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Agitation and psychosis associated with dementia with lewy bodies exacerbated by modafinil use

Eduardo Prado1, Pongsatorn Paholpak, Myha Ngo

  • 1Department of Psychiatry, State University of Londrina, Brazil. eduardostp@hotmail.com

American Journal of Alzheimer'S Disease and Other Dementias
|August 16, 2012
PubMed

Insights

Modafinil may worsen agitation and hallucinations in Dementia with Lewy bodies (DLB) patients with excessive daytime somnolence (EDS). Caution is advised when using modafinil for EDS in DLB, pending further research.

Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Dementia with Lewy bodies (DLB) frequently presents with excessive daytime somnolence (EDS).
  • Modafinil, a wakefulness-promoting agent, is considered for EDS in DLB due to limited dopaminergic interaction.
  • DLB patients are susceptible to psychosis, potentially worsened by dopaminergic stimulation.

Observation:

  • Two cases of Dementia with Lewy bodies (DLB) patients experiencing exacerbated agitation and hallucinations after modafinil administration.
  • Psychotic symptoms appeared with modafinil initiation and resolved upon discontinuation.

Findings:

  • Modafinil administration was associated with increased psychotic symptoms in two DLB patients.
  • The observed adverse effects suggest a potential for modafinil to exacerbate psychosis in DLB.

Implications:

  • These findings suggest caution when prescribing modafinil for excessive daytime somnolence in Dementia with Lewy bodies.
  • Further controlled studies are needed to definitively assess the risk-benefit profile of modafinil in DLB patients with EDS.

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