Originally Posted by DejaVu

While everyone's different and may find different approaches helpful, it's very wise to start with the safest approach and then work your way through various meds if needed.

Caffeine is one of the safest, as Mark has pointed out.

I have a complicated medical and neurological history, with lots of pre-existing severe fatigue prior to a TBI and whiplash. I had suffered a random assault in (in broad daylight) just over 2 yrs ago now. I have not recovered 100% yet.

I have also suffered moodswings since the assault which maybe the TBI and/or PTSD.
I control those with Depakote 24/7. I cannot be without an anti-epileptic drug (AED) for mood stabilization since the assault. I have used low-dose Depakote (375-500mg/day) for this. (Depakote also helps with my neuromuscular disorder and my headaches, thus it is the AED we'd chosen to use.)


As for stimulants-

I have tried: caffeine, Provigil, Nuvigil, Ritalin and Adderall.
Yet another option I am now trying: Wellbutrin (bupropion)

Some people do really well on one of the above.

I have found my brain function changes and we often must switch/rotate meds/approaches. It's very frustrating, Luckily, my specialists don't find this as frustrating as I find it.

The TBI left me extremely fatigued, with some periods of agitation.
When I am very fatigued for long periods, I can use Adderall at a very low dose, in the immediate release form. At the right time, it can be very helpful to me. If/when I am going through an agitated period, I do not touch Adderall.

Currently, we are trying Wellbutrin (bupropion) as an everyday med.
I have just started bupropion this week, so will see if it's helpful.
(Any stimulants are on hold when trying bupropion as they cannot be safely combined with bupropion.)

If you have medication coverage, most insurers will require a pre-authorization for each Ritalin and Adderall. Most also require a trial with Ritalin before moving to Adderall. These meds are quite expensive in generic form for a monthly supply without coverage.

I hope this info helps.

To Our Healing,
DejaVu