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my GP offered to prescribe it to me

On Wed, Jul 15, 2009 at 4:42 AM, rich_lender <rich_lender@...> wrote:

>

>

> Who typically prescribes Provigil for fatigue? A neurologist? A general

> practitioner? A psychiatrist?

>

> Thanks, in advance, for any guidance.

>

>

>

--

Margaret

Peace, Love, & Babies!

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Hi Amy, Margaret,

Thank you both for the information. From your messages, it seems that your

physicians were open-minded about prescribing this to help with fatigue. I

wonder if other physicians would be similarly receptive. Don't forget:

1. Fatigue is an off-label use

2. Provigil is a controlled substance that has the potential to be abused or

lead to dependence

Rich

>

> >

> >

> > Who typically prescribes Provigil for fatigue? A neurologist? A general

> > practitioner? A psychiatrist?

> >

> > Thanks, in advance, for any guidance.

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have you tried the supplement NADH for fatigue ?

 

seems to me one should try this before going the provigil route...

 

if you have tried NADH and other energy enhancing supplements with little

success  , then ignore what i said....

 

cheers

>

>

> Who typically prescribes Provigil for fatigue? A neurologist? A general

> practitioner? A psychiatrist?

>

> Thanks, in advance, for any guidance.

>

>

>

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i personally did not want to try the provigil, even though it was offered to

me. it was actually offered by 2 different western med docs, an internist &

a GP, so i just wanted to throw it out there.

best of luck!

On Wed, Jul 15, 2009 at 2:42 PM, Rollwagen <kylerollwagen@...>wrote:

>

>

> have you tried the supplement NADH for fatigue ?

>

> seems to me one should try this before going the provigil route...

>

> if you have tried NADH and other energy enhancing supplements with little

> success , then ignore what i said....

>

> cheers

>

>

>

> >

> >

> > Who typically prescribes Provigil for fatigue? A neurologist? A general

> > practitioner? A psychiatrist?

> >

> > Thanks, in advance, for any guidance.

> >

> >

> >

>

>

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Hi

Have you tried NADH ?

How has it worked for you?

I have been thinking of trying it

Thanks

Steve

On Jul 15, 2009, at 12:42 PM, Rollwagen wrote:

> have you tried the supplement NADH for fatigue ?

>

> seems to me one should try this before going the provigil route...

>

> if you have tried NADH and other energy enhancing supplements with

> little success , then ignore what i said....

>

> cheers

>

>

>

> >

> >

> > Who typically prescribes Provigil for fatigue? A neurologist? A

> general

> > practitioner? A psychiatrist?

> >

> > Thanks, in advance, for any guidance.

> >

> >

> >

>

>

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Hi Rich,

Both of my doctors gave me samples (one of them twice). One of these docs

seems to have drug reps in her office every other time I go in there and she

has given me samples of several other drugs as well. The other doc I've

only

seen drug reps in his office once and he told them he was too busy to talk

to

them. But, he also seems to have drug samples to give away. Both of these

docs are treating me for CFS, so they are obviously very open to treating me

for fatigue.

If you can find a doc who is at least sympathetic to CFS and who seems to

be " in " with drug reps, you might be able to get a prescription. I don't

know,

just a thought.

BTW, I threw out all my Provigil samples and both prescriptions for it

because

Cheney is against it: http://www.prohealth.com/library/print.cfm?libid=8480

Amy

On Wed, Jul 15, 2009 at 12:06 PM, rich_lender <rlender2@...> wrote:

>

>

> Hi Amy, Margaret,

>

> Thank you both for the information. From your messages, it seems that your

> physicians were open-minded about prescribing this to help with fatigue. I

> wonder if other physicians would be similarly receptive. Don't forget:

>

> 1. Fatigue is an off-label use

> 2. Provigil is a controlled substance that has the potential to be abused

> or lead to dependence

>

> Rich

>

>

> >

> > >

> > >

> > > Who typically prescribes Provigil for fatigue? A neurologist? A general

> > > practitioner? A psychiatrist?

> > >

> > > Thanks, in advance, for any guidance.

>

>

>

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Hi ,

Yes, I'm going to try this as well.

I've heard many friends swear by to boost energy and brain power. I read that

they've looked at NADH as a treatment for jet lag, Alzheimer's disease,

Parkinson's disease. But only the first item (jet lag), has been evaluated in

double-blind studies.

Rich

>

> have you tried the supplement NADH for fatigue ?

>  

> seems to me one should try this before going the provigil route...

>  

> if you have tried NADH and other energy enhancing supplements with little

success  , then ignore what i said....

>  

> cheers

>

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Hi Margaret,

Thank you for your interesting response. I actually was surprised by what you

wrote. Let me explain why.

I am afraid that I'm going to have the opposite problem, namely that I want to

try Provigil (at my own expense) but my doctor won't prescribe it for me because

it has a growing reputation as a recreational drug. From what I've read about

the drug, it can have positive effects on the cognition of so-called " normal

people. "

Nevertheless, if it may be therapeutically useful for a medical condition, I

don't see how they can justifiably decline prescribing it.

Rich

>

> i personally did not want to try the provigil, even though it was offered to

> me. it was actually offered by 2 different western med docs, an internist &

> a GP, so i just wanted to throw it out there.

> best of luck!

>

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Hi Amy,

Thank you for the useful information.

If my own physician won't help me, I may come back to the group and ask for some

advice in finding a physician who will prescribe Provigil.

I understand why you threw out all your Provigil samples, based on Cheney. I

do, however, know people who would pay up to $12 per pill for this stuff!

By the way, I worked for a pharmaceutical company for 10 years. While I don't

want to disparage the fact that pharmaceutical representatives provide a vital

function, we used to hire them based on criteria far removed from their

scientific background and pharmaceutical knowlege.

Rich

>

> Hi Rich,

>

> Both of my doctors gave me samples (one of them twice). One of these docs

> seems to have drug reps in her office every other time I go in there and she

> has given me samples of several other drugs as well. The other doc I've

> only

> seen drug reps in his office once and he told them he was too busy to talk

> to

> them. But, he also seems to have drug samples to give away. Both of these

> docs are treating me for CFS, so they are obviously very open to treating me

> for fatigue.

>

> If you can find a doc who is at least sympathetic to CFS and who seems to

> be " in " with drug reps, you might be able to get a prescription. I don't

> know,

> just a thought.

>

> BTW, I threw out all my Provigil samples and both prescriptions for it

> because

> Cheney is against it: http://www.prohealth.com/library/print.cfm?libid=8480

>

> Amy

>

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My son had Provigil prescribed by a neurologist who specializes in sleep

disorders. He went the whole sleep study route and they found he didn't get

any phase III or IV sleep but didn't have any apnea or other easily solved

sleep disorder. The doctor had him try several other medications first and

then prescribed the Provigil. Unfortunately, it doesn't help my son feel

any less exhausted, but just thought I'd let you know what kind of doctor

he'd had prescribe it.

Kara

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Hi Rich,

I wish I'd sold my samples for $12 a pill!! Of course, that's illegal,

isn't it. Well,

I could certainly use the money for all the supplements I buy now!! :-)

Interesting comment from you pharmaceutical company experience, too! :)

Best of wishes to you, Amy

On Wed, Jul 15, 2009 at 4:09 PM, rich_lender <rlender2@...> wrote:

>

>

> Hi Amy,

>

> Thank you for the useful information.

>

> If my own physician won't help me, I may come back to the group and ask for

> some advice in finding a physician who will prescribe Provigil.

>

> I understand why you threw out all your Provigil samples, based on Cheney.

> I do, however, know people who would pay up to $12 per pill for this stuff!

>

> By the way, I worked for a pharmaceutical company for 10 years. While I

> don't want to disparage the fact that pharmaceutical representatives provide

> a vital function, we used to hire them based on criteria far removed from

> their scientific background and pharmaceutical knowlege.

>

> Rich

>

>

> >

> > Hi Rich,

> >

> > Both of my doctors gave me samples (one of them twice). One of these docs

> > seems to have drug reps in her office every other time I go in there and

> she

> > has given me samples of several other drugs as well. The other doc I've

> > only

> > seen drug reps in his office once and he told them he was too busy to

> talk

> > to

> > them. But, he also seems to have drug samples to give away. Both of these

> > docs are treating me for CFS, so they are obviously very open to treating

> me

> > for fatigue.

> >

> > If you can find a doc who is at least sympathetic to CFS and who seems to

> > be " in " with drug reps, you might be able to get a prescription. I don't

> > know,

> > just a thought.

> >

> > BTW, I threw out all my Provigil samples and both prescriptions for it

> > because

> > Cheney is against it:

> http://www.prohealth.com/library/print.cfm?libid=8480

> >

> > Amy

> >

>

>

>

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Who told you that provigil can lead to dependence? I doubt that someone taking

it as prescribed by a licenses physician can have dependence problems.

It's one of the safest " stimulants " on the market and I said " stimulants "

because it's not really a stimulant.

Very different from ritalin or other older amphetamine based stimulants, which

can lead to physical dependence IF used improperly.

By the way I don't give much credit to Cheney's " fry brain " theory. Neither

Cheney nor the doctor he based his claim on have any scientific evidence to

support their claims.

" Prozac Backslash by ph Glenmullen " is just another mumbo-jumbo anti

antidepressants book.

It seems ridicule to think that SSRI's and other antidepressants can " fry " your

brain. These meds are life savers for millions of people.

> >

> > >

> > >

> > > Who typically prescribes Provigil for fatigue? A neurologist? A general

> > > practitioner? A psychiatrist?

> > >

> > > Thanks, in advance, for any guidance.

>

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Dear Rich

One of the problems with these so-called stimulant medications is that in

patients who really need and benefit from them, compliance is an issue, ie

patients forget to take them. LOL

Regards

R

Re: Provigil

> Hi Amy, Margaret,

>

> Thank you both for the information. From your messages, it seems that

> your physicians were open-minded about prescribing this to help with

> fatigue. I wonder if other physicians would be similarly receptive.

> Don't forget:

>

> 1. Fatigue is an off-label use

> 2. Provigil is a controlled substance that has the potential to be abused

> or lead to dependence

>

> Rich

>

>

>>

>> >

>> >

>> > Who typically prescribes Provigil for fatigue? A neurologist? A general

>> > practitioner? A psychiatrist?

>> >

>> > Thanks, in advance, for any guidance.

>

>

>

> ------------------------------------

>

> This list is intended for patients to share personal experiences with each

> other, not to give medical advice. If you are interested in any treatment

> discussed here, please consult your doctor.

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Hi o,

Thanks for your input on this. You bring up some excellent points.

A study was published in the Journal of the American Medical Association about

four months ago. The study stated that people taking Provigil experience a

surge of dopamine, an important neurotransmitter. And these dopamine increases

are seen in people taking Ritalin, Adderall and cocaine, from what I read in the

study. The study went on to say that Provigil exhibits the chemical signature

of possible addictiveness.

Yes, I too believe that that someone taking Provigil as prescribed by a licensed

physician will be unlikely to have dependence problems. But what starts off

medicinal, as you know, sometimes goes recreational. By this I mean that a

person can sometimes develop a psychological dependence on a drug. As you may

already realize, Provigil is sometimes used by students, writers, programmers,

and workaholics who want to remain alert and be more productive or simply to

have fun. I call this a " dependence " because these individuals believe (rightly

or wrongly) that they cannot function fully without the drug; also, they are not

using the drug therapeutically to treat a medical condition.

I didn't realize that Cheney is so anti-antidepressants and anti-Provigil. I

didn't read Glenmullen's book in total, but I understand his point that such

drugs have become too widely used without proper precautions. I did notice that

much of his evidence is anecdotal (based on stories from his own patients or

other patients). He doesn't discuss in detail the years of double-blind studies

that the FDA required.

Rich

>

> Who told you that provigil can lead to dependence? I doubt that someone taking

it as prescribed by a licenses physician can have dependence problems.

>

> It's one of the safest " stimulants " on the market and I said " stimulants "

because it's not really a stimulant.

>

> Very different from ritalin or other older amphetamine based stimulants, which

can lead to physical dependence IF used improperly.

>

> By the way I don't give much credit to Cheney's " fry brain " theory. Neither

Cheney nor the doctor he based his claim on have any scientific evidence to

support their claims.

>

> " Prozac Backslash by ph Glenmullen " is just another mumbo-jumbo anti

antidepressants book.

>

> It seems ridicule to think that SSRI's and other antidepressants can " fry "

your brain. These meds are life savers for millions of people.

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I've taken both Provigil and Ritalin. I really didn't like Provigil, gave me a

very " artificial " energy, like I really knew I was taking something. Didn't

help much and I didn't like it. Coffee was more effective. Ritalin at small

doses really helped at first. Cleared my head a bit and expanded my mental and

physical envelope. However, whether because I overdid things or just from the

drug, I crashed badly and never could get the benefits from it afterward. I

tried many different doses. I take no stimulants now. I get the " tired and

wired " feeling when I overdo things, as I imagine most of us do, (even if we

don't always recognise it when it is happening), and stimulants only make it

worse. I'm really working towards the relaxation end of things.

> >

> > Who told you that provigil can lead to dependence? I doubt that someone

taking it as prescribed by a licenses physician can have dependence problems.

> >

> > It's one of the safest " stimulants " on the market and I said " stimulants "

because it's not really a stimulant.

> >

> > Very different from ritalin or other older amphetamine based stimulants,

which can lead to physical dependence IF used improperly.

> >

> > By the way I don't give much credit to Cheney's " fry brain " theory. Neither

Cheney nor the doctor he based his claim on have any scientific evidence to

support their claims.

> >

> > " Prozac Backslash by ph Glenmullen " is just another mumbo-jumbo anti

antidepressants book.

> >

> > It seems ridicule to think that SSRI's and other antidepressants can " fry "

your brain. These meds are life savers for millions of people.

>

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Dear .

I've been taking 5mg of NADH daily for over a year, as part of the

Yasko protocol, and I haven't had any noticeable reaction to it, pro

or con. As a matter of fact, I can't think of any supplements (or

Rx's) that have improved my fatigue levels. I suspect one or more

underlying infections, because the things that I react to are ones

that give me a flu-like detox /die-off reaction. From that I infer

that they are effectively killing pathogens somewhere inside me. But

the result is that I feel worse, not better, for a bit. I'd say I have

slightly more energy than I had a couple years ago, but the progress

has been *very* gradual and haven't noticed a clear improvement from

any one thing. Just my own experience, YMMV.

I haven't been particularly interested in Provigil. I'm already taking

Effexor, after a 2-3 year effort with a very good psychiatrist to find

an anti-depressant that worked for me and didn't have undesirable side

effects. The Effexor is " habit forming " in that regular use physically

alters the population of receptors in the brain. If I stop suddenly, I

get horrible side effects. Sometimes my mood goes south and I start to

feel mildly suicidal. More pronounced is the terrible, nauseating

dizziness, severe grogginess, and bizarre dreams. I'm working with my

doctor to gradually back off on the dose. It worries me to be so open

to such severe side effects if I should run out of something.

Oh, and the whole, " you're not ill with chronic fatigue, you're just

depressed " thing? I was genuinely, clinically depressed. Finding the

right antidepressant lifted the depression and improved my life.

However (and to the frustration of my psychiatrist, who is really a

very good doctor), it did nothing to lift my crushing fatigue. So I'm

an example of someone who had *both* depression *and* chronic fatigue,

and it was reasonable to treat the depression, even though treating

the depression did not cure the chronic fatigue.

Marcia on

in Salem, Massachusetts

On Jul 15, 2009, at 3:42 PM, Rollwagen wrote:

> have you tried the supplement NADH for fatigue ?

>

> seems to me one should try this before going the provigil route...

>

> if you have tried NADH and other energy enhancing supplements with

> little success , then ignore what i said....

>

> cheers

>

>

>

> >

> >

> > Who typically prescribes Provigil for fatigue? A neurologist? A

> general

> > practitioner? A psychiatrist?

> >

> > Thanks, in advance, for any guidance.

> >

> >

> >

>

>

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Hi all

I used Rhodiola for a while. It helped me alot at first.Sometime later i started

developing hypomania symptoms.Did not know what caused it. Than someone

mentioned Rhodiola was boosting dopamine. Thanks to her. Than i read someplace

else that taking dopamine enhancing products while person is low in serotonin

could cause hypomania.And my serotonin is low.

Just thought i should pass this info.

cindi

Re: Provigil

Hi o,

Thanks for your input on this. You bring up some excellent points.

A study was published in the Journal of the American Medical Association about

four months ago. The study stated that people taking Provigil experience a

surge of dopamine, an important neurotransmitter.

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>

Hi Marica,

Some thoughts below.

> Dear .

>

> I've been taking 5mg of NADH daily for over a year, as part of the

> Yasko protocol, and I haven't had any noticeable reaction to it, pro

> or con.

***I also have not noticed anything with NADH. I feel the most benefit from

fatigue from high dose Vitamin C. Very subtle but noticeable.

I'm already taking

> Effexor, after a 2-3 year effort with a very good psychiatrist to find

> an anti-depressant that worked for me and didn't have undesirable side

> effects. The Effexor is " habit forming " in that regular use physically

> alters the population of receptors in the brain. If I stop suddenly, I

> get horrible side effects.

***I was unable to tolerate Effexor. The first night I took it, I was paralyzed

when I woke up. It was awful and took about 30 min. to be able to roll over

onto my back from a side position. I could not even call for my son to help.

My eyes opened and I was awake but could not move. It was frightening. I hope

you will be able to get off slowly and easily.

.. So I'm

> an example of someone who had *both* depression *and* chronic fatigue,

> and it was reasonable to treat the depression, even though treating

> the depression did not cure the chronic fatigue.

>

***This is a very good point. Just because we have this illness doesn't mean

other things can't be a problem. I tend to forget that and dismiss new symptoms

as just more CFIDS issues.

Thanks for the reminder,

Marti

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Provigil is not specifically approved by the FDA for treating fatigue,

but--given the countless anecdotal reports, double-blind studies, messages in

this group, and other sources--I don't think there's anyone that can dispute

that it shows benefit in treating fatigue. In fact, I see that it's useful in

treating fatigue that is secondary to illnesses other than CFS/fibromyalgia,

including multiple sclerosis, depression, and cancer. The side effect and

adverse event profile seems good, based on my having read a tremendous volume of

information on this topic.

I believe that Provigil may help with the fatigue that is preventing from going

back to work full-time. I'm willing to absorb the cost of Provigil myself.

The clinic I go to has a conservative philosophy and is not very open-minded

when it comes to off-label uses of prescription drugs. So, my problem at this

point is finding someone who is willing to actually consider prescribing the

medication for me. I believe that I can make a strong case for being allowed to

at least given a trial of this drug.

Can anyone point me in the right direction on this?

Thank you, in advance, for any guidance you can provide.

Sincerely,

Rich

> >>

> >> >

> >> >

> >> > Who typically prescribes Provigil for fatigue? A neurologist? A general

> >> > practitioner? A psychiatrist?

> >> >

> >> > Thanks, in advance, for any guidance.

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Hi, again,

I hope you can find someone who will at least give you a trial dose of

this! I live in Austin, TX, where all the doctors are pill-pushers. I was

offered it by 3 doctors. I think it depends a lot on the medical community

in which you live.

Good luck!

On Tue, Jul 21, 2009 at 2:36 AM, rich_lender <rlender2@...> wrote:

>

>

> Provigil is not specifically approved by the FDA for treating fatigue,

> but--given the countless anecdotal reports, double-blind studies, messages

> in this group, and other sources--I don't think there's anyone that can

> dispute that it shows benefit in treating fatigue. In fact, I see that it's

> useful in treating fatigue that is secondary to illnesses other than

> CFS/fibromyalgia, including multiple sclerosis, depression, and cancer. The

> side effect and adverse event profile seems good, based on my having read a

> tremendous volume of information on this topic.

>

> I believe that Provigil may help with the fatigue that is preventing from

> going back to work full-time. I'm willing to absorb the cost of Provigil

> myself.

>

> The clinic I go to has a conservative philosophy and is not very

> open-minded when it comes to off-label uses of prescription drugs. So, my

> problem at this point is finding someone who is willing to actually consider

> prescribing the medication for me. I believe that I can make a strong case

> for being allowed to at least given a trial of this drug.

>

> Can anyone point me in the right direction on this?

>

> Thank you, in advance, for any guidance you can provide.

>

> Sincerely,

> Rich

>

>

> > >>

> > >> >

> > >> >

> > >> > Who typically prescribes Provigil for fatigue? A neurologist? A

> general

> > >> > practitioner? A psychiatrist?

> > >> >

> > >> > Thanks, in advance, for any guidance.

>

>

>

--

Margaret

Peace, Love, & Babies!

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Hi Margaret,

Thanks you for the information. I guess some doctors are more conservative,

preferring to stick to traditional and well-established therapies, and others

more aggressive and creative, willing to use the newest tests and to consider

unconventional treatments. I suppose that sometimes such variations depend on

what area you live in.

Please, if anyone in the group has any thoughts or suggestions on finding a

physician who might be willing to give me a trial of Provigil, please let me

know.

From what I've heard, neurologists seem to be the ones who most frequently

prescribe this medication. I am also looking at alternative medicine

practitioners who practice complementary or unconventional medicine, yet have a

license to prescribe.

Thanks,

Rich

>

> >

> >

> > Provigil is not specifically approved by the FDA for treating fatigue,

> > but--given the countless anecdotal reports, double-blind studies, messages

> > in this group, and other sources--I don't think there's anyone that can

> > dispute that it shows benefit in treating fatigue. In fact, I see that it's

> > useful in treating fatigue that is secondary to illnesses other than

> > CFS/fibromyalgia, including multiple sclerosis, depression, and cancer. The

> > side effect and adverse event profile seems good, based on my having read a

> > tremendous volume of information on this topic.

> >

> > I believe that Provigil may help with the fatigue that is preventing from

> > going back to work full-time. I'm willing to absorb the cost of Provigil

> > myself.

> >

> > The clinic I go to has a conservative philosophy and is not very

> > open-minded when it comes to off-label uses of prescription drugs. So, my

> > problem at this point is finding someone who is willing to actually consider

> > prescribing the medication for me. I believe that I can make a strong case

> > for being allowed to at least given a trial of this drug.

> >

> > Can anyone point me in the right direction on this?

> >

> > Thank you, in advance, for any guidance you can provide.

> >

> > Sincerely,

> > Rich

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If you can't get an Rx for Provigil, Adrafinil is a precurser to Provigil,

unregulated in the U.S. and available over the internet:

http://www.antiaging-systems.com/iasstore/acatalog/adrafinil.html

in the U.K.

http://qhi.co.uk/list.asp?r=860

Adrafinil is not recommended if you have mental, kidney or liver problems.

I haven't tried Provigil or Adrafinil. I'm getting a good morning energy boost

from SAM-e, NADH, and other supplements.

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Thank you for this information, I really appreciate it.

I looked up Adrafinil, it's over-the-counter in Europe. Adrafinil is primarily

metabolized in vivo to modafinil (Provigil), and it takes time for the

metabolite to accumulate in the bloodstream. Also, Adrafinil needs monitoring

of your liver enzymes: a baseline, then in 3 months, then every 6 months.

Adrafinil is cheaper than Provigil, not regulated by the FDA, and can be

imported privately by citizens.

International Antiaging Systems sells not only Adrafinil but Alertec (the

Canadian version of Provigil) without a prescription. ly, that worries me

a little (possibility of counterfeits, contamination, and so on).

But I do appreciate the suggestion. And I'm glad that the SAM-e, NADH, and

other supplements are working for you.

Rich

>

> If you can't get an Rx for Provigil, Adrafinil is a precurser to Provigil,

unregulated in the U.S. and available over the internet:

> http://www.antiaging-systems.com/iasstore/acatalog/adrafinil.html

> in the U.K.

> http://qhi.co.uk/list.asp?r=860

> Adrafinil is not recommended if you have mental, kidney or liver problems.

>

> I haven't tried Provigil or Adrafinil. I'm getting a good morning energy boost

from SAM-e, NADH, and other supplements.

>

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