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DocHarrison, Doctor
Category: Mental Health
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Experience:  Physician
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I currently work shift work at a gas plant. 7 to 7. These

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I currently work shift work at a gas plant. 7 to 7. These shifts rotate from 4 days on to 4 days off to 4 nights on to 4 days off. This is my cycle. I take 20 MG daily of Paxil which I am currently dropping to 15MG daily because of fatigue problems. I have read alot about Provigil (modonofil) Sorry If spelling is off. This medicine sounds like a godsend to my fatigue problems associated with this shift work do you have any opionions?

How long have you had the fatigue problems?

How long have you been on the paxil?

Customer: replied 8 years ago.
Sorry, fatigue problems seem to be a problem mostly in mornings. I've had them maybe 16 months. I have been on paxil for just about a year. Started the first week at 10MG then up to 20MG for about 3 months. Anxiety was not gone so I bumped up to 30MG for about a month and could not handle side affects so Dr suggested I go back down to 20MG which has been alright but now I am not seeing that Dr actually inbetween Dr's and am going down to 15MG. I also have Clonazepam for when anxiety gets to critical levels just taken as needed. Usually .25mg or .5mg starts to work after 1 hour. average about 20MG per month of Clonazepam.


Thanks for the information. I can understand the attraction to provigil, especially since you are a shift worker with difficult hours. However, provigil is a very potent stimulant, and ABSOLUTELY should not be taken by someone requiring medication for anxiety. Think of provigil as 100 cups of coffee in a pill. You can only imagine what it would do for your anxiety!

I must say, paxil is a medication with a lot of side effects, especially fatigue. It makes almost all my patients feel tired, and it is no better than other better tolerated medications for anxiety.

If you were my patient, Id try to taper off the paxil and start lexapro, along with your clonazepam. I bet you will be less tired off the paxil, regardless of your schedule.

Before you do anything, speak with your doctor. Paxil can give you withdrawals, so you must change its dosage only with the help of your doctor.

Good luck and please click ACCEPT if this information was helpful. Thanks.

Customer: replied 8 years ago.
I also have a prescription for wellbutrin 10MG per day that I do not take should I try to replace my paxil with this. I am well aware of paxils side effects and the withdrawls coming off of it as I have lowered my daily intake in the past. The provogil would be used on a as needed basis. I have acid reflux disease as well so just drinkin a bunch of coffee or pop is not an option for me. I could take a smaller dosage perhaps the nature of my job requires me to be ready for emergency's even if they take place at 4 in the morning there are 2 people at this gas plant at night and I could possibly have to throw on a SCBA and rescue my co-worker who has just been knocked down from H2S. I'm sorry but there needs to be somthing to keep the mind fresh do you have any more options. Like I said I do not want to continue taking amphetamines to stay awake!


Since I'm not your doctor, I can't tell you what to take. However, I do think exploring a different medication that paxil is a good idea, since it is likely preventing you from staying awake.

Provigil, even on just as "as needed basis" is a very bad idea for you. I think you won't need the stimulant if you get on a different antidepressant that doesn't have the sedating side effects like paxil does.

Please click ACCEPT so I can get credit for time spent on your case. Thanks.

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