[Tart Cherry Jam]

I am now on a stimulant medication for narcolepsy which is more commonly prescribed for ADHD. It 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?

[MuddyBoots]

(Turns out I don't have ADHD it's all dissociation/CPTSD related, buuuuut...)

If you have bipolar or are prone to psychosis or addiction and need ADHD treatment there are non-stimulant options like Strattera (which can still cause hypo/mania but not as likely as stimulants), guanfacine, and clonidine (both of which would not be helpful for you as they cause sleepiness). I had a short trial with clonidine, but that was for insomnia and that was over 10 years ago. Every stimulant comes with greater risk of speeding you up and are straight up not recommended for comorbid bipolar/ADHD.

Not sure what would be best for (your suspected) narcolepsy though. I know that's generally treated with stimulants, so I guess if you have BP and narcolepsy--like with seemingly everything--it's a trial and error thing. Maybe you'll have better tolerance with a lower dose or methylphenidate?

[Tart Cherry Jam]

Clonidone I tried for insomnia. It did not help plus it can lower blood pressure and mine is already on the low side.

I can develop psychosis but am not prone to addictions.

I will check if Strattera can help with wakefulness and will try the last drug you mentioned, maybe starting with half the lowest dose.

[MuddyBoots]

There's a few different forms of methylphenidate, the only two that I know of off the top of my head are Ritalin and Concerta, but there might be more I don't know of.

[Tart Cherry Jam]

Strattera is indicated for narcolepsy. It is an SNRI so I would run the risk of mania on it. I developed mania on low doses of Elavil, an old tricyclic AD. But it is worth trying. As you said, trial and error is my only way.