drops, though: Provigil enables you to go extremely long stretches (weeks) on five hours of sleep per night, and being more focused from taking it, you naturally fall into doing so. The problem is: all Provigil is really doing on the sleep side is walling over your brain's off-switch (I'm typing this from my memory of the Wikpedia article on Modafinil: it blocks reuptake of norepinephrine in the ventrolateral pre-optic nucleus ...yep, I was right). There's nothing to suggest it helps mitigate any of the neurochemical or neurotopological problems induced by sleep deprivation, let alone the broader physiological problems. Put simply: Provigil encourages you to sleep less, but doesn't reduce your overall need for sleep in any medium or long-term sense.

What I'm left with as a takeaway is that it's far too easy to seriously fuck yourself up with Provigil. It's almost a trap of a sort. That's why I stopped cold-turkey for six weeks. That and to check for withdrawl symptoms (there weren't any). I've resumed taking it with a hard upper limit of 100mg, and I take the weekends off. So far this approach seems to be working fairly well, but I'm still a bit leary on the prospect of longterm daily intake.

And there's always that metaphor about the candle that burned twice as brightly.
posted by Ryvar at 9:24 PM on December 27, 2008 [9 favorites]


Yes, I have to chime in and speak highly of LSD as a wonder drug. Provigil is also very effective and I find it simply marvellous for creative work too. But I take a small amount, 300mg a week off label.
posted by lupus_yonderboy at 9:27 PM on December 27, 2008


Here's a second to Artifice_Eternity from the BBC. Something to think about when you're into your third Big Mac during that paper.
posted by carping demon at 9:27 PM on December 27, 2008


Furthermore, it's a prescription medication. Is that really the same thing as being banned?

In the US, the same's true of cocaine and meth.


That's a dramatic oversimplification. There are various schedules 1-4. Cocaine, LSD and heroin are schedule 1 ("very illegal"); modafinil is schedule 4 ("barely illegal").
posted by lupus_yonderboy at 9:30 PM on December 27, 2008


OK, let me try that again. Here's a second to Artifice_Eternity from the BBC. Something to think about when you're into your third Big Mac during that paper. (HTML nooby)
posted by carping demon at 9:48 PM on December 27, 2008


delmoi: In other news, tomatos and nicotine are both nightshades! That means they're like eachother! That means tomatoes might cause cancer! We should ban them right away! No one wants cancer!

Mmmmm, tomacco.
posted by not_on_display at 9:52 PM on December 27, 2008


I've taken Adrafanil a bit, it alleviates all the mental + psych effects of prolonged wakefulness, but still leaves the normal physical ones: my muscles, eyes, and back ache, and I need to eat meals every 6 hours or so.

Only tangible side effect is asparagus-pee.
posted by blasdelf at 9:52 PM on December 27, 2008


Wow. First I find out that racism isn't actually over, and now I find out that humanity isn't on the verge of becoming a species of enlightened mega-beings who can banish sleep forever.

But that's fine, I guess...just so long as that $700-billion economic bailout keeps saving the U.S. economy from a painful and prolonged recession. Phew.
posted by evidenceofabsence at 10:39 PM on December 27, 2008


Perhaps this is a result of ADD being under-diagnosed in adults?

I had the head-shrinker prescribe Wellbutrin, and while I could definiely see the good an anti-depressant would do me, I wondered why not just a standard SSRI?

Well, because I have ADD, she said.

Bullshit, I replied, that's just another term for "slacker asshole."

How much caffeine do you drink in a day? She asked.

Around a two-liter's worth of Diet Mtn. Dew, I reply.

How does it make you feel? She asked.

Composed and focused, I replied.

Do you sleep OK at night? She asked.

Yes, I replied.

OK, since you drink enough caffeine in a day to kill the Bulgarian Army, and it makes you calm and focused, and you aren't up until three AM every night cataloging facial tics, this is an indication your brain isn't getting what it needs naturally, so you're using caffeine to make up for it. Wellbutrin has a mild stimulant effect that you'll find to be better on the system than six cans of Diet Cherry Pepsi daily, she said.

And she was right. I have more focus thanks to the stimulant, more energy thanks to the anti-depressant, and fewer space-out sessions or weekends-spent-in-bed, and no "shakes" or high blood-pressure from guzzling Diet Coke with Lime by the quart.

Is Wellbutrin a wonder-drug that will make everyone who takes it smarter and more efficient? Fuck, no. You have to have something seriously wrong with you to begin with for it to have much effect. I wonder if the same can't be said for Provigil?
posted by Slap*Happy at 10:42 PM on December 27, 2008


I wouldn't even say that LSD makes you temporarily a crazy person. I did some of my calc III homework on my first LSD outing, and it was straightforward and error-free in the light of day.

You could argue that it temporarily induces psychosis which according to wikipedia just means hallucinations, difficulty thinking clearly, etc. I've never taken any so I don't know exactly what it's like. But wikipedia seems to say that psychosis needs to be negative, so an LSD trip perhaps wouldn't qualify unless it was a "bad trip". On the hand, an induced, positive psychosis wouldn't make you "crazy" in any sense.
posted by delmoi at 10:57 PM on December 27, 2008


lupus_yonderboy: There are various schedules 1-4.

Actually five.

Cocaine, LSD and heroin are schedule 1 ("very illegal")

Cocaine is Schedule II i.e. high potential for abuse but with accepted medical use. LSD is Schedule I i.e. high potential for abuse but no accepted medical use. Heroin a.k.a diamorphine is also schedule I but would be II if not for all the related opioid class drugs (morphine, codeine, oxycodone...etc), which are in lower schedules permitting medical use.

modafinil is schedule 4 ("barely illegal").

Is that like being half pregnant?

The point the original commenter was making is that since there were provisions under which the drug could be legally availed, it wasn't "banned", but that's true of meth et al. as well. Come to think of it, even Schedule I drugs can be obtained with a DEA license. They must have a 1-800 number posted somewhere. In the US, drugs aren't technically banned but controlled. But mark the technically. Also, amphetamines or methylphenidate being Schedule II ("very illegal") hasn't stopped a huge upsurge in their issued scrips within the last decade.
posted by daksya at 11:25 PM on December 27, 2008


Slap*Happy - is it possible that the Wellbutrin works so well on you is because you're drinking a few liters of Moutain Dew a day? That you were already on a caffeine dependency?

I'm bipolar2, never went on meds, got Zyban/Wellbutrin for smoking cessation (without telling about my mental) and the 'selective'-norepinephrin reuptake inhibition screwed the BLEEPING BLEEP out of me.

Then again, I can't drink too much pop and can't have more than a cup of dark coffee in the morning without getting focused-weird.

--

What I'm not getting in this thread is that nootropics come in two (plus) different kinds of use.

People with deficiencies (against a median "normal") are getting neuromodulators so that they can report feelings and "productivity" that's closer to the mean, and...

people who use nootropics to enhance what they have to be better than (or to be as good as) some arbitrarily (and comparatively) high standard.

If you want to beat the standard, there's a price to pay. Just ask the people who took/take body-modifying substances (primarily steroids of one kind or another) to enhance their physical side.

Interesting point - is permanent improvement possible with the current crop of nootropics or are the current crop just like steroids/hormones; it's great as long as you take them (and do the physical stuff that takes advantage of them*) but it all goes away (and worse, plus side effects) when you stop taking them?

*I've heard a lot of talk about people taking enhancement drugs, then not really following a good regimen regularly, then not gaining what they wanted but suffered all the side effects plus)
posted by porpoise at 11:26 PM on December 27, 2008


This thread seems to be veering towards a redux of a recent discussion on the Blue.
posted by daksya at 11:37 PM on December 27, 2008


Provigil isn't going to end up being tightly controlled, it's too boring. It's not a central nervous system stimulant like cocaine and amphetamines, in fact it's less noticeable than coffee. It's only when it's 4 AM and you're not feeling the least bit fatigued that you'll even notice something is amiss. The whole point of a recreational drug is that they're fun (enough to make you want to do it again and again and WANT MOAR) and dangerous, and Provigil isn't. We're never going to see 'Faces of Provigil' on the evening news.
posted by mullingitover at 12:30 AM on December 28, 2008


Interesting point - is permanent improvement possible with the current crop of nootropics or are the current crop just like steroids/hormones; it's great as long as you take them (and do the physical stuff that takes advantage of them*) but it all goes away (and worse, plus side effects) when you stop taking them?

Some wild speculation based on my own experiences: longterm usage of nootropics might result in the brain reconfiguring its neurotopology for optimal efficiency while under the effect of said nootropic. Simply: it seems likely that over time the brain would rewire itself with the 'assumption' that the drug in question is now a 'given' within its chemistry.

Depending on the specific nature of the topological reconfiguration imparted by a given substance, the user would experience effects ranging from permanent benefits to catastrophic topological failure. Simply: this rewiring might lead to a better general layout for memory retrieval that continues even when the drug that sparked it isn't around.

Alternately, if the drug were one that, say, somehow accelerated neural transmission speed, core pathways in your brain might rewire based on the assumption of that increased speed and then fail outright once the enhancing drug was pulled because all the timings were suddenly off. In short, you stop taking the drug, you become a vegetable overnight.

This is, again, just wild speculation. It doesn't help that modern psychiatry and psychopharmaceuticals are still in the performing-surgery-with-sledgehammers stage.
posted by Ryvar at 1:19 AM on December 28, 2008


When I first heard about this my immediate thought was, say, could I get a prescription for this filled without having to go through some sort of arcane ritual that makes buying a .50 cal sniper rifle with a scope suitable for deep sky astronomy look easy? Or will it be like getting a refill on Concerta?
posted by Kid Charlemagne at 1:20 AM on December 28, 2008 [1 favorite]


I've had this problem focusing for a couple years now. I can almost obsessively engage in passive forms of entertainment - it's way too easy for me to stay up until 4 in the morning reading the internet or flipping around on TV.

However, anytime I try to focus on something that requires active attention or decision making, it's like trying to catch a fish. It's a real problem at work, where if I have to wait 30-60 seconds for a compile, I'll start wandering around on to other tasks and forget what I was doing originally. I don't think I have ADD, though - I don't think caffeine affects me the same way it does most people with ADD. I actually think I might have ADHD-I, but I'm not sure what to do about that.

Asking strangers on the internet for medical advice probably isn't a good idea, but I'm not even sure how to ask my doctor about this. I've recently started taking antidepressants, and it's made a marked improvement in my quality of life, so I'm hoping there's a similar treatment option here.
posted by heathkit at 2:37 AM on December 28, 2008


Provigil isn't going to end up being tightly controlled, it's too boring.

Indeed. Provigil's effects in my case are pretty limited to straight up wakefulness. My doctor prescribed it to me during a particularly insidious bout of depression that had left me sleeping all day as much as I could. I still go through bouts of intense sleepiness that mess with my quality of life, but only if I've not taken my meds. Recently I changed anti-depressants, though, and found myself extremely agitated in the morning, so I stopped taking the Provigil. I'm excessively sleepy again. I'm going to half my dose and try taking it again.

:::gulp:::

Now excuse me while I run around the house and clean while simultaneously memorizing the entirety of the Jabberwocky.
posted by Stewriffic at 6:05 AM on December 28, 2008


I love the way so many threads on MeFi end up being about how awesome LSD is. That's how I know this is the website for me.
posted by Bageena at 7:43 AM on December 28, 2008 [2 favorites]


And what we all found out is that [LSD] didn't open your mind. It made you a crazy person.

Last I read it was being looked at to "cure" addictions and childhood trauma, in tandem with personal therapies, and not to simply treat those problems by replacing one drug with another. I recommend reading Jay Stevens' book, Storming Heaven, to review the mass hysteria surrounding LSD instead.
posted by Brian B. at 10:16 AM on December 28, 2008


When I first heard about this my immediate thought was, say, could I get a prescription for this filled without having to go through some sort of arcane ritual that makes buying a .50 cal sniper rifle with a scope suitable for deep sky astronomy look easy? Or will it be like getting a refill on Concerta?
posted by Kid Charlemagne at 4:20 AM on December 28 [1 favorite +] [!]


Actually, buying .50 cal sniper rifles is supposedly pretty easy since they aren't classified as destructive devices or anything - they're just deer rifles of unusual size.

The process for getting Provigil is simple: convince someone who can legally write prescriptions that you have a legitimate medical need, and then go to the pharmacy. Last time I went to the pharmacy I asked the pharmacist how much the Provigil would cost me if I didn't have health insurance - he came back with wide-open eyes and said "about five hundred dollars."

So if, like me, you have United Healthcare, be prepared to convince them you have a legitimate medical need, which is a lot tougher. Cigna never batted an eyelash back when I had them.
posted by Ryvar at 1:32 PM on December 28, 2008


Take Provigil when you are on chemotherapy and your brain is jello. Snaps it back to attention. But after chemo...not so much.
posted by trii at 3:20 PM on December 28, 2008


Kind of late to the thread here but I wanted to share a bit about my personal experience with Provigil and other related substances.

I started taking it in early 2008, and it had a pretty quick impact on wakefulness for me (I, like several people above, have idiopathic hypersomnia / ES - which is basically a catchall phrase for "you like to sleep a lot and it's a brain thing, we dunno.") So that part of it was pretty good. It isn't a stimulant, really, just short-circuits your sleepiness indicators, so if you take it early in the morning you'll be up all day. if you take it at night you'll be up all night. it does this quite well, and is its primary purpose.

I have found though that it has some side effects, none of which are too obvious but only become noticeable over time. The biggest of these, which I struggle with as an artist, is that it really wipes out my creativity. I used to have random moments of artistic inspiration which absolutely *required* me to make my visions into reality, and I would happily spend hours working on something that had just occurred to me. Since Provigil, I find that I no longer have any of these thoughts, nor any real desire to create anything in general. I view this as a negative side effect :)

However the positive effects, like being able to function more normally and the appetite suppression / metabolic changes (I've lost about 50lbs since I started taking it a year ago with little initial change in activity) means that I am reluctant to go off it. I want my creativity back but not at the expense of uncontrolled sleepiness and a potential weight gain. Right now I'm trying to figure out what my options are for other meds that might have different effects, but until I have an alternative I'm on it for the time being.

What's funny is that some people find it enhances focus and memory, for me it's the opposite... I'm drifting in a fog most times, and it's hard to remember things or stay on task at all. Making decisions is difficult. But who knows how much of these sorts of side effects are the drug, and how much of it is our underlying personality?

I concur with the commenter who said that modern psychotherapy involves using medication like a sledgehammer to the brain. I am very leery of taking drugs for this exact reason, after unpleasant past experiences and the general knowledge that any of these pills are just a crapshoot in the end as to how they will work for me. I don't want a sledgehammer, I want precision tools. Provigil is widely viewed to be a much more subtle and useful drug, and having also used Adderall and the like I can agree with that, but as with all things it's a YMMV situation.

(I often wonder what Provigil is like for someone who doesn't have a built-in predilection for sleeping all the time... why would you ever take something like this? it fucks up your sleep cycles something fierce. Even I have a hard time sleeping with this drug in my system, and without it I could sleep all day long every day.)

FWIW, after a health insurance change (HSA, paying for prescriptions at full retail up front? WTF?) I started buying my modafinil from mail-order european pharmacies instead of via my pharmacy in the US. it's about $100 for a one month supply vs. $300+ in the US. I don't know if this is fully legal or not but I personally feel our pharmaceutical industry here in the US *is* criminal, so my personal morals say fuck it and I buy it from some guy in Switzerland.
posted by EricGjerde at 4:13 PM on December 28, 2008 [1 favorite]


I don't know if this is fully legal or not
It would be wisest to keep your prescription, from the doctor, up to date; and import no more than a few months' personal supply.

Since multiple people have MeFi-mailed me to ask the name of the online pharmacy I order mine from - it's "pharma-orders", add the obvious prefix and suffix. Hopefully that won't trigger spam-flagging, and if it does, well, I ask the mod to look at my MeFi-mail inbox to confirm the above.
posted by aeschenkarnos at 5:29 PM on December 28, 2008


« Older Everything you know about Alternate Reality Games ...  |  Samuel Phillip Huntington, bes... Newer »


This thread has been archived and is closed to new comments