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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35031
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I've been on provigil for 2 months and feel nothing. Yes I

Customer Question

Hi there I've been on provigil for 2 months and feel nothing. Yes I am able to do my tasks easier, but still have to force myself to get out of bed I will take it in the morning and after droppimg kids at school I'm back in bed, and have no motivation whatsoever, I will gladly stay in bed doing nothing, nor reading or watching TV, just lye here like a vegetable
Submitted: 2 years ago.
Category: Health
Expert:  Dr. Anil replied 2 years ago.
Do you have sleeping problem at night?
Have you undergone any investigations/blood work so far?
Body ache,fatigue?
Since how long have you been suffering from?
Are you taking any other medications?
Waiting for your response.
Customer: replied 2 years ago.
I take dormonoct at night and sleep through. I have been on anti depressants for over 12 years, lolly fluoxetinew (60mg) in morning, well butrin (300xr) Lamictin 100mg morning and night) I also take 2 x neurobion vit b tablets to try help me thru the day. Dont really have muscle pains, just hectic fatigue and no motivation, when I say I go back to bed and do nothing, I seriously do nothing, don't sleep, watch TV or read, just lye down, surface around 11, because I know I have to. I work from home, and know I got to get up to get work started. I used to be an avid horse rider, and competed, had goals I was trying to reach, that was 3 years ago. Now I have no interest, yet when I drive past horse and rider am sort of a tiny bit envious. I still have my horses, but I hardly even talk to them. I have a friend who comes to ride them every now and again (my horses are at home), and I hide away so he thinks I'm not home. In fact I hide away from everyone, I don't like having to speak to people even if it's my friends or family.
Expert:  Dr. Arun Phophalia replied 2 years ago.
I am Dr. Arun and will be helping you today.
I am sorry that your question was unanswered for long.
Your symptoms can be due to;
1) Persisting depression.
2) Side effects of the medication.
You may consider following (trying of other therapies for depression;
These are other therapies which can be tried as following;
1) Psychotherapy;
a) Cognitive-behavioral therapy (CBT)
b) Interpersonal therapy
c) Mindfulness-based cognitive therapy (MBC
d) Psychodynamic psychotherapy
2) Transcranial magnetic stimulation (TMS) has been approved for the treatment of major depressive disorder.
3) Physical activity and exercise contribute to recovery from major depressive disorder.
4) Stress reduction techniques.
5) Massage and physical therapy
6) Acupuncture.
Following herbs can be also be tried;
1) Ginkgo
2) St. John's wort
I would also suggest to reduce your drugs and may be dose modifications for these medicines.
I would also like to rule out chronic fatigue syndrome for your symptoms so following investigations may also be done;
1) Complete blood count,
2) Erythrocyte sedimentation rate,
3) Thyroid function tests,
4) Muscle enzymes;
5) Anti-nuclear antibodies (ANA)
6) Adrenal function test
7) Anti-dsDNA
8) Anti-Sm
9) Anti-SSA (Ro) or Anti-SSB (La)
10) Coombs test
11) Anti-histone
12) HBV.
Following also may help you meanwhile;
1) Aerobic exercise; low-impact aerobics, walking, water aerobics, stationary bicycle.
2) Heat, massage, and other treatments like sauna, hot baths and showers, hot mud, and massage.
3) Neural pulse stimulation (CNP) device
4) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT) as discussed perviously
4) Relaxation training and biofeedback
It is privilege assisting you.
Please let me know if you have further queries or unanswered questions.
Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.
Thank you.
Customer: replied 2 years ago.
I have been for full blood counts, all normal except seratonin which was almost non existing, it was abnormally low and that's when my doctor put me up from 40 llily fluoxetine to 60 and then the 200 privileged.
Expert:  Dr. Arun Phophalia replied 2 years ago.

Thanks for the further information.

CBT, and transmagnetic stimulation has shown to improve the serotonin levels. So you may consider them.

It is privilege assisting you.

Expert:  Dr. Arun Phophalia replied 2 years ago.
Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited for my work.
Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.
This additional service offer can be used for
- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.
Thank you.