Sorry you're dealing with this.

The only thing that's helped me is Ritalin. However, I know that Adderall made me completely manic to the point I was hearing voices telling me to kill myself. So stimulants are a hit or miss for me. I think if you're prone to mania in general, I'd err on the side of caution with stimulants and ask your pdoc about that one.

As far as I know, Wellbutrin was recently approved for weight loss. And there is metformin as well. I know those meds may not help with sedation per se, but they can really help you lose the excess weight in the mean time. That's all I can suggest.

It sounds like you've tried pretty much everything. But exercise helps me stay awake. It gives me an adrenaline boost, which is funny because you'd expect to be tired after working out. But not for me.