[Crook32]

So I take the max dose of Nuvigil but I still get tired starting around 2pm. What else can I do to stay awake?

[sarahsweets]

Originally Posted by Crook32

So I take the max dose of Nuvigil but I still get tired starting around 2pm. What else can I do to stay awake?

What do you take the nuvigil for ? What
Is your diagnosis?

Nuvigil is interesting. Here’s a brief history. My husband was dx with narcolepsy in like 2000 or 2001. At that time there was only provigil made by Cephalon and no generic. When my husband still had his union health benefits they picked up the tab. But the economy tanked in 08 and he was out of work for a year. Around that time Cephalon was fighting in the courts to extend its patent for the third time preventing generic versions a no go. They even went as far as trying to patent the way the medication crumbles. But they knew it was a losing battle. We lost our benefits and. It was 800$ a month and he stopped taking it. So I put my ear to the ground and learned about nuvigil. It’s basically half of the isomer of
What’s in provigil with the usual tweaks. Nuvigil got fast tracked by the fda. Right around that time there were nuvigil ads everywhere and provigil dropped its patent lawsuits. Guess which company owns nuvigil?
Cephalon! I don’t know all the chemistry involved with DAT this and dat that but many who do ok but could be better with nuvigil have great success with provigil (Modafinil). It very well be the missing isomer you need.

[bpcyclist]

Thank you very much, @sarahsweets. That was perfecto!

I have been on either Nuvigil or Provigil for a total of around five years, first starting back in 2010. We had to fight my insurance company initially to get Provigil covered, as I do not have narcolepsy, but my psychiatrist is smart and persuasive and we got it done. When Nuvigil was released, the manufacturer, in the region where I live, the Pacific Northwest, started trying to get everybody moved over onto Nuvigil for the reasons @sarahsweets outlined so well. Suddenly, Provigil sucked and Nuvigil was the best ever! I remember I had months and months of totally free Nuvigil suddenly falling down from heaven. They were literally giving it away. Meanwhile, the price for Provigil actually went up from $800 a a month to like $1400 a month. At exactly the same time. Then, we got a letter from the insurer that they would no longer cover Provigil. At all. I needed to switch to Nuvigil if I wanted to be on that class of drug. It was Nuvigil or nothing.

Presto! I started on Nuvigil. Guess what happened? Well, the R-enantiomer of modafinil didn't work for me. At all. It was nothing like Provigil for me. In fact, it put me to sleep. Every time I took it I had to take a nap. It just spaced me out and put me to bed. It was almost like being on some kind of a sleepy high. Maybe benzos or something--a lot of them. It could not have been more different than Provigil if it had tried. Worthless. Worse than worthless, since it actually made me more tired. And I was already very tired!

So, we switched me over to Adderall. It works for me, but not as well as Provigil. Later, we had to stop the Adderall due to side effects and I was able to get back on the Provigil with a different insurer. It is still almost $800 a month here in Portland for the generic. But it works really well for me. I would be in bed much of the time without it.

All of which is a long way of saying, I've sort of tried them all (including Ritalin, which I like less than Adderall, personally). For me, Provigil is in another league compared to Nuvigil. I would try to get switched over to it ASAP if at all possible. If that's not an option, I would personally switch over to Adderall. That's what we did and it worked great. The long-acting version can still be quite expensive, though, so just be aware. My last choice would be Ritalin. It made me feel weird and irritable, for some reason. I've never taken Sunosi, the newest entrant into the daytime sleepiness treatment world, so can't comment on that one.

It sounds to me like you are having a similar response to Nuvigil to me. I say that because at the times you are getting sleepy/tired, your armodafinil (Nuvigil) blood levels are still just fine. It actually stays in the bloodstream longer than Provigil does. Which is great--unless you have to go take a giant nap!

There is something about Nuvigil very clearly that makes some people drowsy or sleepy. Google it and you will see. You're not crazy. It;s the medication.

So, see about that Provigil. If not that, then look into Adderall. Or Ritalin. And if none of that works, what I would do were I you is I would explore the possibility of Sunosi. Maybe that's an option. Sending you positive vibes and wishing you the bes!!