Yup. My Dx stays in that range as well, with alternative diagnoses of Personality Change Due to (underlying medical condition: CRPS) (DSM iv 310.10) and Mood Disorder Due to Underlying . . . (296.83).

The best I can do to maintain alertness is a combination of the following:

Namenda (memantine HCL) (10 mg.) [3/day]
Razadyne (galantamine HBr) (16 mg) [1/day]
Provigil (200 mg) [3/day]
Wellbutrin SR (100 mg.) [2/day]

That said, I've been on Namenda and Razadyne - two drugs commonly taken to slow the spread of Alzheimer's disease - for years. I don't know if they did anything to slow the onset of the fog, which rolled perhaps 2 years ago, but haven't done anything to mitigate it since.

Most impotantly, when all I had was ADHD, a slightly smaller dose of Wellbutrin was sufficient to totally compensate for it, for about a month, and then I developed extreme out of the blue anxiety - enough to leave me close to cowering under my office desk - until 6 weeks of Clonazepam brought me back to normal. But now the Wellbutrin neither appears to (significantly) cut the fog, although with the Xanax I take to control shhoting pains, along with a small amount of Clonazepam for opioid induced aggitation (as the levels in my ststem go down), Wellbutrin at least is no longer bringing on anxiety.

But the lack of effectiveness of Wellbutrin now, as opposed to when there was only ADHD(I) to deal with, that is the most telling, at least with regard to the loss of executory function, e.g., organization.

And while Provigil works well for me in staying awake through Baclofen and opiods - as opposed to the newer Nuvigil that kicked my BP up by 40 pts. on both ends - it doesn't appear to do anything for either executory dysfunction or memory issues.

This is about what I know, hope it's useful.

Mike