i realize this probably isnt the proper forum to ask this question as it has nothing to do with my colitis or jpouch but im really in need of some emotional support right now and this community has been the greatest source of reassurance to me through my trials these past few years battling with illness.

my doctor prescribed provigil to me recently to battle my constant fatigue and daytime sleepiness. i began taking it just yesterday and its the most alive ive felt in years. being on the medication, i really dont know how i survived with the quality of life i had before. for the first time, i dont constantly look forward to my next nap.

before colitis, i would blindly trust my doctors and take any medication prescribed. however, after this ordeal the past few years, i have become very cynical and fearful of medications. and can you really blame me?

after extensive research, ive learnt that provigil is fairly harmless with few side effects, but it scares me that the drug is so relatively new with no long term studies. anything you're putting in your body ultimately will affect it in the long run. although they claim otherwise, it makes too much sense that outright dependency and addiction could be a likely outcome.

this scares the hell out of me as after tasting what life should be like without constantly feeling tired, i know now i cannot get off this drug and go back to my old life. so i keep taking this stuff the rest of my life? wont my body become addicted and need higher doses? should i just get off now?

I was on Provigil for about three years to combat the intense fatigue I had from taking large doses of 6MP and Remicade. I liked that it kept me feeling awake without making me feel jittery or anxious. It's actually used to treat narcolepsy, so there should be some studies on it's continued use in those patients.
I did gradually need an increased doseage of the medication as time went on, but please remember that this "tolerance effect" is something completely different from addiction. I had no problems weaning myself off of it after I had my surgery and no longer was taking the 6MP.
As for how long you will want to take it, I wouldn't stress so much about the distant future. If it's working for you now, great, but I would also do other things to keep your energy up as well: get plenty of rest, eat a balanced diet, and try and get some exercise in each day. And I'm sure if you ask your doctor he or she could provide you with some information about the studies done on Provigil, if you are concerned.

well im not taking it due to fatigue from the UC medications, thats why i foresee myself taking this indefinitely. i worry that it will lose all effect

Hi there, I actually take Provigil for a sleep disorder (similar to narcolepsy but different). I honestly don't know how I lived before it!! I hope to get pregnant in the next year so will try to come off and DREAD IT! Don't know how I will stay awake....

However regarding your concerns... Although Provigil is similar to stimulants like amphetamines, it is slightly different structurally (my husband - the jpoucher - is a chemist and actually used to work at the company who makes Provigil). It is very close but different enough that it doesn't give all the same effects, good and bad (good when I say things like weight loss IF you are like me and overweight - hee, hee). Bad when I say the extreme jitteriness and 'true' addiction. The studies to date have not shown humans to become addicted (in general) however animal studies have shown that monkeys, when given the opportunity, will self-administer this to themselves as they do with things like cocaine. So it makes them feel good in some way! It is important to clarify between addiction (which can be emotional/psychological and can happen with almost any drug like alcohol, nicotine, caffeine, etc. - anything that one perceives to make them feel good), dependence (body requires the need for the drug and if stopped suddenly will experience negative effects - happens with things like narcotics, drugs in the class of Valium, and even some things like SSRIs - all if taken long-term of course) and tolerence (body requires more of the same drug/a higher dose for the same effect). Tolerance can go along with dependence but not always.

It is typical for people to become tolerant to the effects of Provigil and I have just had to increase my dose. With sleep disorder patients, the dose is usually bumped each year or so (varies) and then sometimes a second-line therapy is added like Ritalin (used for ADD, more of a true stimulant of the amphetamine type). I am not sure why you are taking it (don't know if it is a sleep disorder or not and don't want to pry if you want to keep the info to yourself, however feel free to PM me if you'd like advice if it is) but if it is for something other than a sleep disorder, the dose is probably lower and you probably won't max out.

If there is a need to come off of Provigil, as I will attempt to when trying to get pregnant, the best thing to do is just taper down. Again, some can just come right off as there doesn't seem to be that physical addiction/dependence per se, however I always use the taper approach when I can as I just think it is easier on the body. Many years ago they said there was no dependence on SSRIs and they told me to just stop one and I had awful withdrawl type symptoms which the docs dismissed. Now they recognize this and tell everyone to taper! They are also recognizing this withdrawl in newborns whose mothers took SSRIs during pregnancy so suggest women taper off during the 3rd trimester if their condition allows it. So we often learn things later, which is why I take the careful approach and taper everything that I have been on long-term as long as I am not having a serious side effect.

I hope this was helpful (sorry I wrote a book!) I know you are concerned but if you are feeling good (and we all know that people with UC feel bad enough due to that!) then I would concentrate on that for now. Like I said, this has been my savior and I am so happy to feel 'normal' again. Best of luck to you!