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Suggest treatment for cognitive decline after taking Adrafinil to treat post-stroke fatigue

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Neurologist, Surgical
Practicing since : 2004
Answered : 2885 Questions
Hi, I am 37 years old and had a stroke in January of this year, SAH right frontal intracerebral hematoma effecting the Frontal, temporal and perinatal lobes. I refused medications such as baclofen while in hospital, after leaving hospital I asked my neurologist about modafinil for post-stroke fatigue, his reply was that they do not treat post-stroke fatigue, after some research I found out about Adrfinil and ordered some online. It worked wonders. Though i have started having seizures and was prescribed lamotragine and told to stop the Adrafinil. After two weeks of this I feel as though I am loosing my mind in cognitive decline. I am really unsure as what to do now.
Mon, 5 Mar 2018 in Brain and Spine
Answered by Dr. Erion Spaho 48 hours later
Brief Answer:
Treatment should be continued.

Detailed Answer:
Hello and thanks for using

I have read your question and understand your concerns.

The stroke itself, seizures and lamotrigine use may contribute to cognitive decline.

Drugs such modafinil, armodafinil may stimulate the brain function but don't fight the cause of the fatigue.

Nootropic drugs such piracetam and vitamins B group may be used in cases like yours.

If seizures are confirmed then antiepileptic drugs such levetiracetam, oxcarbazepine may be useful in controlling them.

If you suffer from spasticity, I think low doses of baclofen and physical therapy may be useful.

Discuss with your Neurologist about these issues.

Hope this helps.

Feel free to ask if you have any other questions or clarifications.

Take care.
Above answer was peer-reviewed by
Follow-up: Suggest treatment for cognitive decline after taking Adrafinil to treat post-stroke fatigue 6 hours later
Hello Erion. Thank you very much. Could you also tell me what you think of THC/CBD, Semax and Ceribrolysin in my situation.
Also, what treatment should be continued? I have started taking Huperzine A, using breathing techniques and hypnosis. Thanks again
Answered by Dr. Erion Spaho 11 hours later
Brief Answer:
Explained below.

Detailed Answer:
Welcome back.

THC/CBD use may promote good sleep and may reduce the spasticity.

All other drugs that you mentioned are mostly nootropic drugs (Semax, Huperzine A, and partly Cerebrolysin), I think you should use only one of them and Huperzine A is okay.

There are not sufficient data from studies to prove their efficacy, but it is generally accepted that their use may result in some benefits regarding cognitive functions.

I think behavioral therapy may be more appropriate than hypnosis.

Hope you found the answer helpful.

Kind regards.

Above answer was peer-reviewed by
Follow-up: Suggest treatment for cognitive decline after taking Adrafinil to treat post-stroke fatigue 2 days later
I feel like lamotragine is turning me into a potato... what do you think of Phenylpiracetam in my situation, is it enough of an anticonvulsant to replace lamotragine or could I use it as an add on treatment?
I'm also interested in what you think about modafinil raising seizure threshold?
Thank you
Answered by Dr. Erion Spaho 17 hours later
Brief Answer:
Phenotropil use may be beneficial in your case.

Detailed Answer:
Welcome back and thanks for being on follow up.

Phenylpiracetam is a drug that is mainly used to improve cognitive functions, it's said that it may have anti-convulsive effects too, but is not sufficient to control seizures alone.

Other possibilities should be considered to control seizures.

Phenotropil according to the article you refer , is found to be beneficial in post stroke functioning recovery, so, it remains a good possibility in your case.

About the Modafinil, the study you refer is done on mice, other randomized controlled trials are necessary to assess properly the effects of the Modafinil on seizures threshold and concentrations of anticonvulsants in brain.

Hope this helps.

Kind regards .

Above answer was peer-reviewed by
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