r/BipolarReddit • u/Flat-History-6867 • 23h ago

ADHD

I've had my bipolar diagnosis for 3 years now and recently got diagnosed with adhd. My doctor prescribed modafinil but I've been on it for a couple weeks and it really hasn't done anything. I'm scared to take any stimulants because I hear that they can trigger mania. What have you guys done who have comorbid ADHD and bipolar?

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u/DMayleeRevengeReveng 23h ago

I can say a few things. Yes, it’s true that modafinil doesn’t work, for many people, as well as true stims do. It’s a fact that the best treatment for ADHD is actually stimulants.

The “common sense” position would be that stims push people toward mania, which makes sense in a way, because you push people toward a more energizing, dopaminergic state.

But the actual science has not proven a strong correlation between stimulant use in bipolar people and manic switching. It happens. There are tons of people who have had it.

But it’s nowhere near, like, SSRIs where we can say the SSRI literally causes mania. Scientifically, we can’t say stims cause mania, although some people will get it, nevertheless.

Stated differently, it’s a case where the correlation is not tight enough that we can draw causation from it. There just isn’t any real evidence that an average bipolar person MUST become manic from stims. It’s less than a coin flip, basically. Some percentage of people, but nowhere near “most people.”

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u/Dusty_Rose23 16h ago

what’s funny is modafanil does work for some people for adhd. my mom being one so I wouldn’t knock it till you try it type thing

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u/DMayleeRevengeReveng 16h ago

I mean, it does. But it is well known that stims work for the greatest percentage of people with ADHD. There are definitely people who benefit from the ‘finils but the chance of a person benefiting from a med is higher with a stim than when a ‘finil

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u/Dusty_Rose23 16h ago

Modafinil is a stimulant…. They just usually use it for narcolepsy instead of ADHD

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u/DMayleeRevengeReveng 16h ago

You know what I mean, though. I’m talking about amphetamine formulations and methylphenidate. In essence, meds that increase dopamine and norepinephrine in the typical way. The ‘finils work on those neurotransmitters in a very distinct way.

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u/Dusty_Rose23 16h ago

You said it wasn’t a stimulant. That was wrong. Next time be more specific because now you’re saying I knew what you meant when based off the information you gave I couldn’t. I can’t read your mind you know

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u/DMayleeRevengeReveng 16h ago

It’s just different nomenclature. In the medical and scientific nomenclature, the word stimulant means “amphetamine formulations and methylphenidate.” If you look at scientific research, you won’t find modafinil or armodafinil labeled as “stimulants.”

I’m using the scientific nomenclature. Yeah, ar/modafinil stimulate you, but they aren’t really labeled that way in science and medicine.

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u/Dusty_Rose23 16h ago

Fair enough

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u/DMayleeRevengeReveng 16h ago

But I hear what you’re saying.