“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.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

    Last reviewed: By John M. Grohol, Psy.D. on 25 Sep 2007
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