[somebodynew]

I omitted the Xanax entirely from my previous post because the polypharmacy here is such a mess, but I agree that it probably factors into disinhibition. I don't personally attribute much relevance to modafinil in this instance; while the wakefulness effects are often described mechanistically through dopamine, I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil.

My only experience with pramipexole and cabergoline are for low dose off-label use in persistent sexual dysfunction after the discontinuation of SSRI medication. The biggest difference I have seen between them is a much higher rate of discontinuation due to side effects (extreme tiredness) for pramipexole.

[samatman]

Modafinil is disruptive to the circadian rhythm, which can exacerbate mania. It won't push dopamine on its own but in combination I'm sure it contributed, especially if, as is common with mania (which this article clearly describes without naming it, which is shameful frankly), she started taking her meds whenever she felt like it, instead of on a schedule.

[runnerup]

Modafinil felt far more mild than amphetamine, methylphenidate, or cocaine for me. However, it uniquely (and dramatically) impaired my inhibition for libido compared to the others.

It was a very narrow side effect but also particularly destructive. It was very hard to tell it was the modafinil because it was so mild otherwise, just seemed to “front-load” all my energy and focus for the day into the first six hours of my work day, which worked quite well, and then left me feeling rather normal for the rest of the day (difficulty committing to tasks after it wore off but that is typical after a 6 hour of solid focused work).

I just had extra motivation and capability to flirt with coworkers and strangers and visiting sundry places. I was well-received, but it wasn’t the life choices I would have wanted to make and the workplace romance was self-destructive.

Amphetamine might make me masturbate more but only modafinil caused an impulse to flirt, court, and follow through.

[astrange]

> I have never seen anyone experience any traditional stimulant or dopamine agonist effects from modafinil.

What do you mean by traditional stimulant effects? I mean, modafinil is definitely stimulating, even if Wikipedia says it's an "eugeroic". Combines with caffeine pretty badly.

[somebodynew]

I meant "stimulant" in the context of traditional dopamine reuptake inhibitors and releasing agents like amphetamine and ritalin which are almost incomparable to less controlled or uncontrolled compounds like modafinil, ephedrine, and caffeine. Even a high dose of caffeine will not produce effects anything like amphetamine. The mechanism of action between amphetamine and caffeine are fundamentally different rather than being a matter of strength. It's unfortunate and misleading that the word stimulant is used for both categories.

[astrange]

Modafinil is a dopamine reuptake inhibitor though, it's just an atypical one. I can't take especially high therapeutic doses of either it or Vyvanse without getting similar physical anxiety.

I assume the reason it's not highly controlled in the US is that it's atypical enough to not be addictive (not that I've ever found Vyvanse to be addictive), but it is controlled in Japan and Russia and it's definitely possible to abuse it. People need their sleep even if it can keep it away for a day.

[tbalsam]

Interesting. One minor note is Moda a DRI too, albeit a weak one.