Q. I recently started taking Provigil (200mg) to augment my other medications. (Celexa 40 mg, Zyprexa 5 mg, and Klonopin .5 mg). I've been on Provigil for 12 days now. It is working but not as much as I would like. I'm still sleeping 10-12 hours a day. I didn't notice much effect until after about 10 days. Will the effect of the Provigil continue to improve over time like anti-depressants? What else can you tell me about Provigil?

A. Great questions. Provigil is an agent to cause wakefulness. You are on a number of medications, Zyprexa in particular, which are highly sedating. You can increase the Provigil, with your doctor's permission and guidance, to 200 mg at breakfast and lunch, and it could help even more. You could also discuss lowering your Zyprexa dosage with your physician (I do not know your diagnosis, so go over it with them). Finally, you could get your Celexa to a higher dosage, 60-80 mg, and this may help you need no other medications, so you can get off the Zyprexa and Klonopin, and eventually the Provigil.

Provigil is a bizarre medication since it takes a week or two to work best. It is more antidepressant-like in this way, albeit we have seen no antidepressant properties of Provigil by itself. Finally, you may need all the medications you are on, and need to put up with a bit of sedation for the time being. Go over it with your doctor.