Hmm, I've been prescribed both at different times as a "throw everything at the wall until something sticks" strategy for refractory (chronic) depression.
Generally they're used for quite different things.
Provigil [modafinil] is usually prescribed for narcoleptics and others with excessive lethargy or sleepiness during waking hours. It's also being studied as an add-on for treatment-resistant depression & bipolar disorder.
Adderall [mixed amphetamines] is usually prescribed for patients with ADD/ADHD. It tends to calm them down and allow them to focus. Others use it (often illicitly) to help them become a workaholic, cram for exams, etc... so the 'focus' part is still there, but rather than having a calming effect, it stimulates them (hence 'stimulant') to no end.
Provigil, in my experience, was hit-or-miss. When it worked, it took about two hours to take effect, and provided me with some much-needed motivation for several hours. However, after the motivational aspect wore off, I would often feel 'icky' for the rest of the day, with temple headaches, vertigo, and insomnia (even though I would feel truly fatigued, I couldn't sleep for the life of me).
Adderall often made me giddy and carefree. I wouldn't do any work because I felt too good to care. Sometimes, however, I would get irregular heartbeats and a discomforting, anxious feeling in my chest. Adderall seems to be HIGHLY sensitive to stomach acidity: when I would take a dose with a glass of lemonade, I felt very little. If I took it after downing a few Tums (U.S. brand-name antacids), it would hit me like a ton of bricks.
So neither were the drug for me, though I stalled for months until I eventually forced myself to reluctantly request to be taken off the Adderall (I found it to be quite addictive even with the substantial downsides). In my case, however, it was prescribed because I had exhausted all the 'regular' antidepressants, mood stabilizers, anti-psychotics, lithium, the works, and so though it was unlikely to work, I really didn't have much to lose.
It really depends on who you are and what your symptoms are, I suppose. If you have problems with concentration and focus and your doctor thinks it's worth a try, go for the Adderall. I'd be aware of the addictive properties of the drug, but that doesn't mean you should be too scared to try it. It won't hook you overnight.
I was on Adderall, which helped with my Narcolepsy. But it raised my bp so I was put on bp med. Decided to go off, bc the bp meds made me tired. Its seems like a no win situation for me...maybe you will be diff. Let me know how it works for you?
Hmm, what were your allergic symptoms to the Abilify (aripiprazole)? There are many other so-called "atypical antipsychotics" you could try. I don't know if you could be allergic to all of them, as their formulations can be quite different.
I would recommend Zyprexa (olanzapine) if Abilify seemed to do something. 2.5 and 5 mg of Zyprexa worked so well for me for awhile, until I somehow developed tolerance, and I couldn't take the higher dosages because they agitated me. It knocked me out cold for 24 hours first time I took 2.5mg, then the sleepiness got better and it only took 3 days to kick in, after which I felt actually happy for 2 full weeks before slowly returning to my baseline depression.
Don't despair. There are plenty of options you haven't yet tried.
Last edited by moderator2; 07-13-2009 at 03:55 PM.
Reason: removed off topic comments
eclectico, thank you so much for being for me...i feel like i'm losing my mind...it's so hard to research when my provider is having problems.
i thought zyprexa had prozac in it? oh, no, that was symbyax.
My tongue swelled and i could not talk, i quickly took more benedryl (which i had already been on or gosh knows what would have happened) and it eventually went down. it was scary as heck, but the depression lifted w/in 5 days. Everything was brighter and i was alive for the first time in sooo long. The lifting of the depression lasted another week after i went off it!
amother member mentioned seroquel, but i thought that makes you gain a lot of weight and it so sedating...i don't know anymore, been up all night researching. I took it a long time ago and don't remember it helping my depression.
i'm also low on vit. d so am being supplemented w/that.
i keep seeing zyprexa--i know all of them have the potential for high blood sugar, that's what worried me and made me go off of the abilify the first time...i kept reading the side effects.
Maybe it's something to do w/the dopamine that makes my tongue swell and cause the reaction...i have no idea. I just know it helped the depression and i was on a very small dose.
Thank you for telling me not to despair because i really have been. I really appreciate your advice.
Do you think i should try the zyprexa? I think it's worth a try. Is there a generic? Should I go w/name brand? Give me all the advice i need, please.
Were you concerned about the side effects, blood sugar, etc.? I'm starting to feel that little bit of hope again.
Were you worried about anything about it?
I was only taking 2.5 mg of abilify, i was cutting 5mg. in half.
What's the smallest dose i can take of the zyprexa? What do you think, do you think i should go for it? if i have the same reaction then i don't know what i'll think...i know it can go down w/benedryl though (hopefully).
What should i ask the dr. for dose wise? Did you have any bad side effects? It only gave you 2 weeks, huh? I sure hope it gives me longer than that!
I just called and made the appointment for Wed. afternoon.
I'm hopeful again! I just want to know everything you know about it. If need be, i can cancel it tomorrow.
I think i read abilify was more "mild" than zyprexa...whatever they meant by that.
Hope to hear from you very soon.
Thank you sooo much!
Last edited by moderator2; 07-13-2009 at 03:55 PM.
Reason: removed off topic comments
eclectico, i'm waiting for you...i have hope again for Wed. I think we need to move this or start a new thread or something or you have to get your pm to work because this thread was for adderall vs provigil and now we are on something else.
i'm scared to move it yet because i don't want to lose touch w/you. I'm ready for Wed., i get tears in my eyes thinking about it because i want the zyprexa to work so much!
i know you have a life, but where are you? I want you to tell me about it and what you think. I'm so thankful you brought it to my attention.
I also wanted to ask you what i'm not supposed to take my iron supplement with so that i can get the best absorption. i posted on the vit. board but haven't heard anything.
i'm still having provider problems, so glad i could at least get to the boards.
sounds pitiful, but i'm really waiting to hear from you.
Just got back on here, eclectico, I think we should move this to my thread Does Anyone Know of Another Dopamine-Serotonin System Stabilizer Besides Abilify?
I feel bad that i'm not in the right topic area.
I went there and posted about zyprexa and that i'm waiting to hear from another member about it.
If for any reason i get my connection doesn't hold, i will keep trying to get on the boards to get your response.
Last edited by salty; 07-13-2009 at 09:38 PM.
I would be wary of putting all my hopes into one medication... trust me, I've done this plenty of times. The disappointment's not worth it. At some point I just accepted that there was probably no "magic" pill for me, at least, so I keep trying things and noting when I get a partial response so I can ask my doctor to go back to that, maybe in combination with another partial response med that isn't contraindicated.
Finding a good therapist is also absolutely essential, I feel. I went through five before finding my current one, and I thought that therapy was idiotic to begin with... but honestly, we've been down for so long due to our brain chemistry that I think we start to get into patterns of negative, self-reinforcing thoughts and actions that won't magically "go away" just because our brain chemistry gets back to normal.
Both Abilify (aripiprazole) and Zyprexa (olanzapine) are generally classified as atypical antipsychotics. I know of at least three others available in the U.S., plus there's Clozapine, which I believe is an A.A. as well but requires weekly blood tests to ensure that you don't develop a rare but serious side-effect.
There was no generic Zyprexa at the time I took it, but your doctor might have samples. My doctor always loads me up with at least a month's worth of samples. U.S. drug companies also have patient assistance programs.
If you're worried about insulin maintenance or weight gain, Zyprexa has a bad reputation for this, even among the A.As. Hopefully if it works wonders for you, it'll allow you to exercise again to fend this off, but if this is going to be a problem for you, a better option might be Geodon (Ziprasidone) or Seroquel (Quetiapine). Seroquel also really helps for sleep and anxiety, I've found. Honestly though, I'd at least try the Zyprexa at first if your doctor thinks it's a good idea... you can always go off of it later.
See what your doctor thinks. I think your initial response to Abilify is promising. I've never heard the term "Dopamine-Serotonin System Stabilizer", but A.A's do work on certain serotonin & dopamine receptor subtypes (the anti-psychotic action is thought to be due to their actions on either the D2 or D4 receptors, both part of the dopamine system).
I'm curious, have you ever been put on Wellbutrin (Bupropion)? It's generic now, and is relatively unique as I understand it in that it works kind of like an SSRI, but on the dopamine system rather than the serotonin system. This is a very different drug than Abilify, though, so it might be wise to try another A.A. before Wellbutrin.