I've seen some docs prescribe Providgil in the hospital for stroke pts to stimulate them during waking hrs. I'm seeing this more and more. You think this is effective? Has anyone seen other stimulates used to mimic daytime circadian rhythms? At my hospital, this practice depends on certain docs, but I think more pts could benefit from it.Your thoughts....
Nov 7, '12
I work in inpatient rehab and both of our physiatrists prescribe Providgil for post-stroke patients, as well as Ritalin and sometimes Zoloft. Ritalin is used the most often and I've seen a good result with it.
Nov 8, '12
I've seen aricept used similarly - for TBI. But no exposure to provigil usage.
Nov 9, '12
Ritalin is often given because it is MUCH cheaper than Provigil or it's sister med Nuvigil. Both of these meds are used for (off label) ADD, also for daytime sleepiness in those who have OSA, and those who work crazy shifts. Used by the military to promote alertness in troops. It's a neurostimulant but does not work the same way as amphetamines or ritalin. The patients that I've cared for have been on ritalin.
Personally, I take Nuvigil and even with insurance, it's really expensive. It works quite well for me and I'm still able to sleep when I get home from work. I have ADD and OSA that requires CPAP so my med kinda takes care of both problens.
Nov 10, '12
Ahh...so you guys use Ritalin too? That's interesting! We only use Provigil, but there's only like 2 doctors that do it in the ICU. So, it seems more widely used inpatient rehab. Thanks!
Mar 26, '13
Would like to see where the research based evidence for this is. I hope they do a full assessment of the "sleepiness" ie sleep apnea secondary to stroke, insufficient amount of night sleep (monitored-amount of quality sleep and reasons for lack of eg pain, noise, urinary frequency etc), side effects of other meds, depression etc before putting them on these drugs. I would have thought that in elderly patients with a history of vascular disease and hypertension etc they would be a no no. Are you happy that the patients can reliably tell you if they're having chest pain, and have you looked at the other side effects eg anxiety, dyskinesia?
Mar 27, '13
I'm sure they do a full assessment.
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