Modafinil-Induced Psychosis: A Case Report

Aytaş, Özgür; Yalvaç, Hayriye Dilek

doi:10.5152/npa.2015.7160

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…More studies are needed to highlight their specific effect on behavioral pathways and how their preferential activation of specific brain areas may influence the behavioral response. Similarly, it has to be carefully considered that such drugs may expose patients to a small risk of psychosis and mania [70, 80–82].…”

Section: Resultsmentioning

confidence: 99%

Modafinil in the rehabilitation of a patient with post-surgical posterior fossa syndrome: a lesson to be learned?

et al. 2019

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Disorders of the cerebellum may present with motor, cognitive, behavioral and affective symptoms. There is a growing interest in developing neuroanatomical models of symptoms generation that involve the cerebellum and the cerebello-cortical connections. We describe an exciting first case report of successful use of Modafinil in an adult patient with post-operative posterior fossa syndrome. Following resection of a melanoma metastasis in the cerebellum the patient developed striking affective and behavioral symptoms in the form of withdrawn flat mood and disengagement. This neurobehavioral presentation severely impacted on his quality of life, independence, and ability to engage in the neuro-rehabilitative program. Pharmacological treatment with Modafinil ameliorated these emotional and behavioral aspects, and also fatigue. Treatment with Modafinil hence affected recovery and outcome for the patient. To our knowledge, this is the first description of a successful pharmacological intervention in an adult with post-surgical posterior fossa syndrome and negative neurobehavioral presentation. Our findings illustrate the variability of the presentation of post-operative posterior fossa syndrome in adults, and the importance of delivering targeted treatment to maximize the benefits of neurorehabilitation. The manuscript highlights the following points: 1. post-operative consequences currently under the wide umbrella of posterior fossa syndrome, can indeed manifest in adults; 2. a wide spectrum of neurobehavioral symptoms can occur, including a presentation with predominantly negative features; 3. the type of neurobehavioral presentation should guide the treatment choice with particular consideration of drugs that potentially modulate the cerebello-frontal connections; 4. Modafinil can be a candidate for effective treatment in presentations with predominantly negative behavioral symptoms.

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Section: Resultsmentioning

confidence: 99%

Modafinil in the rehabilitation of a patient with post-surgical posterior fossa syndrome: a lesson to be learned?

et al. 2019

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“…We found two case reports in the literature worth mentioning. One is the case of a patient taking only 100 mg of modafinil who developed psychosis, without psychiatric history 26. The second is a patient with history of psychosis whose symptoms recurred when modafinil 200 mg was added to quetiapine 600 mg 27.…”

Section: Discussionmentioning

confidence: 99%

Modafinil in schizophrenia: is the risk worth taking?

Neto¹,

Spínola

Gago

2017

BMJ Case Reports

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Schizophrenia is a severe mental disorder characterised by positive and negative symptoms. Negative symptoms are difficult to treat and there is no specific treatment. In small trials, modafinil has been studied in association with antipsychotic treatment. We present three cases of its use; two have developed positive symptoms and one developed renal impairment. Further studies are needed to assess its usefulness in schizophrenia and safety in this group of patients.

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“…However, in a recent study, modafinil-induced psychosis was identified in only a few case reports (58,59).…”

Section: Pharmacotherapy and Psychotic Disorder In Narcoleptic Patientsmentioning

confidence: 95%

Comorbidity of Narcolepsy and Psychotic Disorders: A Nationwide Population-Based Study in Taiwan

et al. 2020

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Background: Narcolepsy is a chronic sleep disorder that is likely to have neuropsychiatric comorbidities. Psychotic disorders are characterized by delusion, hallucination, and reality impairments. This study investigates the relationship between narcolepsy and psychotic disorders. Design and Methods: This study involves patients who were diagnosed with narcolepsy between January 2002 and December 2011 (n = 258) and age-and gender-matched controls (n = 2580) from Taiwan's National Health Insurance database. Both the patients and the controls were monitored from January 1, 2002 to December 31, 2011 to identify any occurrence of a psychotic disorder. Drugs that have been approved for treating narcolepsy: immediate-release methylphenidate (IR-MPH), osmotic controlled-release formulations of methylphenidate (OROS-MPH), and modafinil, were analyzed. A multivariate logistic regression model was used to evaluate the potential comorbidity of narcolepsy with psychotic disorders. Results: During the study period, 8.1% of the narcoleptic patients exhibited comorbidity with a psychotic disorder, whereas only 1.5% of the control subjects (1.5%) had psychotic disorders (aOR, 4.07; 95% CI, 2.21-7.47). Of the narcolepsy patients, 41.5, 5.4, and 13.2% were treated with MPH-IR, MPH-OROS, and modafinil, accordingly. Pharmacotherapy for narcolepsy did not significantly affect the risk of exhibiting a psychotic disorder. Conclusions: This nationwide study revealed that narcolepsy and psychotic disorders commonly co-occur. Pharmacotherapy for narcolepsy was not associated with the risk of psychotic disorders. Our findings serve as a reminder that clinicians must consider the comorbidity of narcolepsy and psychosis.

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Modafinil-Induced Psychosis: A Case Report

Cited by 10 publications

References 16 publications

Modafinil in the rehabilitation of a patient with post-surgical posterior fossa syndrome: a lesson to be learned?

Modafinil in the rehabilitation of a patient with post-surgical posterior fossa syndrome: a lesson to be learned?

Modafinil in schizophrenia: is the risk worth taking?

Comorbidity of Narcolepsy and Psychotic Disorders: A Nationwide Population-Based Study in Taiwan

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