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Suggest Cheaper Alternative To Modafinil For Treatment Of Bipolar Disorder
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caffine & L-Theranine, sepatrate or in combination
Detailed Answer:
Hello,
I have read the query and it reflects that you have chronic hypersedation or lethargy . It is quite unlikely that someone in his manic phase also has this complaint.
Lethargy is a part of depressive phase usually and is managed well with proper drugs. You have not mentioned what drugs are you on for treating bipolar disorder or I would have seen their possible role in this sedation.
However, as you have specifically asked for the alternatives to modafinil, I am providing you with two-
caffine and L- Theanine supplements.
Caffine in proper doses, may be in form of tea or coffee can are helpful in remaining awake.
L-Theanine in combination with caffine or separately is also good in countering sedation.
The combination of the above two is good as there is a smooth concentration.
You can even try someone close to accompany you, espically during the sleepy hours. He/ she will help you in remaining awake. People are more prone to sleep when alone.
Somehow I feel that revising your current dosage of bipolar can help.
You may folow the above two options after discussing them with your doctor.
Wish you good health.
Dr. Manisha Gopal
MD Neuropsychiatry
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I sincerely thank you for your time and feedback.
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try addreal and TMS; hike divalproex
Detailed Answer:
Hello,
According to your relpy- excess sleepiness came before everything else and an year later you developed depression.
This can be due to either simple hypersomnia; or prodrome of depression or some neurological cause.
I hope you must have got an MRI Brain/EEG to check for organicity. If not, you may get one to rule out this factor.
Secondly- you are on divalproex 1500mg..this is also a sedative drug and best taken at night to avoid day time sleepiness.
you mentioned a tendency your tendency to gointo mania- it is good that you get Sodium valpoate levels done. When they are in theraputic range only then the tendency for switch is handled effectively.
Thirdly- your antidperessant dosage prozac is very low -20mg. This can be increased to help in managing sedation. The dosage can go upto 40-80mg.
If you feel that this us not proeprly treating your sadness- you may shift to venalafaxine. It is good molecule to handle sleepiness.
There are drugs like adderal or therapies like TMS which might be helpful in your case. You will have to search for the availability of TMS near your place.
Such sleep attacks are also seen in narcolepsy when person is unable to control sleep and lies down anywhere he is. But many times it is stress related.
You have been taking caffine and tea and tried diferent drugs. So, I think you may go for therapies like above and see if they are helpful.
P.S. --Ziprasidone is an antipsychotic and not a mood stabiliser in any sense. The.doctor must have given you this drug to prevent the episode of mania as a precaution. This drug can be avoided by simply increasing the dosage of divalproex to its effective strength.
I hope the reply is useful for you
please ask if there is any doubt.
Dr. Manisha Gopal
MD Neuropsychiatry
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