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Provigil vs Vyvanse
Introduction
For patients with conditions like narcolepsy or attention deficit hyperactivity disorder (ADHD), certain drugs that influence the concentrations of neurotransmitters in the brain can help manage symptoms and improve daily functioning. Provigil and Vyvanse are two such medications often prescribed for these disorders. Both act on different neurotransmitters within the brain, yet they have similar effects on improving alertness and focus. Provigil, also known as modafinil, is a wakefulness-promoting agent believed to work by altering natural chemicals (neurotransmitters) in the brain associated with sleep and wakefulness. On the other hand, Vyvanse is a central nervous system stimulant classified as an amphetamine, which primarily boosts levels of dopamine and norepinephrine in the brain to enhance concentration and reduce impulsivity.
Provigil vs Vyvanse Side By Side
Attribute | Provigil | Vyvanse |
---|---|---|
Brand Name | Provigil | Vyvanse |
Contraindications | Cannot be taken with MAO inhibitors due to risk of hypertensive crisis. | Cannot be taken with MAO inhibitors due to risk of hypertensive crisis. |
Cost | For brand name, around $1,120 for 30 tablets of 200 mg. Generic versions cost between $0.80 and $2.80 per day. | For brand name, about $380 for 30 capsules of 70 mg. Generic versions start from around $1 up to just over $3 per day. |
Generic Name | Modafinil | Lisdexamfetamine |
Most Serious Side Effect | Severe skin reactions requiring hospitalization, changes in mental status including depression, hallucinations, or suicidal thoughts. | Signs of heart issues like chest pain, trouble breathing, psychiatric symptoms including aggression, paranoia, and hallucinations. |
Severe Drug Interactions | MAO inhibitors. | MAO inhibitors. |
Typical Dose | 100–400 mg/day, with 200 mg/day often being sufficient. | Starts at 30 mg/day, can be increased by 20 mg at weekly intervals to a maximum of 70 mg/day. |
What is Provigil?
Modafinil (the generic name for Provigil) was first introduced as a novel wakefulness-promoting agent used to treat narcolepsy, sleep apnea, and shift work sleep disorder. It was approved by the FDA in 1998. Provigil works by increasing levels of dopamine in the brain by reducing its reuptake into nerves, effectively "trapping" it for longer than usual. This drug is also prescribed off-label for conditions such as depression, ADHD, and fatigue related to multiple sclerosis.
On the other hand, Lisdexamfetamine (the generic name for Vyvanse) belongs to a different class of drugs known as stimulants. It was approved by the FDA in 2007 primarily for treating ADHD but later got approval for binge eating disorder treatment too. Vyvanse increases levels of several neurotransmitters including dopamine and norepinephrine resulting in increased attention span and decreased impulsivity seen in those with ADHD.
Each drug has its unique benefits and side effects profile; however both can cause insomnia due their stimulating effect on central nervous system.
What conditions is Provigil approved to treat?
Provigil is approved for the treatment of various conditions including:
- Narcolepsy, a neurological disorder that affects the control of sleep and wakefulness
- Shift work sleep disorder (SWSD), which affects people who often rotate shifts or work at night
- Obstructive sleep apnea/hypopnea syndrome (OSAHS), used as an adjunct to standard treatment(s) for this condition
On the other hand, Vyvanse is primarily used in:
- Attention deficit hyperactivity disorder (ADHD) in both children and adults
- Binge eating disorder in adults.
How does Provigil help with these illnesses?
Provigil, also known as Modafinil, helps manage sleep disorders by altering the natural chemicals in the brain involved in controlling sleep and wakefulness. It works by inhibiting dopamine reuptake into neurons which increases the amount of dopamine available in synapses for longer periods of time. Dopamine is a neurotransmitter that is heavily involved with reward mechanisms, mood regulation, and most notably alertness and vigilance.
On the other hand, Vyvanse (Lisdexamfetamine) is used primarily to treat attention deficit hyperactivity disorder (ADHD). Like Provigil it also affects brain chemicals but does so differently - it increases levels of norepinephrine and dopamine more directly to improve focus and decrease impulsivity and hyperactive behavior common in ADHD patients.
Effectively managing these varied symptoms can significantly help individuals maintain their daily routines with minimized disruptions from either excessive sleepiness or uncontrolled ADHD symptoms. The choice between Provigil or Vyvanse will largely depend on your specific condition – whether you are trying to manage a sleep disorder or improve symptoms associated with ADHD.
What is Vyvanse?
Vyvanse is a brand name for lisdexamfetamine, a central nervous system stimulant that increases the levels of dopamine and norepinephrine in the brain by reducing their reuptake. It also has potential to block another neurotransmitter, serotonin, at various receptors. Lisdexamfetamine was first approved by the FDA in 2007. As it's not considered an SSRI antidepressant or narcolepsy medication like Provigil (modafinil), it does not inhibit the reuptake of serotonin directly. Its mechanism on neurotransmitters means its side-effect profile differs from those of drugs like modafinil; specifically, Vyvanse can cause increased heart rate and blood pressure but is less likely to cause sleep disturbances (common side effects with Provigil). The impact on dopamine and norepinephrine can be advantageous in managing Attention Deficit Hyperactivity Disorder (ADHD) symptoms and binge eating disorders, particularly in patients who do not respond well to conventional ADHD medications such as Ritalin.
What conditions is Vyvanse approved to treat?
Vyvanse is a medication that has been approved by the FDA for use in managing:
- Attention-deficit/hyperactivity disorder (ADHD) in both adults and children
- Binge Eating Disorder (BED) in adults.
Please note that while Vyvanse can help increase attention span, manage impulsive behavior, and reduce hyperactive symptoms when used for ADHD treatment, it's not recommended as a first-line drug treatment option for weight loss.
How does Vyvanse help with these illnesses?
Dopamine is a neurotransmitter that plays several important roles in the brain and body. It's involved in reward, motivation, memory, attention and even regulating body movements. When it comes to certain cognitive disorders such as ADHD (Attention Deficit Hyperactivity Disorder), dopamine levels can be lower than normal. Vyvanse works by increasing the concentration of dopamine available in the brain, thereby improving focus and reducing impulsivity and hyperactive behavior often seen in ADHD patients. Unlike Provigil which acts primarily on wakefulness-promoting areas of the brain without having significant impact on dopamine release, Vyvanse targets both wakefulness and dopamine signaling pathways directly making it more effective for managing symptoms of ADHD specifically. Because it has a direct effect on dopamine levels similar to typical stimulant medications used for ADHD (like Adderall), but with a slower onset due to its unique prodrug formulation, Vyvanse may also reduce potential for misuse or abuse compared to other stimulant drugs.
How effective are both Provigil and Vyvanse?
Both modafinil (Provigil) and lisdexamfetamine (Vyvanse) have established histories of success in managing symptoms associated with attention deficit hyperactivity disorder (ADHD) and narcolepsy. They were initially approved by the FDA a decade apart, with Provigil in 1998 and Vyvanse in 2007. Since they act on different neurotransmitters, they may be prescribed under different circumstances.
The effectiveness of Provigil and Vyvanse has been directly compared in several studies; both drugs have shown similar efficacy at improving symptoms such as daytime sleepiness or trouble focusing but differ slightly when it comes to their safety profiles due to their distinct mechanisms of action. For instance, a study published in 2015 found that while both medications improved ADHD symptoms, patients taking Vyvanse experienced fewer side effects related to appetite suppression.
A systematic review from 2012 demonstrated that Provigil is effective at relieving excessive sleepiness associated with many conditions starting from the first week of treatment. It's generally well-tolerated across populations including shift workers and those suffering from various sleep disorders. The same study reports that although not its primary indication, Provigil has also been used off-label for treating ADHD since around its initial approval date.
In contrast, a meta-analysis conducted in 2016 indicated that lisdexamfetamine seems to be more effective than placebo for treating ADHD over longer periods up to one year. While it's typically considered among the first-line treatments for this condition due primarily to its low potential for abuse relative to other stimulant medications like Adderall or Ritalin; significant research exists supporting its use alone or alongside non-stimulants when necessary.
At what dose is Provigil typically prescribed?
Oral dosages of Provigil typically range from 100–400 mg/day, but research has shown that 200 mg/day is often sufficient for treating narcolepsy or sleep apnea. For Vyvanse, oral doses usually start at 30 mg/day for adults and children over the age of six who are being treated for Attention Deficit Hyperactivity Disorder (ADHD). The dosage can be increased incrementally after a week if symptoms have not improved. However, in any case, the maximum daily dose should not exceed 70 mg/day for Vyvanse or 400mg/day for Provigil.
At what dose is Vyvanse typically prescribed?
Vyvanse treatment is typically initiated at a dosage of 30 mg/day, taken orally in the morning. The dose can then be increased by 20 mg at weekly intervals to achieve an optimal response. The maximum dose per day is generally not more than 70 mg, which should be reached only if there are no significant improvements with lower doses. Vyvanse comes in capsules or chewable tablets and it's important that it's ingested whole without being divided into parts or crushed. Bear in mind that this medication works best when used consistently, so ensure you take your daily dosage as prescribed by your healthcare provider.
What are the most common side effects for Provigil?
Common side effects of Provigil and Vyvanse may include:
- Anxiety or nervousness
- Insomnia, difficulty in falling asleep
- Fatigue, sleepiness/drowsiness (more common with Provigil)
- Increased heart rate
- Tremors (unintentional trembling or shaking)
- Loss of appetite
- Nausea and stomach upset
- Dry mouth is more typically seen with Vyvanse.
- Decreased sex drive is a less common side effect. -Sweating can occur as well. -Rash: While rare, serious rashes requiring hospitalization have been reported in association with the use of Provigil. -Increased blood pressure and palpitations are also potential side effects to be aware of.
It's crucial to discuss any pre-existing conditions you may have with your healthcare provider before starting either medication, as both require monitoring for certain health risks.
Are there any potential serious side effects for Provigil?
While Provigil and Vyvanse are both stimulants used to treat narcolepsy and ADHD, their side effects can vary:
- Changes in mental status: severe anxiety, depression, hallucinations or suicidal thoughts
- Signs of an allergic reaction or serious skin reaction: rashes, hives, difficulty breathing or swallowing; swelling of the face, lips or throat; fever with peeling skin
- Vision issues: blurred vision, eye pain or redness
- Cardiovascular symptoms: chest pain (may spread to your jaw or shoulder), irregular heart rhythm (palpitations), shortness of breath
- Hyponatremia - low sodium levels in the body that may cause headache, confusion, slurred speech weakness and muscle cramps
- Severe nervous system reactions - rigid muscles stiffness , high fever sweating confusion rapid heartbeats
- Symptoms related to serotonin syndrome include but are not limited to agitation restlessness fast heartbeat dilated pupils loss of coordination nausea vomiting diarrhea
Should you experience any such symptoms while using either medication it is crucial that you seek immediate medical attention.
What are the most common side effects for Vyvanse?
Vyvanse, like any medication, can cause a number of side effects. Patients may experience:
- Dry mouth
- Insomnia or other sleep disturbances
- Increased heart rate
- Anxiety and restlessness
- Loss of appetite leading to weight loss
- Nausea or abdominal pain
- Dizziness or lightheadedness In some patients, Vyvanse might also cause tremors and excessive sweating. In rare cases, it could lead to blurred vision and confusion. Always remember that individual reactions to medications vary greatly; these are potential side effects, but not everyone who takes Vyvanse will experience them.
Are there any potential serious side effects for Vyvanse?
With Vyvanse, it's important to be aware of potential serious side effects. These may include:
- Signs of an allergic reaction such as hives, difficulty breathing or swallowing, swelling in your face or throat
- Symptoms suggestive of heart issues like chest pain, trouble breathing, feeling like you might pass out
- Psychiatric symptoms including new behavior problems, aggression, hostility; paranoia and hallucinations
- Circulatory problems - numbness; unexplained wounds on fingers or toes
- A rise in blood pressure leading to severe headaches; blurred vision; pounding in neck or ears If any of these reactions are experienced after taking Vyvanse stop using the medication immediately and consult a healthcare professional.
Contraindications for Provigil and Vyvanse?
Provigil and Vyvanse, along with other stimulant medications for narcolepsy or ADHD, may occasionally exacerbate symptoms related to anxiety or insomnia in some people. If you notice your condition worsening, the emergence of new psychiatric symptoms (such as hallucinations), an increase in blood pressure or heart rate, please seek immediate medical attention.
Neither Provigil nor Vyvanse can be taken if you are taking MAO inhibitors (MAOIs) because they could lead to hypertensive crisis - a severe spike in blood pressure that requires emergency treatment. Always inform your physician about all the medications you are currently on; MAOIs will require a period of about 2 weeks to clear from the system before starting therapy with Provigil and Vyvanse.
How much do Provigil and Vyvanse cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Provigil (200 mg) averages around $1,120, which equates to approximately $37–$74/day depending on your dose.
- The cost for 30 capsules of Vyvanse (70 mg) is about $380, working out to roughly $13/day.
Therefore, if you are in the higher dosage range for Provigil (i.e., 400 mg/day), then brand-name Vyvanse may be less expensive on a per-day treatment basis. Remember that cost should not be your primary deciding factor when determining which drug suits you best.
Moving onto generic versions:
- Modafinil (the generic form of Provigil) reduces costs significantly at an approximate rate between $0.80 and $2.80 per day for dosages ranging from 100mg to 300mg daily.
- Lisdexamfetamine dimesylate represents the generic version of Vyvanse and can bring down costs starting from around $1 up to just over $3 per day with dosages typically ranging from 30mg up to a maximum recommended dose of 70mg daily.
Popularity of Provigil and Vyvanse
Modafinil, sold under the brand name Provigil, is a medication used primarily to treat sleep disorders like narcolepsy and sleep apnea. In 2020, it was estimated that about 850 thousand prescriptions were filled in the U.S., making it one of the most commonly prescribed medications for sleep disorders.
On the other hand, Lisdexamfetamine dimesylate, marketed as Vyvanse, is more commonly prescribed with over 10 million people receiving prescriptions in the U.S. during 2020 alone. While Vyvanse was originally developed for ADHD treatment and still accounts for roughly 14% of all ADHD prescriptions in America, its uses have expanded to include binge-eating disorder treatment recently.
The prevalence of Modafinil has been steady over recent years while lisdexamfetamine's usage has increased since getting approval from FDA for treating binge-eating disorder back in 2015.
Conclusion
Both Provigil (modafinil) and Vyvanse (lisdexamfetamine) are widely used in the management of narcolepsy and attention deficit hyperactivity disorder (ADHD). Both medications have been shown to be more effective than placebo treatments as evidenced by numerous clinical studies and meta-analyses. In some instances, a combination of these drugs may be considered but requires careful evaluation by a healthcare provider due to potential contraindications.
Provigil acts primarily on dopamine reuptake inhibition thus increasing levels of dopamine in the brain while Vyvanse is a prodrug that is converted into active dextroamphetamine once ingested which also increases concentrations of dopamine along with norepinephrine. This variation in their mechanisms leads them to being prescribed under distinct circumstances.
While both drugs are available generically, Vyvanse is often costlier out-of-pocket compared to Provigil due its status as brand-name medication without generic alternatives currently available.
The side effect profiles for both drugs are relatively similar though not identical; they include headaches, insomnia, dry mouth, anxiety and nausea among others. However, patients need to closely monitor themselves especially when starting treatment or changing dosages within either drug regimen because if they experience worsening symptoms such as palpitations or mood swings it should warrant immediate medical attention.
Refrences
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- Turner, D. (2006, April). A review of the use of modafinil for attention-deficit hyperactivity disorder. Expert Review of Neurotherapeutics. Informa UK Limited.http://doi.org/10.1586/14737175.6.4.455
- Keating, G. M., & Raffin, M. J. (2005). Modafinil. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00023210-200519090-00005
- Steiner, H., & Van Waes, V. (2013, January). Addiction-related gene regulation: Risks of exposure to cognitive enhancers vs. other psychostimulants. Progress in Neurobiology. Elsevier BV.http://doi.org/10.1016/j.pneurobio.2012.10.001
- Cowles, B. J. (2009, March 31). Lisdexamfetamine for Treatment of Attention-Deficit/Hyperactivity Disorder. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.1l521
- Prommer, E. (2011, December 4). Methylphenidate. American Journal of Hospice and Palliative Medicine®. SAGE Publications.http://doi.org/10.1177/1049909111427029