Posted by Tony P on September 27, 2008, at 23:07:01
In reply to mania, posted by sam K on September 25, 2008, at 15:35:40
Provigil can both cause overstimulation and/or trigger a manic/hypomanic episode.
In my experience, it can certainly tip me over into hypomania, which is just a milder form -- sub-clinical, you might say. There's still some controversy, I believe, but Bipolar III has been proposed as a diagnosis for people who are depressed and experience manic (or hypo-manic) episodes only when they take antidepressant or stimulating meds (of which I would consider Provigil to be one). So there seems to be a clearly definable class of us who react this way.
On the other hand, a large dose of Provigil (depending on how sensitive you are to it) will certainly make you overstimulated, pretty similar to too much caffeine. How much Provigil did you take? E.g. 200 mg is quite a lot if you're not accustomed to it.
As med_empowered says, what you're experiencing sounds more like drug-induced overstimulation than mania, although I sometimes find it hard to tell the two apart myself, from the inside, so to speak. But Provigil can produce either or both of these effects, depending on the individual, what else you're taking, etc.
One way to distinguish mania from overstimulation (although there are some uncommon mixed states to confuse the issue) is that on the whole mania feels g-o-o-d. If I'm manic, I may be behaving irrationally, (as others will notice), babbling nonsense, going on shopping sprees, working for hours on something completely unimportant, but I _feel_ calm, in control, creative and expansive.
If I'm overstimulated on the other hand I feel anxious, irritable, I have racing thoughts and a feeling that I am NOT OK. Also, overstimulation gives me insomnia which I _experience_ as MISSING needed sleep, whereas hypomania causes me to sleep less and feel just fine -- a subtle but very real distinction.
Med_empowered also mentioned that you've had a tentative schizophrenia diagnosis? Are you taking any neuroleptics (major tranqs, anti-psychotics or whatever) for that? If so, does it help with the reaction to the Provigil? I find Seroquel will bring me down very quickly from a hypo-manic episode, but if instead I'm anxious or overstimulated it just makes me feel overstimulated AND sleepy (not very nice, but it does draw a distinction between the two states).
The Lamictal may also be a factor. How long have you been taking it, and what dose are you at? Despite its being generally slightly sedating, I found myself a few years ago when I was titrating up the dose of Lamictal that at about 100 mg/day I suddenly experienced quite severe general anxiety, that lasted for several weeks. I have read other people on Lamictal describe a similar experience.
Do post again and tell us how you are doing.
Tony P
poster:Tony P
thread:854050
URL: http://www.dr-bob.org/babble/20080926/msgs/854534.html