Modafinil and Benzodizepines taken together

[Back2Good]

As some of you know, I began to use Modalert 200 (Sun Pharma's Modafinil) three mornings per week some time ago to counteract both my chronic insomnia and the effects of working with an international clientele (midnight and 2AM calls two nights a week for program status reporting) and while limiting my use to three mornings per week, and taking a week entirely off it every other week has kept me from building a tolerance to the drug, I've been very happy with it - I no longer feel the need to nap instead of eating lunch, regardless of how little I slept the night before.  Adding the Nootropic Phenylpiracetam (200mg twice daily, once at 4:30AM on an empty stomach with my Modalert 200 dose, and then another 200mg at 1PM or so by itself, works even better.

The elimination of my Narcolepsy was pleasing enough, but here's the funny thing: I also take Prilosec OTC every morning, and have found that the Prilosec potentiates the 3mg / day Alprazolam I'm prescribed.  On the days I take ModAlert 200, though, the effect is quite different - While the Alprazolam continues to work as  it supposed to, keeping my panic attacks at bay, it effect is somewhat muted, and there seems to be some synergy with the Modafinil, as during rare periods during the day when I don't have anything scheduled, I don't find myself pacing around looking for something to do.

All of this is good, of course, don't get me wrong, but I wanted to find out WHY that synergy was there, so I asked a couple of online Doctors.  Here's what they had to say (interestingly enough, both responded to my emails by saying that they had been asked this question before, and were simply copying and pasting their previous replies):

Carlo Carandang, MD, Psychiatrist, AnxietyBoss.com

Great question- it seems that they would counteract one another, but they work on different neurotransmitters and brain circuits. Modafinil (Provigil) inhibits the reuptake of dopamine, and is effective for attentional problems seen in ADHD (attention deficit hyperactivity disorder). Alprazolam (Xanax) works on an entirely different neurotransmitter and circuit- it enhances the GABA neurotransmitter, and has an effect on the anxiety circuits mediated by the amygdala. Alprazolam is effective for panic disorder. A stimulant-type of drug (Provigil) combined with a benzodiazepine (Xanax) can treat both ADHD symptoms and anxiety symptoms, which can co-occur. So combining these two drugs does not counteract each other.

Peter Simonov, MD, Psychaitrist

Benzodiazepines seem to lessen the intensity of physical side effects, it takes care of potential hypehirdrosis-like symptoms like a pro; you're much less likely to experience the side effect of wanting to do something proactive and wanting it so much that you end up doing less than you normally would; as bizarre as it sounds, it actually helps with one's focus, you probably are familiar with the notion of having all this focus suddenly available and being aware of it but being unable to channel it properly, resulting in restlessness, being annoyed, irritable, other than that, you won't find yourself as easily exhausted when performing physical tasks. Having said all this, please keep in mind that I used the term benzodiazepines rather than alprazolam while forming my answer due to the fact that all this was based on the exosubjective perception of effects of clonazepam vs alprazolam in conjunction with modafinil, as you obviously know, it has a different onset time and duration, and recently discovered anomalous serotonergic effects of clonazepam, exclusively. Furthermore, clonazepam seems to be far superior to alprazolam from my observations at this point.

So now I find myself wondering if I should switch to Clonazepam from Xanax for a while to test Dr. Simonov's theory (like any benzo aficionado worth his salt, somewhere in my stash are 200 Rivotrils), or just be happy that the synergy between my ModAlert 200 and Xanax works so well on the days I take them together.  As my Daddy used to say, "If it ain't broke, don't fix it".

Anyhow, thought this might be useful for daily benzo users who are considering trying Modafinil - At the very least there's no harm in doing so.

Best,

- b2g

[teddy1998]

Good grief b2g...my attention span is nil. The part I'm fixated on is the prilosec. Medications like these change the ph balance in the body therefore changing the effects on drugs. The synergistic effect is always in motion when you combine drugs (as im sure you already know). I don't have an answer and I may be overanalyzing but the OTC meds that change the ph balance in the body may have a large part in your experience. Check it out.

[Back2Good]

Oh, I'm well aware of the Prilosec's effect on Benzodiazepine half-life stretching - It's not why I started taking it (Heck, I'm from Texas - I eat things with sauces with names like "Devil's Spit" on them on a daily basis - even my breakfast eggs, so when Prilosec OTC came out I immediately threw all of my Zantac in the trash...One pill, once a day, and never any heartburn or indigestion?  Oh yeah.)  That's why I still use it, though, rather than newer products such as Nexium...It definitely gives you more bang for your benzo buck, where Nexium, Tums, or Zantac do not.  I've read that products containing Cimetidine have the same effect (and you can get those super-cheap, Equate's brand sells for about $9.99 for 100 tablets) - But Cimetidine works like Zantac or Tums, you have to take it with your meal (or with your benzo).  Omeprazole is a time released med, so taking it first thing in the morning gives me a "benzo-boost" all day long :-)

Best,

- b2g

[teddy1998]

I take zegrid for the heartburn/acid reflux. I'll have check into prilosec. I haven't taken zegrid or prilosec with benzos so im not aware of the effects. I'll have to check into both prilosec and zegrid.

Unlike most, you have much insight on this sh*t.

[Back2Good]

I take zegrid for the heartburn/acid reflux.  I'll have check into prilosec.  I haven't taken zegrid or prilosec with benzos so im not aware of the effects.  I'll have to check into both prilosec and zegrid.

Unlike most, you have much insight on this sh*t.

LOL, that's because I'm old as dirt, my friend...Have been using one form of benzo or another for 24 years, one picks up little tricks like this accidentally along the way.  I'm more than happy to pass them on, this is a community, so everything I know or learn is community property - Within the rules, of course

I don't know what Zegrid is, but the primary ingredient in Prilosec (Omeprazole - The generics work just as well) is what stretches the benzo half-life out, and Cimetidine (which I think is sold simply as "Cimetidine") is the other one that works in the same manner, you just have to take it each time you take a dose of benzos, where with Omeprazole you take it once in the morning and you're set for the entire day.

[teddy1998]

I take zegrid for the heartburn/acid reflux.  I'll have check into prilosec.  I haven't taken zegrid or prilosec with benzos so im not aware of the effects.  I'll have to check into both prilosec and zegrid.

Unlike most, you have much insight on this sh*t.

LOL, that's because I'm old as dirt, my friend...Have been using one form of benzo or another for 24 years, one picks up little tricks like this accidentally along the way.  I'm more than happy to pass them on, this is a community, so everything I know or learn is community property - Within the rules, of course

I don't know what Zegrid is, but the primary ingredient in Prilosec (Omeprazole - The generics work just as well) is what stretches the benzo half-life out, and Cimetidine (which I think is sold simply as "Cimetidine") is the other one that works in the same manner, you just have to take it each time you take a dose of benzos, where with Omeprazole you take it once in the morning and you're set for the entire day.

Good to know.  Thanks b2g.

[Bishop]

Very educational as always b2g. Now I find myself compelled to give modafinil another try. Motivation was good but I always found myself scattered and irritated wanting to do more as described in the text. I never thought of trying to synergize it with clon to negate side effects. Very interesting and very compelling read. Thanks

[annaleighx12]

interesting tidbit about the clonezapam from siminov, re: it being superior to alprazolam. while i don't necessarily have attention deficit issues, per se, or issues with chronic insomnia or narcolepsy, i do have anxiety troubles occasionally and find that (depending on severity) if left untreated, it can become REALLY problematic for focus and productivity with work--for obvious reasons, i'm sure. i've been prescribed alprazolam in the past, and my partner is prescribed clonazepam, so on the occasion that i do not have alprazolam, i've taken the clonazepam (in a pinch). i find that the clonazepam is way more conducive to addressing panic/anxiety during the day as it does not seem to make me as drowsy as the alprazolam.

not sure that my anecdotal observations are necessarily what you're talking about, but thought the doc's comment was really interesting!

also, from one GERD sufferer to another--cheers and best wishes for a painfree day!

[Bishop]

interesting tidbit about the clonezapam from siminov, re: it being superior to alprazolam. while i don't necessarily have attention deficit issues, per se, or issues with chronic insomnia or narcolepsy, i do have anxiety troubles occasionally and find that (depending on severity) if left untreated, it can become REALLY problematic for focus and productivity with work--for obvious reasons, i'm sure. i've been prescribed alprazolam in the past, and my partner is prescribed clonazepam, so on the occasion that i do not have alprazolam, i've taken the clonazepam (in a pinch). i find that the clonazepam is way more conducive to addressing panic/anxiety during the day as it does not seem to make me as drowsy as the alprazolam.

not sure that my anecdotal observations are necessarily what you're talking about, but thought the doc's comment was really interesting!

also, from one GERD sufferer to another--cheers and best wishes for a painfree day!

Thanks for sharing your experiences annaleigh. I too find clon more helpful during daytime work situations. It prevents me from reaching a panic keeps me calmer and the duration would seem to match up perfectly with mod. Let me know if you ever pair the mod with the clon B2G as I am very interested in how that would compare to the alp.

[nwiron]

I take zegrid for the heartburn/acid reflux.  I'll have check into prilosec.  I haven't taken zegrid or prilosec with benzos so im not aware of the effects.  I'll have to check into both prilosec and zegrid.

Unlike most, you have much insight on this sh*t.

LOL, that's because I'm old as dirt, my friend...Have been using one form of benzo or another for 24 years, one picks up little tricks like this accidentally along the way.  I'm more than happy to pass them on, this is a community, so everything I know or learn is community property - Within the rules, of course

I don't know what Zegrid is, but the primary ingredient in Prilosec (Omeprazole - The generics work just as well) is what stretches the benzo half-life out, and Cimetidine (which I think is sold simply as "Cimetidine") is the other one that works in the same manner, you just have to take it each time you take a dose of benzos, where with Omeprazole you take it once in the morning and you're set for the entire day.

Well that's good to know - i've been searching for a remedy.