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Modafinil Induced Psychosis in a Patient with Bipolar 1 Depression

Alexander A DiSciullo1, Clayton D English1,2, William T Horn1

  • 1University of Vermont Medical Center, USA.

Case Reports in Psychiatry
|November 13, 2018
PubMed

Insights

Modafinil, used for bipolar depression, can rapidly induce psychosis even at low doses. This case highlights the risk in patients on mood stabilizers and antipsychotics, necessitating clinical caution.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Pharmacology

Background:

  • Modafinil is an adjunctive treatment for bipolar depression.
  • Previous reports indicate modafinil can induce mania in bipolar patients and psychosis in schizophrenic patients.

Observation:

  • This report details a unique case of modafinil-induced psychosis in a bipolar depression patient.
  • The patient was concurrently treated with mood stabilizers and antipsychotics.

Findings:

  • The psychosis onset was rapid (2 days) at a low modafinil dosage (100 mg/day).
  • This represents the quickest onset and lowest dosage reported in literature for modafinil-induced psychosis in this population.

Implications:

  • Clinicians must exercise caution when prescribing modafinil for bipolar depression.
  • The risk of rapid psychosis induction exists even with concomitant mood stabilizers and antipsychotics.

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