Modafinil
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Modafinil Neurocognitive changes: case report A 33-year-old man, with a 13-year history of aggressive obsessions, excessive daytime sleepiness (EDS), low mood and panic anxiety, started modafinil 100 mg/day [route not stated] for treatment-resistant obsessive-compulsive disorder and EDS. He was concomitantly receiving escitalopram. His modafinil dose was increased to 200mg, in two divided doses, 3 weeks later. After 4 weeks of modafinil therapy, his EDS had marginally improved. However, the scores from clinical rating scales for depression and illness severity were unchanged, while the score for anxiety had worsened. Thereafter, his modafinil dose was increased to 400mg, in two divided doses, and 1 day later he reported feeling irritable, agitated and paranoid. Modafinil was discontinued. [Patient outcome not stated.] Author comment: "Our patient was taking a stable, high dose of SSRI. Co-administration of modafinil did not improve depressive ratings and was found to worsen anxiety, paranoia, and irritability." Dittrich WH, et al. Clinical and neurocognitive changes with modafinil in obsessive-compulsive disorder: A case report. Psychopharmacology 212: 449-451, No. 3, Oct 2010. Available from: URL: http://dx.doi.org/10.1007/ 803046793 s00213-010-1958-9 - Germany
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Reactions 22 Jan 2011 No. 1335
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