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What should I know about Alertec?


sepia

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My psychiatrist kind of goes back and forth over whether I have ADD at all or not, mostly because I test really damn well (to my disadvantage, when it comes to skills assessments), but for the moment he seems to agree with me: feeling like I'm snatching random bits of information from a rotating blur around my head is not something normal. My level of functioning could definitely be improved. The Strattera trial of 05/06 did not go terribly well. Now my pdoc doesn't want me on methylphenidate or amphetamine anything, but he is willing to try alertec (modafinil). 100mg increments, take 1-4 tablets per day at my discretion, probably best to try them in the morning. Okay.

I've read this post on modafinil's approval to treat childhood ADD, and I've skimmed the side effect profile. What else, if anything, do I need to know?

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Einstein had ADD too. How you test has nothing to do with it. Einstein had ADD. He turned 3000 years of physics on its ear but he did in his pjs because he forgot to change before coming to work.

It's better than nothing. It can help with some parts of some types of ADD. It can help with getting stuck on tasks and having trouble initiating new tasks and executive functioning issues like that. The consensus by now is that it pretty much doesn't do dick for attention.

According to the rumor mill, Cephalon developed the drug as a "Ritalin killer." As it's not a schedule-II drug rules on its handling are a lot more lax. Prescriptions can be called in over the phone, refills are allowed, and most importantly, drug company reps can give away samples like candy.

The problem is that after sinking a quarter billion dollars into it, provigil isn't nearly as effective as the drugs 75 years its senior. That's part of why it's so absurdly expensive in the US. Cephalon is having to recoup the cost of development. It's a revolutionary narcolepsy treatment. It's a fast-acting anti-depressant but it's not that strong a one. OK, lost my train of thought.

Anyway. Here's the deal. When an ADD person tries to focus blood flow to the pre-frontal cortex shuts down. Stimulating dopamine production seems to be one of the best ways to get it flowing again. The problem is that doing so can make people with a predisposition to mania or psychosis flip their lids.

In more conservative circles it's common practice to never give CNS stims to a person who has been psychotic ever, no matter what. It amounts to philosophical issue, what the individual pdoc thinks the purpose of treatment is. I'm thinking that your pdoc might be one of the old school school ones who would say it's impossible to treat bpI and ADD at the same time.

An alternative treatment for ADD that does work but is a pain in the ass is biofeedback. It's not an option for most people in the US because of cost but it might be covered under the Canadian medical thing.

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Executive function would be good. Attention would be better. Meh. We'll see if this stuff's worth my while.

Sadly, according to these people, Medicare will only cover biofeedback if I'm suffering from anal spasm or something similar. I'll check with my mom's insurance policy, though. I remember there was some weird shit listed. If I want acupuncture, they'll cover forty per cent.

Biofeedback therapy is covered under Medicare for muscle re-education of specific muscle groups, incapacitating muscle spasm and/or weakness or for the treatment of pathological muscle abnormalities when conventional treatments (heat, cold massage, exercise, support) have not been successful. This therapy is not covered for the treatment of ordinary muscle tension states or for psychosomatic conditions.
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  • 2 weeks later...

For me, it doesn't come close to pure stimulants with treating ADHD. It's better than nothing though. I went off it for a week and could tell the difference. I fidget a bit less with my fingers and toes and school on Provigil. Schoolwork seems to be going a bit easier too, at least when I get started (which is still close to impossible).

Have you started yet? How's it feeling?

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For me, it doesn't come close to pure stimulants with treating ADHD. It's better than nothing though. I went off it for a week and could tell the difference. I fidget a bit less with my fingers and toes and school on Provigil. Schoolwork seems to be going a bit easier too, at least when I get started (which is still close to impossible).

I'll second Helena on that. I've taken it's older cousin, and that seems to make bright sunlight less harsh too (maybe there IS

an adrenergic effect?), aside from some mild mood lifting. At least it doesn't have as fast a tail-off as the stimulants.

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Yeah, Helena, I've been taking it for a little over a week. I had some additional hand tremor the first few days, especially after taking the second dose, and I was also doing some weird jaw-tensing (but not clenching) thing that seems to have stopped now. I haven't noticed any real affect on my ADD stuff. I did drive for a few hours, and I didn't find all the stuff I was supposed to be paying attention to as overwhelming as usual, but I'm not sure if that was the never-before-experienced combination of nighttime/highway/NOT-the-day-after-an-ice-storm driving, or if it was the med. It would be interesting to try some more driving and see if this is a consistent thing. Maybe over the holiday weekend.

It also might be messing with my appetite, but since my eating habits can also vary widely (binging to starving and all points in between), I won't be able to make an informed judgment on that for another week or so. Nonetheless, I suspect.

I ended up not taking it today for a handful of unrelated reasons, and I don't notice any difference in anything.

Anway, I shall continue playing with it for the next few weeks unless something terrible occurs. Maybe I can use my entirely unremarkable response to modafinil to persuade my pdoc to give one of the more effective stims a chance.

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That's the way I feel too... it's almost working. Did you try the full 400 mg dose? I was up to 300, but my pdoc thought that was making my anxiety worse so we're gonna wait a while for an increase.

If you like coffee, Provigil/Alertec seems to potentiate the effects of the caffeine for me. A good thing in my case.

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