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Tart Cherry Jam
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Default Jan 29, 2024 at 05:50 PM
  #1
cross-posting in the Bipolar forum

I am now on a stimulant medication for narcolepsy which is more commonly prescribed for ADHD. I do not have ADHD. The medication is producing side effects, and especially triggering hypomania and insomnia. The medication is Dexedrine. There are other stimulants to try.

if I take too little, I still need naps during the day. If I take a full dose, I end up sped up etc.

If you have ADHD comorbid with Bipolar, what is your treatment regimen?

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Confirmed dx: Bipolar I w/psychotic features, since 2009 or earlier
Suspected dx: Narcolepsy type 2, since 2022

Current rx:

Geodon 40 mg (for mood)
Seroquel 75 mg (for sleep)
Gabapentin 1200 mg (against extrapyramidal side effects from the ^)
Dextroamphetamine 5 mg (for narcolepsy)

Past rx:
Way too many to list
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Brentus
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Default Feb 26, 2024 at 04:19 PM
  #2
Hi there @Tart Cherry Jam,
I know this was posted a while back, but I thought I'd try to get a response in for you. I am diagnosed with both ADHD and Bipolar. Stimulant meds can be a bit tricky -- sometimes it's dose related, sometimes it's a need for a different medication. I was wanting to check in and see how you are doing on it? 5mg I think is the lowest dose for Dexedrine(dextroamphetamine), so if you're still having problems with that maybe you could talk to your doctor about maybe trying Adderall (Dextroamphetamine-amphetamine) (a combination drug of dextro- and levo- amphetamine; has a different effect profile than straight dexedrine), or perhaps try Ritalin based drugs (methylphenidate drugs).

In general, amphetamine based stimulants are going to be more potent, and actually create a efflux of dopamine out of the cell. Methylphenidate doesn't cause the efflux of or "rushing out of dopmaine", but does increase it in the synpatic cleft. If your issues are feeling hypomanic and can't sleep-- I'd say you'd be better to try a ritalin based product OR attempt Adderall or even racemic amphetamine (50/50 Dextro- and levo- amphetamine) called Evekeo. Also, I can attest to a lot of the issues with sleep and hypomanic feelings tend to wane with a little time. Has your medicine been working for the narcolepsy well? Are you tolerating it? Have the issues you had subsided?

Anyway, I hope you find this helpful. for ADHD, narcolepsy, and all things stimulant related -- there is are TONS of options out there. Don't get discouraged. It's a trial and error, both dosage and type of med. I hope you find yours soon.



I should mention there are some nacrolepsy specific "wake-inducing agent" meds to try as well.

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Tart Cherry Jam
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Default Feb 26, 2024 at 04:27 PM
  #3
the wake-inducing agents are out of reach for me. My doctor cannot prescribe them: they are available only from special doctors and special pharmacies, not general retail pharmacies. And to get those medications through those specific channels, you have to fill out a questionnaire and mention the medications you are taking. Since I take Seroquel to fall asleep, I would not qualify for wake-inducing agents. They consider combining them with hypnotics too risky.

Thank you greatly for all the info! I will explore!

__________________
Confirmed dx: Bipolar I w/psychotic features, since 2009 or earlier
Suspected dx: Narcolepsy type 2, since 2022

Current rx:

Geodon 40 mg (for mood)
Seroquel 75 mg (for sleep)
Gabapentin 1200 mg (against extrapyramidal side effects from the ^)
Dextroamphetamine 5 mg (for narcolepsy)

Past rx:
Way too many to list
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