instruction: hello doctor I have taken fluoxetine 80 my for refractory ocd for about six years now obsessions are 90 percent controlled so I am not currently taking it now but sometimes I have mood fluctuations also so currently I have started aripiprazole 20 my the problem is that I feel sleepy in the day my friends say that I am not alert I am preparing for pig exam what should I do now can I take modafinil to increase my alertness and cognition I want to increase my performance also please help
output: hi I read your query and understood your concerns first of all why have you stopped fluoxetine who advised that were you seeing a psychiatrist who has advised aripiprazole do you have any improvement in your mood fluctuations from it aripiprazole as such does not cause sedation and excessive sleep it is usually an activating drug are you taking any other drug or benzodiazepine to increase alertness one can take modafinil but daily intake is not recommended it can be used on as and when required basis nowadays lots of students do this and take for a long time but as a doctor I would not recommend that instead you can have activating antidepressant like bupropion which also increases concentration another option is atomoxetine revert with answers