Running out of stimulants to try

[saoirse]

I was diagnosed with idiopathic hypersomnia a long time ago.

Nuvigil was excellent, at first. Used it for 5-6 months no problem. But then I was a bit hypomanic in summer, and I think it might've help tilt me off into a mixed state. Kept on it after that was resolved, but a month later I went manic on prozac, and I cut out all stimulating medications (antidepressants, etc) because I desperately never want to feel anything like that ever again --- bummer, because Nuvigil worked beautifully for a long time. Technically, I am not really sure if the Nuvigil worsened the mania, but now I'm paranoid of it (perhaps unjustly).

A low/moderate dose of Ritalin works nicely, for a few hours, but then I become deathly depressed with an awful tension in my chest for a few hours -- the come down. I can't take that comedown, it's brutal!

SO, long story short,

are there any stimulants or medications used to keep one awake that are smoother than ritalin?

[jt07]

How long have you been taking Ritalin? I'm asking because that come down for me went away after the first month. Now I take Ritalin, and I don't notice when it wears off.

There is also an extended release Ritalin available that is supposed to be smoother.

[notfred]

The amphetamines would be a logical choice, Vyvanse, Adderal, Dexadrine, or dextroamphetamine. Some find them smoother than Ritalin.

nf

[otherwise the curved]

My experience is that Vyvanse is smoother than Adderall, but it comes in capsules, so it's not breakable (which isn't the best for me). My doctor says Vyvanse tends to be less harsh than Ritalin, but I've never tried the latter. Nuvigil did not work on me, for the record.

Either way, it sounds like you have some options that might be worth exploring.

otc

[Anna]

You might try provigil instead of nuvigil, some people say they find it less activating (but still activating). There's also adderall to try, if you haven't. But to be honest, I don't see why nuvigil would be any more likely to send you into a mania than the stims, I always found provigil and the stims to be pretty equivalent, honestly. I'd consider maybe a retrial of what worked for you.

Anna

[Cetkat]

I was diagnosed with idiopathic hypersomnia a long time ago.

Nuvigil was excellent, at first. Used it for 5-6 months no problem. But then I was a bit hypomanic in summer, and I think it might've help tilt me off into a mixed state. Kept on it after that was resolved, but a month later I went manic on prozac, and I cut out all stimulating medications (antidepressants, etc) because I desperately never want to feel anything like that ever again --- bummer, because Nuvigil worked beautifully for a long time. Technically, I am not really sure if the Nuvigil worsened the mania, but now I'm paranoid of it (perhaps unjustly).

Anna's suggestion of the Provigil is a good one. It's tolerated better than Nuvigil by many. Also, if you find the med that effective.. there are things like Lithium you can take to stop any hypo/manic symptoms in their tracks.

A low/moderate dose of Ritalin works nicely, for a few hours, but then I become deathly depressed with an awful tension in my chest for a few hours -- the come down. I can't take that comedown, it's brutal!

are there any stimulants or medications used to keep one awake that are smoother than ritalin?

Ritalin is in a stim family separate from Adderall. There are longer acting ritalin meds (Concerta/Metadate CD). With Adderall, it'd be Adderall XR and Vyvanse. It's an individual thing.. but the longer-acting ones are usually less harsh.

[SashaSue]

I think provigil and nuvigil are usually less likely to mess with mood than the stims. If you only became manic on both the nuvigil and prozac, I'd suggest trying it again on its own. Or maybe give provigil a try. I think it maybe tends to be a bit less stimulating.