Low Dose Modafinil-Associated Visual Hallucinations: A Case Report

Öz

Abstract: Modafinil, a wake-promoting agent, is generally considered safe. We report a 32-year-old male with narcolepsy who developed visual hallucinations (VHs) after one month on a low dose (100 mg/day) of modafinil. This suggests modafinil may cause VHs even at low therapeutic doses. Objective: To present a case of visual hallucinations (VHs) associated with low-dose modafinil use (100 mg/day) in a patient with narcolepsy, and to emphasize the importance of clinical awareness regarding this potential adverse effect. Case: A 32-year-old male with narcolepsy developed daily VHs and aggressive behavior after one month of treatment with 100 mg/day modafinil. The VHs resolved completely after modafinil was discontinued and risperidone treatment was initiated. Conclusion: Modafinil use, even at low therapeutic doses, may be associated with the emergence of visual hallucinations. Clinicians should be aware of this potential adverse drug reaction.

Anahtar Kelimeler

• dverse Reactions
• Drug-Related Side Effects
• Hallucination

Destekleyen Kurum

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Etik Beyan

This study was conducted in accordance with ethical standards, and written informed consent was obtained from the patient.

Kaynakça

1. Ozsoy S, Aydin D, Ekici F. Effects of modafinil on pentylenetetrazol-induced convulsive epilepsy. Bratisl Lek Listy 2015; 116 (3): 162-166.
2. Swapnajeet S, Subodh B, Gourav G. Modafinil dependence and hypersexuality: a case report and review of the evidence. Clin Psychopharmacol Neurosci. 2016;14: 402-404.
3. Ballon JS, Feifel D. A systematic review of modafinil: potential clinical uses and mechanisms of action. J Clin Psychiatry 2006; 67: 554-566.
4. Schwartz JR. Modafinil: new indications for wake promotion. Expert Opin Pharmacother 2005; 6: 115-129.
5. Wu P, Jones S, Ryan CJ, Michail D, Robinson TD. Modafinil-induced psychosis. Intern Med J. 2008; 38: 677-678.
6. Mariani JJ, Hart CL. Psychosis associated with modafinil and shift work. Am J Psychiatry. 2005; 162: 1983.
7. Ozer S, Demir B. Hypomania in a Schizophrenic Patient Treated with Modafinil for Clozapine-Induced Sedation. Arch Neuropsychiatr. 2010; 47: 171-173.
8. Aggarwal A, Garg A, Jiloha RC. Psychotic relapse in a patient with schizophrenia associated with modafinil therapy. Primary Psychiatry. 2009; 16: 26-27.

9. Narendran R, Young CM, Valenti AM, Nickolova MK, Pristach CA. Is psychosis exacerbated by modafinil? Arch Gen Psychiatry. 2002; 59: 292-293.
10. McClellan KJ, Spencer CM. Modafinil: A review of its pharmacology and clinical efficacy in the management of narcolepsy. CNS Drugs. 1998; 9(4): 311-324.
11. Wolf J, Fiedler U, Anghelescu I, Schwertfeger N. Manic switch in a patient with treatment-resistant bipolar depression treated with modafinil. Journal of Clinical Psychiatry. 2006; 67(11): 1817.