The drug was certainly never approved for use in treating adverse reactions caused by the combination of Paxil and Klonopin.
As it turns out, when it comes to off-label use, Provigil is a legend. SG Cowen & Co analyst Eric T Schmidt figures more than 50% of the drug's sales are for unapproved uses, according to Business Week Online on November 4, 2004. "Doctors now prescribe it to treat everything from attention deficit hyperactivity disorder (ADHD) to fatigue associated with multiple sclerosis and depression."
The WSJ says doctors wrote 1.9 million prescriptions for Provigil in 2004, generating $414 million in sales for its maker Cephalon, almost half of the company's total revenues.
Susan's case is a perfect example of the vicious cycle that develops when doctors prescribe drugs for unapproved uses. She was given Provigil to counter the sedating effects of Klonopin, which was prescribed to counter the side effects of Paxil.
The adverse reaction that Susan experienced when Provigil was added to the mix was terrifying. "I took one pill and I thought I was coming out of my skin," she says. "It was one of the worst experiences of my life."
"I felt as if someone had climbed inside me," Susan recalls.
"I moved more agitatedly, more stuccato in rhythm; I had trouble concentrating; I couldn't find focus," she said, "and I kept forgetting what I was thinking a second earlier."
"It was nightmarish, because I didn't feel like me," Susan continued, "I didn't think like me, everything felt off."
Twenty minutes after she took the first pill, she called her doctor and told him that she had never felt so depersonalized in her life. "I remember saying that word," Susan recalls.
The doctor explained that the sense of "not being me" was called depersonalization.
Her experience after taking one pill was so horrible that Susan says, "you'd have had to tie me down, hold my nose and open my mouth with pliers to get another one in me."
But was her reaction really due to the Provigil? Its hard to see how anyone could say yes with absolute certainty. Its important to remember that Susan was given Paxil for anxiety.
The latest FDA warnings say SSRI drugs like Paxil can cause anxiety, irritability, hostility, aggressiveness and impulsiveness. Certain behaviors are "known to be associated with these drugs," including "anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness)," according to Proven Dangers of Antidepressants by psychiatrist Dr Peter Breggin.
"Akathisia makes people profoundly agitated, uncomfortable in their own skin, jittery, impulsive," says Dr Joseph Glenmullen, author of Prozac Blacklash.
Akathisia sounds pretty much like what Susan described to me. So was it a reaction to Paxil or Provigil or both?
And Susan's story did not end with Provigil. The mad chemist was not through with her yet.
As it turns out, when it comes to off-label use, Provigil is a legend. SG Cowen & Co analyst Eric T Schmidt figures more than 50% of the drug's sales are for unapproved uses, according to Business Week Online on November 4, 2004. "Doctors now prescribe it to treat everything from attention deficit hyperactivity disorder (ADHD) to fatigue associated with multiple sclerosis and depression."
The WSJ says doctors wrote 1.9 million prescriptions for Provigil in 2004, generating $414 million in sales for its maker Cephalon, almost half of the company's total revenues.
Susan's case is a perfect example of the vicious cycle that develops when doctors prescribe drugs for unapproved uses. She was given Provigil to counter the sedating effects of Klonopin, which was prescribed to counter the side effects of Paxil.
"I felt as if someone had climbed inside me," Susan recalls.
"I moved more agitatedly, more stuccato in rhythm; I had trouble concentrating; I couldn't find focus," she said, "and I kept forgetting what I was thinking a second earlier."
"It was nightmarish, because I didn't feel like me," Susan continued, "I didn't think like me, everything felt off."
Twenty minutes after she took the first pill, she called her doctor and told him that she had never felt so depersonalized in her life. "I remember saying that word," Susan recalls.
The doctor explained that the sense of "not being me" was called depersonalization.
Her experience after taking one pill was so horrible that Susan says, "you'd have had to tie me down, hold my nose and open my mouth with pliers to get another one in me."
But was her reaction really due to the Provigil? Its hard to see how anyone could say yes with absolute certainty. Its important to remember that Susan was given Paxil for anxiety.
The latest FDA warnings say SSRI drugs like Paxil can cause anxiety, irritability, hostility, aggressiveness and impulsiveness. Certain behaviors are "known to be associated with these drugs," including "anxiety, agitation, panic attacks, insomnia, irritability, hostility, impulsivity, akathisia (severe restlessness)," according to Proven Dangers of Antidepressants by psychiatrist Dr Peter Breggin.
"Akathisia makes people profoundly agitated, uncomfortable in their own skin, jittery, impulsive," says Dr Joseph Glenmullen, author of Prozac Blacklash.
Akathisia sounds pretty much like what Susan described to me. So was it a reaction to Paxil or Provigil or both?
And Susan's story did not end with Provigil. The mad chemist was not through with her yet.
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