Modafinil Treatment of Excessive Daytime Sedation and Fatigue Associated With Topiramate

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Sir: Over the past several years, the amount of research inthe use of newer anticonvulsants in the treatment of bipolardisorder has increased.¹ Topiramate is one of those newer anticonvulsants,described in 1998 by Marcotte,² in the treatment ofbipolar disorder. Vieta et al.³ indicate that adjunctive topiramatemay be useful in the long-term treatment of bipolar spectrumdisorders in the most difficult-to-treat patients. Most adverseeffects of topiramate are related to the central nervous systemand include sedation and fatigue.⁴