Bw44 and Modafinil Options

[PittedPanda]

Hello! First post!

Background:

I have been Dx as adult ADHD-PI. It interferes greatly with school, work, and relationships. I have been taking ~2g Omega-3 in the form of Fish Oils and exercising daily for the past 2-3 years with great success. In comparison to every other treatment I've tried (which is pretty much all besides desoxyn), Fish Oils and exercise are the best. Unfortunately, I slipped on the ice this winter and herniated a disc and have not been able to exercise and thus my ADHD symptomatology is back.

I study Neuroscience and Pharmacology; this is a very demanding program. ADHD in my final semester has led me to look at other interventions. Oxiracetam was interesting but expensive and Aniracetam makes me damn near narcoleptic.

Through Serendipity I have run into unlimited amounts of free Modafinil. Nice!

Worry about possible (although exceedingly rare) Stevens-Johnson Syndrom/TEN, as well as studying pharmaco-genetics this semester has led me to research the topic.

Findings:

The most concise and relevant study is a 1987 study on the role various HLA serotypes play in the occurrence of SJS/TEN in Caucasians (I am white). I've attached it so those of you without access can still read it.

The main finding is that B12 is a strong risk factor for sulfinamide induced SJS. Note that Bw44 is a sub-type/split-variant of B12 and they are close to interchangeable in this context. Also, note that Modafinil is a sulfinamide and modafinil induced SJS is most likely due to this property.

I should note that I had a adverse drug reaction in the form of a rash in response to IV ancef, a sufinamide antibiotic.

I have been communicating with the Oxford HLA*IMPutation project and have just recieved my results for HLA-B serotype. They imputed that I am N1 HLA-B*4402 and N2 HLA-B*0801 with greater than 99.9% confidence.

Issue:

I have taken Modafinil three times now and once again this morning, right before I received my results. I am predicted by SNP to be a responder for ADHD symptoms (Val158Met). I do indeed benefit greatly from the drug. However, I feel my breathing is slightly off, a side-effect I've never had before. However, I'm not worried about that as it is a listed side-effect. I have a small itch when I take it all over my body. This is the same as the itch I get when I was previously prescribed either amphetamine or codeine, for ADHD and pain respectively.

How do I weigh this information? I am a student in Quebec and thus it is impossible to see a doctor. My waiting list to see my old ADHD psychiatrist is about two more months!

Is there actual risk in taking Modafinil? Especially since I have the Bw44 HLA-B serotype which is a risk factor for sulfinamide induced SJS? Is being slightly itchy pro-dromal for SJS? It is not as far as I have read.

I would appreciate the input of members on this board familiar with these topics or with personal experience.

Sincerely,
PittedPanda