They think, emphasis on the think, that ADHD has to do with under activation of various areas of the brain, primarily the temporal lobe, during certain tasks such as time discrimination and other executive tasks. The stimulants work by activating these parts of the brain. Mania, they think, primarily has to do with changes in the levels of serotonin. I'm guessing that's why stimulants wouldn't trigger mania? From what I've read, during episodes of mania, there are higher than in unipolar and/or non-depressed patients levels of norephinephrine. I guess giving something like wellbutrin or Strattera or a stimulant that increases NE levels could theoretically potentiate a manic episode. Maybe prolong it or worsen it. But I'm having a hard time seeing how wellbutrin or Strattera or even a stimulant would directly trigger a manic episode. I don't know. Maybe I'm not seeing something, but I don't think so.