Those with widespread pain and tenderness fit an alternative diagnosis of fibromyalgia. Both are severely debilitating illnesses of uncertain cause. Diagnosis and treatment are discussed. We are joined by Dr.
Before we begin with these questions, Doctor, would you be able to reiterate a few key pointers from today's session to our audience? Thank you, Lee. So what I talked about today is a baffling condition called chronic fatigue syndrome, both as a pure entity, and also a strong association with a much more common condition called fibromyalgia. So with that in mind, then we would also need to do Provigi very careful history and physical examination Provigil Dosage Chronic Fatigue Syndrome look for much more common reasons why people are chronically tired, and that unfortunately embraces pretty much https://buymodafinilntx.com/2-expired-provigil-side-effects-nep.php of medicine.
So we need to look into, for example, the general health of the patient. Is there underlying cardiovascular disease, poorly compensated? Congestive heart failure could be a prominent cause of fatigue, so could chronic obstructive lung disease, for example.
Do they have endocrine problems that are Provigil Dosage Chronic Fatigue Syndrome well-managed, low thyroid, adrenal insufficiency by history, or by clinical features? We also keep in mind whether there is significant general anxiety disorder or depression, because some of the somatic complaints there could simply reflect underlying depression and anxiety.
We also want to get a history about drug use, both drug addiction, which can suddenly be linked to fatigue, or even the drugs that are legitimately prescribed to some of them provoke fatigue. So a careful history is important. And then a careful physical examination would also be important in giving you pointers on what may be causing fatigue in that context.
Someone that we call chronic fatigue syndrome or fibromyalgia should really have a normal physical examination, where despite the litany of complaints, we do not find objective clinical evidence causing those conditions. For example, they claim that they are very weak and their muscles are weak, but when we examine muscle strength, it would be normal.
So in summary, the talk really was to concentrate on giving you a clear idea of how a patient with chronic fatigue syndrome, with or without fibromyalgia, would present.
Thank you, Doctor. Yeah, that was one of the questions that was asked, and aroused interest. Some of the drugs that we use to treat narcolepsy or ADD, mainly some of the brain stimulants, would they be beneficial?
And the answer is a provisional yes. In patients who are really fatigued, we have used small doses of these drugs, as well as Ritalin or even dextroamphetamine. The concern is that some patients with chronic fatigue and Provigil Dosage Chronic Fatigue Syndrome have a lot of symptoms of palpitation and tachycardia, shortness of breath; and some of those cardiac symptoms can be aggravated by these stimulants.
So you have to use very small doses to begin with, and not try to push them up to the levels that we used to treat ADD, for example, or narcolepsy, but smaller doses, in addition to other medicines, or even a few cups of coffee to see if that would help the fatigue. What is the most reliable way to test for adrenal insufficiency as a cause of CFS?
Adrenal insufficiency as a cause of CFS is actually uncommon. Clinically, they may bear some of the findings of it. In evaluating my patients, I don't really recommend tests for adrenal axis as part of the routine workup; but in select patients, you could do a early morning plasma cortisol, to see if it's low.
If there were evidence, then you could do an ACTH stimulation test, to see if the axis is normal; but I must say that this occurs in a very small minority of fibromyalgia and chronic fatigue patients because low adrenal function is just link very common in this context. Very strong relationship. Most people who are depressed do feel tired, as you know. The problem, of course, is chicken and the egg.
If you have chronic fatigue syndrome without depression, but it is now a year now since you were able to work full-time, you have to take time out from work very frequently because you're so tired, don't you get depressed? So very often, we are treating depression or general anxiety, but not claiming that the entire cause of the depression I mean, of the fatigue is the depression.
We need to understand that. So every time I treat chronic fatigue syndrome and fibromyalgia, I'm very aware of looking for signs of depression and anxiety, and I may even consult one of my psychiatric colleagues to secure that diagnosis, and make sure that those conditions are well-treated, but I warn the patient that that doesn't necessarily mean Provigil Dosage Chronic Fatigue Syndrome all their fatigue, or all their muscle pains will go away.
So yes, the relationship is complex, but not a direct cause and effect. Treatment of chronic fatigue syndrome is first of all, to recognize Provigil Dosage Chronic Fatigue Syndrome condition, secondly, to educate the patient that at present, we still don't know the cause of the chronic fatigue, but then we're quite sure that it is not caused by a virus or other infection.
Yet, since Provigil may be processed more slowly in older individuals, healthcare providers often start at a lower dose and monitor more closely for side effects.
FAQ for Chronic Fatigue Syndrome
Be sure to tell your provider if you are pregnant or planning to become pregnant. Animal studies suggest that Provigil may cause harm to the baby. In that case, skip the dose and go back to your usual dosing schedule. Taking Provigil too late in the day might cause problems sleeping that night. Do not ever double-up on doses. If you find that you are missing Provigil doses often, consider setting an alarm on your phone, purchasing a pillbox, or asking a loved one or friend to remind you when to take your dose.
Taking more than the maximum recommended dose of Provigil can cause unpleasant side effects.
Pri-Med | FAQ for Chronic Fatigue Syndrome
There is no specific antidote to treat a Provigil overdose. Supportive care, including heart monitoring, may be warranted in some cases. Symptoms of a Provigil overdose can include:. If you think you or someone else may have overdosed on Provigil, call a healthcare provider or the Poison Control Center Your doctor should check your progress at regular visits to make sure that this medicine is working properly.
Your blood pressure may need to be checked more often while taking this medicine. It is important to tell your doctor if you become pregnant. Your doctor may want you to join a pregnancy registry for patients taking this medicine. Serious skin reactions can occur with this medicine.
Stop using this medicine and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using this medicine. This medicine may cause you to have a serious type of allergic reaction called anaphylaxis.
Anaphylaxis can be life-threatening and requires immediate medical attention. Stop taking this medicine and call your doctor right away if you have a skin rash; itching; hives; hoarseness; trouble breathing; trouble swallowing; Provigil Dosage Chronic Fatigue Syndrome any swelling of your hands, face, or mouth while you are using this medicine.
This medicine may cause serious allergic reactions affecting multiple body organs e. Stop using this medicine and check with your doctor right away if you have the following symptoms: chest pain or discomfort, fever and chills, dark urine, headache, rash, stomach pain, unusual tiredness, unusual bleeding or bruising, or yellow eyes or skin. If you think modafinil is not working properly after you have taken it for a few weeks, do not here the dose.
Instead, check with your doctor. If you are using a medicine for birth control such as birth control pills, implants, shots, patches, vaginal rings, or an IUDit may not work properly while you are taking modafinil.
To keep from getting pregnant, use another form of birth control while you are using this medicine and for one month after your last dose. Other forms of birth control include condoms, diaphragms, or contraceptive foams or jellies.
Modafinil may cause some people to feel dizzy, drowsy, have trouble thinking or controlling movements, or trouble seeing clearly. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert, well-coordinated, or able to think or see well. Stop using this medicine and check with your doctor right away if you have the Provigil Dosage Chronic Fatigue Syndrome symptoms while taking the medicine: aggressive behavior, anxiety, depression, hallucinations, mania, thoughts of suicide, or other mental problems.
If you have been taking this medicine for a long time or in large doses and you think you may have become mentally or physically dependent on it, check with your doctor. Some signs of dependence on modafinil are:. If you have been taking this medicine in large doses or for a long time, do not stop taking it without first checking with your doctor.
Your doctor may want you to gradually Provigil Dosage Chronic Fatigue Syndrome the amount you are taking before stopping continue reading completely.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements. You should not take Provigil if you have a known allergy or sensitivity to Provigil or any of its ingredients.
Let your healthcare provider know if you have a history of high blood pressure or mental health, heart, or liver problems. Your healthcare provider may need to monitor these underlying conditions while you are taking Provigil. Moreover, Provigil is not approved to treat children for any health condition. Studies of children taking Provigil showed serious side effects, including severe skin rashes and psychiatric or nervous system reactions. Lastly, Provigil is a controlled substance and may be habit forming or lead to dependence.
As a result, Provigil should Provigil Dosage Chronic Fatigue Syndrome used cautiously in people who have a history of substance abuse disorder. Several medications may interact with Provigil, including:.
A similar medication called Nuvigil armodafinil is available to use for improving wakefulness in patients with narcolepsy, obstructive sleep apnea, and shift-work disorder. Provigil and Nuvigil share a similar chemical structure, availability, dosing once a daydrug interactions, and side effects. However, blood levels of Nuvigil are higher later in the day compared with Provigil, suggesting that Nuvigil may be better at improving wakefulness over the course of a day.
Provigil and Nuvigil both have stimulant-like effects, similar to drugs like Adderall dextroamphetamine-amphetamine and Ritalin methylphenidate. That said, the potential for abuse and dependence is higher for stimulant drugs than for Provigil or Nuvigil. The FDA approved Provigil to treat excessive daytime sleepiness in patients with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. Dopamine is a chemical involved in arousal attention, mood, motivation, and memory, among other functions.
Serious side effects of Provigil are not common but require immediate medical attention and include:. Provigil will not cure your health condition, but it can ease the excessive sleepiness you feel during the day. Taking Provigil will hopefully grant you the time and energy you need to focus on other healthy behaviors in your life, such as engaging in physical activity or connecting with friends or family members.
Keep taking or using your other health-related medications or devices. For instance, do not stop using your CPAP machine for sleep apnea unless your healthcare provider tells you to do so. Also, always tell your healthcare provider if you are taking any new medications or experiencing any bothersome or persistent side effects. Remember that Provigil can be habit forming, so let your healthcare team know if you think this is becoming a problem for you.
In the end, Provigil can be a welcome relief to your daily exhaustion, but it's not a perfect or miracle drug. Scientists are still learning about how it works and its long-term effects. As with any medication, be mindful while taking Provigil and stay in touch with your healthcare team. Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication s.
IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Provigil: Side effects, dosage, uses, and more
Tossing and turning night over night can have a big impact on your quality of life. Our free Provigil Dosage Chronic Fatigue Syndrome can help you get the rest you need. Sign up for our newsletter and get it free. Food and Drug Administration. Full prescribing information for Provigil modafinil.
Effects of modafinil on dopamine and dopamine transporters in the male human brain: Clinical implications. Efficacy of modafinil on fatigue and excessive daytime sleepiness associated with neurological disorders: A systematic review and meta-analysis. PLoS One. Modafinil moderates the relationship between cancer-related fatigue and depression in patients receiving chemotherapy.
J Clin Psychopharmacol.
Background: Modafinil is a unique wake-promoting agent that is chemically distinct from traditional stimulants. Results of a placebo-controlled study showed. User Reviews for Modafinil to treat Chronic Fatigue Syndrome. Also known as: Provigil. Modafinil has an average rating of out of 10 from a total of