“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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Links to This Article
Provigil for Bipolar Depression by Health Tips (9/27/2007)
10 Comments to
“Provigil for Bipolar Depression”
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.
I went off medication about 3 years ago for Bipolar II after severe head trauma and have had relatively few problems. I have ADD bad and wanted something to help me concentrate that was not going to send me into mania. I have been on the Provigil now for about a year and actually found that it helped stabilize my mood by itself. I am now at the point where I am going to be adding lamictal for a little more stabilization but I would recommend this drug to anyone suffering from Bipolar
I take provigil as an adjunct therapy to my mood-stabilizer and anti-depressant… it works great for me… I am an ultridian bi-polar patient.
I am 18 years old i was diagnosed with Bipolar II at the age of 6. I went through 7 to 8 diffrent kinds of medication and was always still having extreme mood swings. When i turned 16 my freshman year of high school i stopped taking ym medication all together i went into a down spiral i ended up going to jail for extremely violent behavior my sophmore year. After i got out of jail i started back up on my medication and had a hard time waking up ( Seroquel and Depakote) i was so tired i just couldnt get up on time for school. My doctor put me on Provigil and i am now awake my mood is completley stable all the time and i havn’t got into any trouble. I wake up easier i have more energy and feel great! It did amazign thigns for me. however be careful and do not overlap doeses it will put your body systems in overdrive and make you feel like you have stayed awake all night and make crash.
- Ryan S. 18.
Doris asked what is NORD. It is ‘National Organization for Rare Disorders.” One of my friends gets her provigil payed for through NORD.
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Last reviewed: By John M. Grohol, Psy.D. on 25 Sep 2007
