Bipolar Disorder (Manic Depression)

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Provigil for Bipolar Depression

by John M. Grohol, Psy.D.
September 25, 2007

“Bipolar depression” refers to someone who has been diagnosed with bipolar disorder, but is the midst of a depressive episode (one-half of what defines bipolar disorder). While a type of medication call a mood stabilizer helps people when they are feeling manic, antidepressants — the typical treatment for depression — don’t seem to work as well in people with bipolar disorder (Sachs 2007).

So a bunch of researchers conducted a study last month to evaluate the efficacy and safety of adding the drug modafinil (Provigil) to the treatment of people with bipolar depression, which is often characterized by excessive sleepiness and fatigue. (Which at least partially answers my question yesterday of where off-label prescribing comes from.)

Modafinil (Provigil) is in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the area of the brain that controls sleep and wakefulness. Modafinil is FDA-approved to treat excessive sleepiness caused by narcolepsy or shift work sleep disorder.

Although the study was short — only 6 weeks — it found significant improvements in both response and remission rates for the group that took the Provigil as opposed to the placebo control group.

The researchers conclude that “adjunctive modafinil at doses of 100-200 mg a day may improve depressive symptoms in patients with bipolar disorder.”

Something to consider if you’re battling with bipolar depression.

A placebo-controlled evaluation of adjunctive moda…[Am J Psychiatry. 2007] - PubMed Result

References:

Frye, MA et al. (2007). A placebo-controlled evaluation of adjunctive modafinil in the treatment of bipolar depression. Am J Psychiatry, 164(8):1242-9.

Sachs GS et al. (2007). Effectiveness of adjunctive antidepressant treatment for bipolar depression. New England Journal of Medicine, Mar 28.

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This entry was posted on Tuesday, September 25th, 2007 at 12:35 pm and is filed under General, Medications, Brain and Behavior, Disorders, Depression, Bipolar, Treatment. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

7 Responses to “Provigil for Bipolar Depression” (Pingbacks/trackbacks not shown below)

My son, 12.11 years old, has bipolar with comorbid ADHD. He had attemtped to use all the known ADHD meds but the stimulant would always drive the mood disorder way up and out of balance. Our doctor, Dr. V, tried provigal to capture the ADHD without driving the mood disorder. So far, over 8 months, it has worked GREAT!

C. Sargeant

Bipolar research is in the baby stages for infants in 2007. This article is verygood.

I’ve been on Provigil (have bipolar 1) for about 8 years now. I can’t imagine functioning without it. Also taking Abilify, Lamictal, Concerta, Trazodone, klonopin–somehow all these in concert with each other have produced good results.

I have been diagnosed with bi-polar disorder over 10 years. Five years ago during a hospital visit, my Dr. put me on Provigil. It has been the one drug besides Seroquel that has helped me. Thank God for NORD who obtains this for me. I also don’t know how I would manage without it. If I had to make a choice between food and provigil I would eat beans and weenies just to have the Provigil. I also take Zoloft, klonopin,and Seroquel. I would like to know more about abilify.

Gail Anne said, Thank God for NORD what is that?

My father has bipolar disorder and his Dr. prescribed provigil. He started acting very strangely and my family and I thought he was on drugs. Turns out it had a reverse reaction on him, and it almost broke our family apart. I have been doing research online and it appears that it can be bad for people with bipolar disorder! Please be careful.

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Last reviewed:
  On September 25, 2007
  By John M. Grohol, Psy.D.



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