Further there have been reports of modafinil induced psychosis in patients with schizophrenia, Dementia with Lewy Bodies, and in patients with excessive daytime sleepiness and difficulty concentrating [ 14 — 18 ]. We report a case of rapid modafinil induced psychosis at a low dosage in a patient with bipolar 1 disorder with severe depression and hypersomnia. This patient was a year-old currently employed male with a diagnosis of bipolar 1 disorder who was admitted to our inpatient psychiatric unit for treatment of severe bipolar 1 depression.
About Can Provigil Cause Mania months prior to this admission for depression, he had been involuntarily hospitalized at another facility for mania.
Standard laboratory measures, which were within normal limits, and a urine toxicology screen, which was negative, were obtained prior to admission. During the initial days on our service, the patient endorsed depressed Can Provigil Cause Mania and low energy.
He had profound hypersomnia and slept through the night and much of the day. He rarely would attend group therapy or socialize with staff or other patients. The patient was started on modafinil mg daily with plans to use short term to help combat hypersomnia. Psychiatric medications at the time included divalproex 2, mg QHS, quetiapine mg QHS, and venlafaxine mg once daily.
Venlafaxine had been increased to mg several weeks prior to initiation of modafinil. There were no other changes made to his medication regimen at this time. Two days following the initiation of modafinil the patient begins to demonstrate symptoms of psychosis. The following day the patient demonstrated more psychotic behaviors including waking his roommate up in the middle of the go here to accuse his roommate of abusing his daughter and later accusing the treatment team of including him in experimental research.
Following these psychotic events, the modafinil was discontinued and the psychotic features subsided within the following days.
To our knowledge this is the only case report of Can Provigil Cause Mania induced psychosis in a patient with bipolar depression taking both mood stabilizers and antipsychotics.
Provigil: Side effects, dosage, uses, and more
Although the time course of initiation of modafinil correlates with the onset of psychosis, it is possible that the combination of both modafinil and venlafaxine could have induced psychosis due to synergistic effects and clinicians should be aware of this potential interaction. Secondly, it is important to note that hypersomnia is an atypical feature Can Provigil Cause Mania bipolar depression and it is possible that this clinical subgroup of patients is more vulnerable to modafinil induced psychosis than patients without atypical features.
The mechanism of action of modafinil, in addition to its potential mechanism of inducing psychosis, is unknown.
It has been proposed that modafinil may inhibit the release of y-aminobutyric acid GABA resulting in a loss of see more of the excitatory cholinergic and glutaminergic pathways resulting in psychosis [ 1920 ].
Can Provigil Cause Mania has also been proposed that modafinil increases dopamine levels via inhibition of GABA release and via weak inhibition of dopamine reuptake thereby Provigill psychosis [ 1320 ]. More research needs to be conducted regarding the mechanisms of action of modafinil and its potential to induce psychosis. DiSciullo et al. This is an open access article distributed under the Creative Commons Attribution LicenseProviigl permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors. Read the winning articles. Journal overview. Special Issues. DiSciullo1 Clayton D. English, 1,2 and William T. Academic Editor: Lut Tamam.
Received 30 Aug Accepted 02 Oct Published 17 Oct Abstract Modafinil has been used as an adjunctive medication in the treatment of bipolar Can Provigil Cause Mania depression with reported success.
Introduction Modafinil is typically used to induce wakefulness in the treatment of narcolepsy and obstructive sleep apnea [ 1 — 3 ]. Case Report This patient was a year-old currently employed male with a diagnosis of bipolar 1 disorder who was admitted to our inpatient psychiatric unit for treatment of Prvigil bipolar 1 depression.
Adjunctive use of modafinil in bipolar patients: just another stimulant or not?
Discussion To Czuse knowledge this is the only case report of modafinil induced psychosis in a patient with bipolar depression taking both mood stabilizers and antipsychotics. Conflicts of Interest The authors declare that they have no conflicts of interest.
Pack, J. Black, J. Schwartz, and J. Calabrese, M. Frye, R. Yang, and T. Frye, H. Grunze, T. Suppes Can Provigil Cause Mania al.
In his biochemical tests, there a slightly elevated uric acid level but nothing else is other than normal. Csuse affect is euthymic, sleeps well, speech speed normal, aggressive behavior resolved. His follow-ups are Manja. In literature, modafinil is used as additive drug for resistant major depression, bipolar depression episodes.
In this case, modafinil was added to treatment because of Can Provigil Cause Mania and distraction. In this case, there is no other first axis diagnosis too.
In a research with bipolar disorder patients, who is on remission with hypersomnia, it was shown that modafinil was efficacious on patients with not manifested depressions.
The paper says that modafinil was more tolerable and less episodic than the other stimulants. There are case reports, which describes psychosis, manic shifts induced by modafinil too. In this case, it is remarkable that, even with valproate treatment, on a remission bipolar disorder patient, modafinil can induce manic shift.
This case report Can Provigil Cause Mania to get attention to modafinil treatment follow-ups, especially for manic shifts. Home Modafinil associated mania: a Modafinil associated mania: a Provigll report. Keywords : modafinilmaniashift.
Case reports have been published demonstrating modafinil induced mania in bipolar patients and modafinil induced psychosis in schizophrenic. It is plausible that modafinil, via its inhibition of. GABA secretion, can exacerbate or induce psychosis or mania with psychotic features.