What? You're skeptical about the Wakeup Diet™ and how it might help you? Of course, skepticism is healthy. You should also be skeptical about the drug treatments for narcolepsy and other phasal disorders. Read the circulars that come with these drugs! The medical community doesn't know how Provigil and Xyrem work. This statement is buried in the fine print about both products. (See our labeling extracts below.) As to how effective these drugs are, and the many side effects: You'll find ample admission of potential problems in both areas.

> Those who object to the Wakeup Diet™ tend to exaggerate what their medications can achieve.

Drugs aren't helping. Recently, two narcoleptics admitted to me that they’d quit the medication because of problems. For one of these people, a narcolepsy prescription had caused heart damage. Yet both people seek “better medication.” (There is none.) I suggested the Wakeup Diet™. Not only could the program help, but it could improve a patient’s general health. The second person claimed that “drugs are easier and involve less thought than changing my routine.” Yet this person admits that the drugs aren’t helping!

> Some confusion must result from the term “diet.”

No calorie-counting. You'll be happy to hear this: The Wakeup Diet™ program involves no calorie counting and no weight loss. Instead, this is a weight-neutral system. The purpose of the Wakeup Diet™ is daytime alertness and nighttime sleep quality. Although someone could lose weight by adjusting the program, consider my own weight. It's been stable for decades. I wear the same size bathing suit as in high school.

From Provigil Circular

CLINICAL PHARMACOLOGY
Mechanism of Action and Pharmacology

The precise mechanism(s) through which modafinil promotes wakefulness is unknown.

Source: “FDA Approved Labeling Text for NDA 20-717/S-005 & S-008 Approved-23-Jan-2004”

See...Provigil circular.

From Xyrem Circular

CLINICAL PHARMACOLOGY
Mechanism of Action

The precise mechanism by which sodium oxybate produces an effect on cataplexy is unknown.

Source: “NDA 21-196/S-005 FDA Approved Labeling Text dated 11/18/05, page 2”

See...Xyrem circular.

...In many or most children, stimulants routinely cause rebound, involving a worsening of behavioral symptoms a few hours after the last dose. And especially with larger or more prolonged dosing, they can lead to severe withdrawal reactions such as “crashing,” which is characterized by extreme fatigue, depression, and even suicidal feelings (see Chapter 9).

Stimulants can also cause the following: excessive stimulation of the brain, including insomnia and seizures, agitation, irritability, and nervousness; confusion and disorientation; personality changes; apathy, social isolation, sadness, and, very commonly, depression.

...Furthermore, stimulants can cause a variety of emotional disturbances that are mistakenly considered “therapeutic,” including flattened emotions and robotic behavior.

...Permanent tics, sometimes categorized as Tourette's syndrome, are a serious complication. They often start in the face and neck.

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