armodafinil

[glenwood73]

I have been on cpap for three years but still feel sleepy during the day,was wondering if anyone feels this way,and if anyone is taking armodafinil along with their cpap..

[Slinky]

I had to look armodafinil up to see what it was. It is more commonly known as Nuvigil. Its a stimulant-like drug which was approved by the FDA June 2007. Nuvigil has been available for prescription as of June 2009. March 2010, the FDA declined to approve use of Nuvigil to treat jet lag.

I didn't find what it has been approved FOR. The manufacturer plans to conduct clinical trials evaluating its use as a treatment for serious medical conditions such as bipolar depression, cognition abnormalities associated with schizophrenia, and excessive sleepiness, and fatigue in conditions such as Parkinson's disease, cancer, and narcolepsy, which is a sleep disorder. Nuvigil is protected by a U.S. patent expiring in 2023.

Nope, I've never taken Nuvigil.

[mars]

Hi Glenwood73

This link is worth looking at -

http://www.theage.com.au/news/general/a ... 66910.html

cheers

Mars

[Slinky]

Fascinating article, Mars!! Thank you!

And now - off for Easter dinner w/my daughter's family and her in-laws. Happy Easter to you all.

[howkim]

I didn't find what it has been approved FOR.

“NUVIGIL is an FDA-approved prescription medicine used to improve wakefulness in adults who experience excessive sleepiness (ES) associated with treated obstructive sleep apnea (OSA), shift work sleep disorder, also known as shift work disorder (SWD), or narcolepsy.” (http://www.nuvigil.com)

The full prescribing information for nuvigil with the approved indications (what conditions the drug is approved to treat) may be found at http://www.nuvigil.com/hcp/full_prescri ... mation.php. The indication statement is on the second page, about half-way down the right column.

[kteague]

I haven't taken the Nuvigil - I think it's the long release version of Provigil, which I do take. The goal is to be be alert and functional, and sometimes a little help is necessary. But I'm wondering what has been done this past 3 years to pinpoint if there's any tweaking of your therapy that could help. If getting a data capable machine is not an option right now, you could ask your doc to order a trial for a couple weeks on an autopap loaner. My personal perspective on the stimulants is they can be helpful but are not a substitute for effective treatment for OSA or other contributing factors. Have you been evaluated for other things that can cause sleepiness, like limb movements during sleep, diabetes, medication side effect - things like that? I'm interested in hearing experiences with Nuvigil too.

[roster]

But I'm wondering what has been done this past 3 years to pinpoint if there's any tweaking of your therapy that could help. If getting a data capable machine is not an option right now, you could ask your doc to order a trial for a couple weeks on an autopap loaner.

Yes. Yes.

Always, always, the first step is to have a machine that gives you data on your therapy.

It is very common for patients to be using the wrong machine, the wrong mask and the wrong machine settings. They are unknowingly getting poor therapy and this is why they don't feel good.

Before experimenting with expensive, risky drugs, get home data capability and make sure you have the CPAP therapy working effectively.

[SleepingUgly]

Here is a recent threat on Nuvigil:

viewtopic.php?f=1&t=50735&p=466600&hili ... il#p466600

I don't think that Provigil and Nuvigil are exactly the same, although they are related drugs. In my experience, Nuvigil does not last a whole lot longer than Provigil, but I tend to metabolize drugs very rapidly.

One of the benefits of Provigil (and I assume Nuvigil too) is that it doesn't have a deleterious effect on sleep architecture. Obviously you still can't take it late in the day if you have issues with insomnia.

[ecocyber]

My mostly central related AHI has gone from above 70 down to around 20 in the few months I have been using my BiPAPautoSV Advanced. I think you would agree I still have a long way to go. I was originally on Provigil 200mg 2 times daily which I needed just to stay away once I got out of bed in the morning! Now I take Nuvigil 250mg daily and have seen better results with it. To my understanding, Provigil is a mixture of two isomers which "naturally" result when the drug Modafinil is synthesized. Nuvigil is simply 100% of the "R" isomer. It has been shown to be the active isomer with the other isomer possibly responsible for some of the undesirable side effects. The maker came out with Nuvigil at about the same time Provigil was allowed to go generic. So, to a cynic like myself, it is clear that the maker "sat" on a better version of the drug for many, many years in order to maximize their sales and profits. To anyone taking Provigil, I would strongly recommend you try the Nuvigil. It is not that I am supporting the drug maker in any way; but if you need the drug to stay awake like I do, it is more effective IMHO. I get the drug approved by my insurance policy. It is not on their formulary, but I do get a substantial reduction in the negotiated price (allowable). If you go to the makers website, you can download a coupon for 7 free Nuvigil tablets in either the 150mg or 250mg variety (of course you still need to get a prescription from your doctor to submit to the pharmacist with the coupon. Cheers everybody.

[SleepingUgly]

ecocyber, did you have any problems with dry mouth or dry eyes with Nuvigil? I found those side effects to be much more extreme with Nuvigil than with Provigil.

[mars]

Hi All

I talked to my GP (General Practitioner) today and she told me that only a specialist could prescibe armodafinil, and that there had to be a diagnosis of narcolepsy.

http://en.wikipedia.org/wiki/Narcolepsy

http://www.medicareaustralia.gov.au/pro ... olepsy.jsp

This is what applies to Australia, it may be different in your country.

cheers

Mars

[JohnBFisher]

I have been on cpap for three years but still feel sleepy during the day,was wondering if anyone feels this way,and if anyone is taking armodafinil along with their cpap..

I take ProVigil and use a ResMed VPAP Adapt SV unit. Some days it is a Godsend. I fortunately can skip it (and often do just that). But on those "bad" days, it helps when nothing else will touch the fog.

[ecocyber]

To SleepingUgly,
Does my mouth get dry? Yes, a little bit. But it is something I will gladly put up with in order to keep my consciousness and live my life as best I can until this central apnea problem is brought under control. With regular AHI in the 70's before I started xPAP therapy, I often got out of bed in the morning, come downstairs and started looking at the morning paper, and ............ realize I had fallen asleep for the past hour or so when I came back to consciousness! With this drug, I can be alive and functioning. At age 61, my life is whizzing by fast enough as it is without sleeping most of the day. As of today, even with my therapy reducing my AHI to around 20-25, I still need the drug to stay awake most days.

To kteague:
As far as I have been able to find out, both Provigil and Nuvigil have about the same half-life. So, I think we are just getting a more effective drug with the R-isomer version of modafili (Nuvigil). The product literature I have seen gave me the distinct impression that the undesireable side effects were reduced with the Nuvigil product. Now, you and I know that we need to take all this with a grain of salt because the maker of Nuvigil is trying their darndest to get people to switch to Nuvigil since the Provigil has now gone generic. But, for my body anyway, I really do find Nuvigil to be more effective and have less side effects. But, everybody is different.

To JohnBFisher:
John, it looks like you and I are in the same boat with our centrals (I also have a problem with periodic breathing on about 60% of the nights). I don't have diabetes but I know the long term effects of my apnea have impacted my life very negatively. I am so glad that the word is getting out that sleep apnea is a serious and debilitating disease.

Cheers

[JohnBFisher]

... John, it looks like you and I are in the same boat with our centrals (I also have a problem with periodic breathing on about 60% of the nights). I don't have diabetes but I know the long term effects of my apnea have impacted my life very negatively. I am so glad that the word is getting out that sleep apnea is a serious and debilitating disease. ...

Agreed. We all have our own burdens. While others have often noted they would not want my situation, I can honestly note most of the time it does not feel all that bad to me ... but I also would not wish it on anyone else.

And I guess that by posting here and helping answer questions I might, just might, help lift that boulder off the path up that hill for ecocyber ... er ... sisyphus. Seriously, helping here helps give some meaning to the years of bad sleep.

[roster]

Provigil Use In Autoimmune Disease
Patient comments: http://www.wellsphere.com/general-medic ... 45934ADCCE

Also, what is with this? -> http://www.medstore.biz/prescriptions/m ... /?fid=5635