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Fatigue and AnemiaFatigue and Anemia
           
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Provigil for fatigue/Ritalin
Jun 4, 2008

I saw in some of the postings where you talked about Provigil and wanted to share this because others may have the same situation. I was checked for everything that has been mentioned about causes of fatigue to see why and everything was OK. Finally the HIV specialist I go to prescribed Provigil. I have great insurance coverage and they turned down the request saying fatigue from HIV and meds is not the intended use of Provigil. My doctor even countered the decision and still lost. In 15 years of having this coverage this is the first drug they ever turned down. I guess its expensive so if they can get out of approving it they will. So he prescribed Ritalin. I have been taking this for a month now and I feel great. I'm exercising and eating healthy foods. I lost weight.My blood pressure is even lower probably attributed to the cardio exercising. I have spent the last 10 years going to work and totally dragging thru the day. I would get home and get in bed and watch TV. I just existed, period. I was on anti-depressants for 5 years which I got off because I thought they were causing or adding to the fatigue and the weight gain. But after a year of being off of anti-depressants I was still exhausted. I have a top level high stress job too that doesn't help the situation. I have been on EPZICOM and VIRAMUNE for years and always maintained an undetectable level. At 55 years old I don't feel like I'm dying anymore. Dealing with fatigue is horrible because it affects so much or your life and causes chain reactions affecting your whole lifestyle.

Response from Dr. Frascino

Hi,

It's always a worry when "great insurance coverage" decides they understand the practice of medicine better than a trained physician! I doubt I would refer to your insurer as "great." Your physician was correct to fight this decision. Chances are if he persisted, ultimately they would have covered the cost of Provigil (it's not excessively expensive compared to most prescription drugs!). It works on an entirely different mechanism than Ritalin and is in some ways safer to use. Nonetheless, you seem to be remarkably improved on Ritalin, so we certainly can't argue with success. Thanks for taking the time to write in and share your story. I'm delighted your batteries are recharged. I should also mention for our readers that I have never had difficulty getting insurance coverage for Provigil for use in the treatment of HIV-associated fatigue when indicated.

Dr. Bob


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