Adderall and Provigil

[dojoloach]

I have no getup and go. Like, if I am a car, my engine does not turn over. I don't even know if it makes that clicking sound when you turn the key.

I'm on lots of pills. I spend much time inside, isolating. I've got lupus and yes, I'm depressed, distressed, anxious and all.

Adderall XR just isn't doing enough for me. It does something, especially for the hour or two with/after morning coffee. It's great for hyperfocusing (this is both good and bad), and when I'm productive, it's thanks to Adderall. But, Adderall is not getting me through the day. My fatigue and inertia are debilitating.

Here are the pills I take. I'd like to cut back, but I just moved to a new city and none of my new doctors wanna touch my mix yet.

Adderall XR 30mg; Klonopin 1mg; Cymbalta 60; Wellbutrin (IR) 350; Plaquenil 400; Metformin 1000; Aldactone 100; Claritin, Albuterol; Prevacid 60; Zantac who knows; Fever Few (Mygrafew); umm...I think that's it. O, Mucinex daily and Tums for kicks. Sometimes Tylenol (NSAIDs/Aspirin done tore up my stomach).

Has anyone ever been on both Provigil and Adderall at the same time? If so, how'd that go? Is it a bad idea to combine the two? I'd like to see if Provigil would help me out. If I could do it without taking Adderall away, would that be safer or less likely to rock the boat? Or is my boat/liver already screwed 'cause it is all filled up with pills?

I do have a lower seizure threshold than other kids, it seems, and have had one grand mal due to an accidental overdose of Wellbutrin, once upon a time.

If anyone has ideas as far as which crazy med I might try cutting down/out of my mix, such advice is quite welcome. It's tough, 'cause I need to feel better and I don't know which meds are the ones keeping me up and mostly non-suicidal right now. Sorta like Jenga, no?

ps - this loss of go power, of drive and all, has been going on for a few years now. Cymbalta helped by allowing me to once again desire some things in life, although I'm still not excited about things enough to get out there and try to get them. Procrastination doesn't even work anymore. I just keep falling farther and farther from the world. With my current meds, I don't feel like offing myself, but I don't feel like doing much of anything else either. In theory, I want things, but I can hardly take the smallest baby steps towards any sort of goal. It's an achievement to simply leave the house. I need a job ASAP for money, and I'm really scared. Any thoughts?

[null0trooper]

I have no getup and go. Like, if I am a car, my engine does not turn over. I don't even know if it makes that clicking sound when you turn the key.

I'm on lots of pills. I spend much time inside, isolating. I've got lupus and yes, I'm depressed, distressed, anxious and all.

Lupus, PCOS, asthma, allergies, migraines, acid reflux, depression, and what else? Keep the Tums. In fact you should probably be taking that with the Adderall that you washed down with the morning coffee. Even then, I'm not sure you would even notice the Provigil amidst that combination. It's possible that you're pushing so hard chemically to keep going that you've outrun your body's ability to really keep going... which would make everything worse.

Speaking of how your body is holding up, how normal are your thyroid test results?

[dojoloach]

Lupus, PCOS, asthma, allergies, migraines, acid reflux, depression, and what else? Keep the Tums. In fact you should probably be taking that with the Adderall that you washed down with the morning coffee. Even then, I'm not sure you would even notice the Provigil amidst that combination. It's possible that you're pushing so hard chemically to keep going that you've outrun your body's ability to really keep going... which would make everything worse.

Speaking of how your body is holding up, how normal are your thyroid test results?

My thyroid results are normal. I have it checked every 3-4 months because I have subclinical Hashimoto's (diagnosed by ultrasound). At least I've still got years before I have to take those pills.

Do you think a reduction of meds should be my first focus? I've been on most of these for over a year. The reflux drugs are new - Cymbalta has helped burn up my upper GI tract, and it's gotten bad enough for me to have seen yet another specialist. There's an endoscopy in my future - something to look forward to, right?

Another reason I'm worried about all the pills: I have severe dry mouth, and am developing small cavities along the gumline and elsewhere. I've always kept my teeth v. healthy and whole, but I can't keep up with this hard core xerostomia (neither can Biotene). I don't know which med is causing it because most of them cause dry mouth, so it's likely the combo, with a little help from lupus.

O my.

How do you decide which med goes? I can't lose the plaquenil - tried to cut that back recently and my lupus symptoms got worse. I'd rather not mess with the PCOS meds, either, which leaves allergies and brain pills.

But, like, cut out Adderall when I'm having a hard time staying awake and functional? Last time I tried to scale back on the Klonopin, I had my first panic attack, and my life isn't exactly stable right now. I've got some anxiety problems in addition to my depression. Maybe boot out the Wellbutrin and see how that goes?

It'd be cool if one could go all clean slate, without withdrawal - sorry - discontinuation syndrome. Starting from scratch seems much easier, but to get there I'd have to go through weeks of hell, and probably be hospitalized in the meantime!

But...do you think adding Provigil would help? 'cause I'm willing to try that out. 'cause...I'm like that.

O why, why isn't there just one pill to fix me? The novelty of taking more pills than oldsters, of wowing people with my laptop-sized pill box, has totally worn off.

Thanks for the feedback - I'm sure you're right. My instinct has been that it's too heavy a load, all these meds, but I don't know which piece to remove first.

[null0trooper]

How do you decide which med goes? I can't lose the plaquenil - tried to cut that back recently and my lupus symptoms got worse. I'd rather not mess with the PCOS meds, either, which leaves allergies and brain pills.

You *need* to keep the PCOS, lupus, and gastric reflux in check. So those pills have to stay as long as they keep working.

I'm a little surprised that you still need the allergy meds. Adderall is my favorite legally-available decongestant - to the point that I'm buying benadryl maybe once a year instead of once or twice a month and pseudoephedrine less often (vasomotor rhinitis). Adderall and Wellbutrin both tend to cause dry mouth - the only thing that really counteracts that is to be more proactive on your water intake.

But...do you think adding Provigil would help? 'cause I'm willing to try that out. 'cause...I'm like that.

I don't think it will help much, but trying it for a couple of weeks isn't likely to hurt you. But definitely take that opinion with as large a grain of salt as your doctors will allow - most of the time I was on it, Wellbutrin was a more potent sleep-inducer than Benadryl.