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Thread: Modafinil - Effective Treatment for Hypotension Dizziness and Spasticity?

  1. #1

    Modafinil - Effective Treatment for Hypotension Dizziness and Spasticity?

    In research to discover another option for a drug to treat postural hypotension, I came across a few articles that included Modifinal as an effective vasoconstrictor. Several articles also listed it as a drug to treat spasticity in spinal cord injured and also as a potential research drug to promote regenerative neuron cells in spinal cord injury patients.

    Recently the drug, Dexedrine 5 mg Spansule ER, that I have taken an hour before I transfer from my bed to sitting in my wheelchair for about 15 years to treat my hypotension is unavailable. Since I have very uncomfortable side effects from the other choices such as Midodrine and ephedrine, the only option my doctor and pharmacist could provide was taking the available 10 mg Dexedrine Spansule. Unfortunately, if I need to take one later in the day, like a really hot day, I have trouble sleeping. I also have a noticeable "crash" around 2:00 pm making me so tired I could almost fall asleep in my chair.

    As a sidenote, one of the articles discussed how Modifinal had little potential for addiction and has now replaced Dexedrine as a drug used in the military for those that need extended wakefulness and concentration.

    Some Research Resources:

    1. GENERAL INFORMATION BROCHURE ON ORTHOSTATIC INTOLERANCE AND ITS TREATMENT, Peter C. Rowe, MD Chronic Fatigue Clinic Johns Hopkins Children?s Center March 2014

    Medications that improve vasoconstriction:
    Stimulants: (e.g., methylphenidate [Ritalin] or dextroamphetamine [Dexedrine])
    Midodrine (Proamatine)
    Modafanil (Provigil)
    Pseudoephedrine (Sudafed)
    Selective serotonin reuptake inhibitors (examples include fluoxetine [Prozac], sertraline [Zoloft], and escitalopram [Lexapro]) or related medications like Effexor or Cymbalta. These medications may also affect the central nervous system reflex pathways in NMH as well.

    Modafinil Elicits Sympathomedullary Activation

    1. -Author Affiliations
      1. Indu Taneja,
      2. Andre Diedrich,
      3. Bonnie K. Black,
      4. Daniel W. Byrne,
      5. Sachin Y. Paranjape,
      6. David Robertson
      7. From the Autonomic Dysfunction Center, Division of Clinical Pharmacology, Departments of Medicine, Pharmacology, Neurology, and Biostatistics, Vanderbilt University, Nashville, Tenn.
      8. Reprint requests to David Robertson, MD, AA3228, MCN Vanderbilt University, 1161 21st Ave S, Nashville, TN 37232-2195. E-mail

    Update on neurogenic orthostatic hypotension Pathophysiology, prevalence and treatment, Horacio Kaufmann (Editor)

    1. Official Journal of the American Autonomic Society, Clinical Autonomic Research Society andEuropean Federation of Autonomic Societies

  2. #2
    Senior Member darty's Avatar
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    Aug 2004
    Las Vegas, NV
    A few years ago my Hypotension (low blood pressure) was getting worse. After 30 + years it appears to have come on all of a sudden. My bp has always been low around 90/60 but I had no side effects. I ended up in an ER with a bp of 60/40 and they admitted me for a few days. I saw a really good Neurologist who ran multiple test on my body and brain then put me on Fludrocortisone 0.05 mg/day. It is the smallest pill I have ever seen, I take it in the a.m. with my other meds and it has helped greatly.

  3. #3
    for dizziness when i sit up i cross my eyes. that stops it. dam if i know why

  4. #4
    Interesting. I have never seen it used for orthostatic hypotension- mostly for fatigue in MS patients and alertness etc.. in brain injury pts. I don't see where FDA has labeled it for this use and it would be up to your doctor to prescribe and monitor it and insurance may or not approve if off label so I would suggest s/he include alertness/fatigue also. Some with implanted pain pump/narcotics with side effects of drowsiness. And less side effects than Dexedrine. Let us know results if you do try it!

  5. #5
    I, too suffer lower than my normal blood pressure for just over a year. My initial thought was the 0.5 mg of Suboxen I'm taking is the cause. In the morning around 11 am I start to get real drowsy and act as if I'm a narcoleptic. Quite often I jolt myself awake and find that my hand or finger was on my keyboard and I typed a couple of lines of the letter"g" let's say. I started tracking my blood pressure and found my blood pressure to range from 69/45 to 132/75. I take the Suboxen around 12:30 pm. I then also find myself in the same condition around 3:30 pm. At this point there does not seem to be a correlation between my Suboxen intake and my lower than blood pressure. My "normal" blood pressure is between 96/70 and 101/75.

    I'm seeing a cardiologist and for now he is recommending taking 5 mg of Midodrine three times in the afternoon. For quite some time I've been 5 mg of Midodrine at approximately 12 noon and again at 3 pm. I have found the Midodrine really hasn't help keep my blood pressure up where I'd like to see it. Most of the blood pressure readings I talked about above include me using the 5 mg Midodrine. My cardiologist wants me to add a third 5 mg dose around 5 or 5:30 pm. Not sure if that is going to help. What is interesting is there will be times where I can hardly keep my eyes open and my bp will be 110/78. There are also the times where I'm feeling reallyi good and productive and my bp will be 72/45. So, is my drowsiness related to my low blood pressure or something else? Either way I would like to see my bp back in the mid 90's to low 100's from an overall health standpoint and I would to get rid of being drowsy during different times of the day.

    I'm wondering then if the Modafinil would be a better option for getting my blood pressure up. My concern is that it might get too high. Quite often when I'm sitting in my bed my blood pressure automatically increases to around 115/80 to 122/82. I really don't want it to go much higher than that. At the same time I'd like to eliminate the 0.5 mg of Suboxen. Right now though that little bit of Suboxen will control spasms in my stomach for about 8 hours. I'm looking to try and get off the Suboxen next week. In the mean time I'll ask my cardiologist about Modafinil.
    Last edited by DaDutchman; 08-02-2016 at 03:36 PM.
    C5/C6 since 2007 due to car accident

  6. #6
    I have a post 45 year quad friend who has been these same problems the last couple of years. I'm wondering if lower BP is part of aging with SCI. While I've always had low BP issues, I'm hearing more people now facing that issue when it wasn't a problem early on after their injury.

    Mine has been getting worse the last 5 years though. I recently had a surgery that was to be outpatient. However, my BP dipped and stayed so low they wouldn't release me for a few days and wouldn't administer pain meds until it raised.

  7. #7
    Tried your method, but crossing my eyes only makes me dizzier.

  8. #8
    I'd be interested in what your cardiologist tells you.

  9. #9
    Did some more research on Modanifil, but mostly found info about it being a cognitive enhancer and to stay awake. It's the smart drug used in the TV show "Limitless" with Brian Cooper.

    NEW YORK (CBSNewYork) ? Everyone?s looking for an edge ? that?s what humans do.
    For business consultant Peter Borden, that ?edge? comes in the form of a pill ? called modafinil.
    ?The effects in the movie ?Limitless? were pretty much one for one to what happens,? Borden said.
    In the movie, and now the CBS drama, it?s a fictional drug that gives the user super human intelligence.
    It reality, modafinil, which is FDA-approved for sleep disorders, is developing a following because of it?s off-label success ? as a smart pill.

  10. #10
    Have you contacted any of the researchers, say at Hopkins? They may be able to provide you with more information. Curious if it works. Please let us now if you try it and if it does work.


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