Provigil update

[Salamander2]

Has anyone heard that the insurance companies are starting to approve Provigil for MS?  The company must have changed the recommendations for use.  I did a prior authorization for a patient today.  She needed Provigil for Sleep Apnea.  Sleep disorders are what this med has mostly been used for.  But this time, where the approved diagnosis' were listed, MS was on the list.  It's the first time I have seen this since I have been doing the authorizations.  

I think everyone who has been denied should try again to see if their insurance is starting to cover it.  In the past, use with MS was considered "off label", but I think that may have changed.

Blessings,
Sally

[BOK2Bjan]

Glad I'm not alone in this. No, I never take Provigil past 6 - 7 am.  But I've been trying taking it at 3-4-5am to see if that would help.  I'm up now at 4:30 cause I can't sleep, yet I was so lethargic all day.  Around 8pm I started waking up.  I can't relate it to just bad sleep hygiene, although it's not the best.  It's hard to have a perfect sleep/wake cycle when you're dealing with so many disruptions at night (bladder, aspirating, sleep apnea)  One of the problems is caffeine, admittedly.  I drink diet coke (a whole other can of worms) due to the fatigue.  I hardly drank any until I started on all my pain meds and had such fatigue from all the illness.  A true catch 22 isn't it?  Exercise would help - but uh. . . another can of worms! lol  Vicious circle of doom! (said faticiously)  

I too am thankful for those energetic times - they're so rare anymore though.  I miss them.  My normal (Past tense) MO is to get up in the morning and never sit down until dinner that night.  I was known as the energizer bunny.  My batteries are definitely dead.  OH my, oh my.  At least I can't be accused of being a perfectionist anymore or having a home that doesn't look lived in! lol.My house looks like an entire fraternity lives here - and they're not the nice studious type!  I used to go in my son's room and feel disgusted. Now it just looks like the rest of the place.  Do you think I could count that as a blessing?

Take care, Jan

[Salamander2]

I have the same issues (MS and Sleep Apnea). There are times when I can take the Provigil and still lay down and go right to sleep.  I told The Physician Asst at my Neuro office there are times when the fatigue is so bad the Provigil doesn't help.  She said that when someone has that level of fatigue there probably isn't anything that will help except sleep.  

Quix might be able to tell us what the half life of Provigil is.  I only take it in the morning.  If I take it after 2PM it will keep me from sleeping.  You may be taking it too late in the day.

As far as the change in energy level, I experience the same thing.  I can't really connect it to anything specific,  I'm just grateful that I do have days when I am energetic.

Good Luck,
Sally

[BOK2Bjan]

I've been on Provigil for several years, due to having fatigue from Systemic Sclerosis. And now MS, plus sleep apnea, I'm a sleeping fool sometimes. It has helped a lot, but of course it helps less as time goes on.  One thing I'd like to ask is if anyone else has experienced not feeling awake until evening or night time.  I've tried taking it in the wee hours of the morning (I wake up all through the night - sleep apnea & bladder issues & night sweats & pain .....) but still it doesn't help.  I'm not sure what it is I'm doing, or if it's just normal cycling of melanin, or _______?  Anyone else?  I have such profound fatigue sometimes and then once in a while, I'll have a day or a few days where I'm energized.  No med changes - just changes out of the blue.

Blessings, Jan

[Fluffysmom]

Thank you, I hope that all insurances are adding MS as a covered diagnosis for Provigil.

Now if I could just get a diagnosis, or they would approve it for whatever I have, as its the only thing that helps me have a clearer, more productive day!

Hopefully my 3T MRIs of  my brain, C and T spine on April 30th will help with the diagnosis thing.  Close to $400 for a month's supply is obscene, so people like me need to ration them out.  I'm doing fine, but it would be so much easier if I could have them covered!

Kathy