I'm so sorry you are here, this sounds really scary. I don't know if a psychiatric diagnosis can be made until she's off the Nuvigil. Psychosis is listed as a possible side effect.
This could be: 1) Direct drug reaction to Nuvigil 2) Triggering of bipolar mania by the Nuvigil (provigil has some antidepressant effects in bipolar depression, and anything that treats bipolar depression risks triggering mania). 3) She could have some other physiological cause of psychosis (hyperthyroidism comes to mind).
Prior to the events of the last couple years, did she have any symptoms suspicious for bipolar disorder? Depressive episodes, hypomania ( people who are hypomanic can appear just very energetic and effective).
Is there a family history of thyroid disease or other autoimmune diseases? Family history of bipolar or schizophrenia?
Did she have any history of recreational drug use/abuse?
Unfortunately, you don't have a lot of power in this situation, especially since it has been couched in terms of her "following her dream". (Be prepared, also, for the possibility that some of her staying up all night was to carry on an affair online or otherwise).
My advice: Make sure her doctors understand that this behavior coincided with taking the narcolepsy drugs and that they are not refilling them. (She can probably still get them elsewhere but there's a chance that if she goes a few days without she might calm down).
Protect yourself financially - NOW. Close or take her off any joint accounts, credit cards etc. put your half of money away in an acciount that's only in your name. Consult an attorney on how best to protect yourself financially.
Also find out your options in terms of getting her admitted on a psych hold if she escalates. It's not easy and unfortunately it's nearly impossible to get even a three day hold, which may not be nearly long enough to initiate treatment, but it's an option you and her family should familiarize yourselves with now in case it becomes necessary.
The hardest part is that you may not have any control in this situation. As long as she sees you as the enemy, it may fall on her family to get her help when the time comes. Still, consult with a lawyer about what might be needed to get a conservatorship over her (she'd probably have to get a lot worse first).
Take care of yourself in the meantime. Stay in the apartment if you can since she's traveling anyway. Spend time with friends. Exercise. Eat healthy. Pay attention at your job. YOU need to be whole and intact if she comes down from this mania.
