Introduction to Supportive Psychotherapy

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Sir: When used concomitantly, medications having the potential to cause sedation may produce additive sedative effects. Certainly this may have occurred in our patients² as a result of divalproex administration. Importantly, however, at the time of modafinil initiation our patients were stable and sedation was their primary complaint. Thus, regardless of serum levels, it would not have been prudent to decrease the dosage of divalproex in order to minimize the existing sedation at the risk of symptom decompensation.