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Re: Nuvigil update

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Lyndi wrote:

> lori wrote:

>> Finished day one on Nuvigil.

>

> Please let us know how you do with this Lori. My doctor and I discussed

> Nuvigil awhile back, but I was so scared of all the side effects that I

> wasn't prepared to try it.

>

Lyndi,

What side effects specifically, I like the news it keeps you awake. Bennie

,

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All,

Nuvigel is used to treat sleep disorders like narcolepsy and shift work disorder

(people who work at night and get their sleep cycles screwed up).

I take Provigel which is an alternate also and it is like a amphetamine effect

to ward of the sedation effects of narcotics or sleep disorders and treat

chronic fatigue patients although insurance companies may require justification

(mine does) to take for anything besides narcolepsy.

It does make Blood pressure go up but it makes me get up and not stay in bed.

Nuvigil is described on : http://www.nuvigil.com

Bennie

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I had good luck with Provigil, which is a similar drug. If I took too much, it

gave me a headache, but I found I could take half the dose and still have the

same effects without the headache. But sadly my insurance won't pay for it now.

--- Lyndi wrote:

>

> lori wrote:

> > Finished day one on Nuvigil.

>

> Please let us know how you do with this Lori. My doctor and I discussed

> Nuvigil awhile back, but I was so scared of all the side effects that I

> wasn't prepared to try it.

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Bennie wrote:

> What side effects specifically, I like the news it keeps you awake.

I am very medication sensitive - hence no Lyrica, Savella, Topomax, or

antidepressants for me. I also have fairly severe asthma, so I really

need to be careful.

The side effects that concerned me are: Tightness in the chest;

blisters on the inside of the eyes, nose, or mouth; chest pain; fast or

irregular heartbeat; mental or mood changes (eg, aggression, agitation,

anxiety, depression, exaggerated sense of well-being, hallucinations,

irritability, nervousness); red, swollen, blistered, or peeling skin;

shortness of breath; suicidal thoughts or actions; swelling of the legs;

unusual bruising or bleeding; vomiting; yellowing of the skin or eyes.

That's enough to scare the daylights out of me.

Lyndi

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> Darylene wrote:

>> Lori wrote:

>> Finished day one on Nuvigil.

>> Stayed awake all day, which I rarely do (have chronic fatigue, fibro, ddd,

etc. auto-immune stuff).

Darylene: (Sorry I deleted your posts specifics but below is what I did )

I would talk to a case manager and get you Doctor to write a letter of

justification. It usually is that they require a sleep study OR BIPAP

and if you are diagnosed with the Shift Work Disorder, they usually pay. It is a

matter of putting the right words in.

My Doctor first put in sedation from opioids and boy did they deny that. Then I

appealed and the justification required a sleep specialist, sleep study, and the

sleep questionnaire which I was happy to provide.

Funny, they will pay thousands on long term items and tests, but no

prescriptions Provigil is losing it patent specific and then other companies

can provide generics in 2012 and pricing of the drug will go down and maybe

restrictions, hopefully. Bennie

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> Cheryl in AZ wrote:

> It's not on the formulary here at all, so it would require an entire appeal,

and I doubt any doctor would be willing to sign appeal paperwork with a fibbed

diagnosis. Besides which, I don't dare ask this new doctor to lie for me, so I

just won't be getting that drug here. I'm just lucky I've found a GP in this

tiny town who is willing to prescribe my pain meds. I can't risk that by

suggesting he do something unethical.

Cheryl in AZ,

I DON'T have a sleep disorder either but in a sleep study if you roll around or

do not sleep eight hours, you are considered to have a sleep disorder.

You will be surprised when you have a sleep study what is considered a sleep

disorder <smile>

My Doctor first submitted it with the reasoning to combat opioid sedation and

they denied it. They required me to go to a sleep specialist, which I did and my

insurance paid. She did a sleep study and I roll around a lot at night and do

not get REM sleep, so I was able to get approved.

The form my insurance has states. At least two of these problems and mine was:

has sleep study on file, has seen sleep specialist, diagnosed with sleep

problems. Oh also this sleep questionnaire, so they paid for it and I have it

updated yearly.

So, it is not fibbing, lying etc. I have seen a sleep specialist, I have had a

sleep study, I have sleep problems but not disorder such as Narcolepsy or Shift

Work Disorder which is what the manufacturer lists its use for and does not list

any off brand use.

I do not encourage anyone to lie but I do encourage people to know the

stipulations of their insurance companies and see if they fit those stipulations

to receive medications they would otherwise not receive because of formulary

restrictions.

It is the Doctors' decision and my Doctor is VERY ethical and my sleep

specialist is also. The sleep specialist stated that sedation causes reduced

respiration and with the sleep study this showed true, prevented deep REM sleep.

I found out my previous Doctor did not have to lie for me, there were ethical

ways to get a medication prescribed for support that was needed.

Getting a sleep study, seeing a sleep specialist, and getting a CPAP if

prescribed and if needed is ethical and gets my Provigil. That if it helps, I

will do it.

My sleep specialist stated the CPAP can help pain patients by increasing oxygen

in blood cells.

So, it might be an option later on. Bennie

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Hi Janet,

I have Medical Mutual. I had to have my primary care doctor, sleep doctor and

cardiologist write letters to my insurance company. I had to have a sleep study,

which showed I never get to REM and I wake over 400 times, with multiple other

problems.

Does the pharmaceutical company have a patient assistance fund that you might

get help from?

I hope you can get it covered.

> Janet wrote:

> I am sorry for jumping in on your " Nuvigil Topic " . I haven't read all the

postings yet, still going through them) but I have to ask: How did you, as

patients, get your insurance companies to pay for it?

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---Drinksmix2 wrote:

>

> my doctor wrote the " medication is necessary for my patients care and

well-being " letter, and we have faxed it numerous times, I am down to three days

left, then I have to take Adderall, if I can't get them to cover it again, after

filling it five times!

If the insurance is simply sitting on it, I'd be on the phone four times a day

to the insurance company demanding that they process my paperwork. That's the

only way you're going to get them to move quickly enough - harrass them!

If they've denied it, then you need to go back to your doctor to get him to

rewrite his appeal, because he needs to take responsibility for figuring out

exactly how to fill out the form correctly.

I've appealed a lot of drugs in my day, and it's often taken me sitting on the

phone with the insurance company, demanding to speak to a manager, then to speak

to their boss, then to speak to their boss before they got off their duffs and

did their job.

The " squeaky wheel gets the grease, " as they say.

Cheryl in AZ

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