Even then, blood tests may not show anything because many changes in gland function are not reflected in the blood. When the episodes were spaced far apart, testing a medication took many months. In my own case, tests have showed high levels of Vitamin D 1-25, iron, and parathyroid, and low levels of leptin and testosterone. Testosterone levels increased slightly after episode. Reactions to medications showed - Increasing serotonin imitated the episode.
Depressants act as stimulants during episodes.
Provigil helps a lot. It has allowed me to function this past year. Radical changes in testosterone level production, seems to be one of the main factors. I suspect that my testosterone levels don't regulate properly and my body produces extra vitamin D, parathyroid, and iron to compensate. When a critical low level is reached, my glands over-react by producing excessive amounts of testosterone, which causes the acne.