R. Jewell, Research Advice Needed on Topa/Provigil

[Guest]

Very sorry to double post, as this is also in Ask Dr. Garcia as: Provigil/Topamax Research Help Dr. Garcia or R. J. (I think I should have just maybe posted here)

I am at 225mg of Topa and abstinent for a month now and doing great but for the ongoing tiredness and cognitive effects. This is affecting my life in some very negative ways that I must overcome ASAP. My doctor, who is absolutely an angel, prescribed Provigil recently.

However, my insurance (Pacificare) will not cover it yet, and is asking for me to provide 2 "peer reviews" (from MD's) or medical write ups saying how Provigil effectively counteracts the sleepiness that Topamax creates. These have to be peer reviews or write ups that specifically address Provigil?s effectiveness on Topamax?s side effects, or I am out of luck with the insurance.

Where on earth, or I might ask, in what medical journals, or elsewhere should I start searching for this type of information? Will I need to go to a medical library to find such info? (I live in Denver, and know a bit on how to research, and have some medical connections, but not at a med school.) Or are "peer reviews" such things I can get from MD's and if so, they are not my "peers" to start with, so how do I get this info? Any suggestions are appreciated.

Peace,
Backpacker

[Guest]

R. Jewell, Research Advice Needed on Topa/Provigil

Hi, Backpacker. I don't know if they're trying to snooker you out of an Rx or they truly believe many peer reviewed articles have been written regarding Provigil's use to mitigate the Topamax sleepies. I'm pretty sure my book was the first time it had ever been mentioned (Provigil had just been introduced). Your doc has prescribed it and if s/he's willing to write an off label prescription, seems to me that should be adequate.

This may be a tough one, but is still worth a try. I'd suggest the following: first collect information supporting the fact that drowsiness is a well reported side effect of Topamax. That should be very easy. Then, dig up some peer reviewed articles regarding Provigil as a "vigilance promoting agent". Go to Google Scholar and enter the terms "provigil vigilance". Some of the free articles are not peer reviewed (but informative). And many of the scientific journals are expensive. However, the abstracts are free and should provide you with the information you need.

Hopefully, that'll give you the documentation to justify the insurance support. Either that or suddenly get a job as a shift worker and develop SWSD, a treatable condition also known as Shift Work Sleep Disorder. ;-)

RJ

[Guest]

R. Jewell, Research Advice Needed on Topa/Provigil

Thanks a bunch

Sincere thanks RJ,

I did not even know about Google Scholar. I also contacted Cephalon (makers of Provigil). They were very helpful over the phone, and seem well set up to assist in such matters and work with MD's and patients. One person there (at the insurance reimbursment hotline) explained that insurance companies are often ill-informed about Provigil, and often just need a little "educating." Thank you so much. I am learning much here.

[Guest]

R. Jewell, Research Advice Needed on Topa/Provigil

Re: Thanks a bunch

Great idea and good for you! Thanks for sharing this excellent strategy. Hopefully your insurance company will cooperate. I supposed it's difficult--with so many meds introduced each year--for everyone to keep up. It's good they've got us to help, lol. Do keep us posted.

Best,

RJ

[Guest]

R. Jewell, Research Advice Needed on Topa/Provigil

Re: Thanks a bunch

Yes, thanks a bunch to both of you. I am extremely interested in Provigil & Topamax and balancing the affects, as I am still working on all of it. Thank you. Great information. Are there any other good ways to research into this area. I am not opposed to paying for access into one or two good medical databases, maybe ;>) if reasonable. But I would love some additional research tips.

Best Regards, Chrysa