The use of Modafinil on Methamphetamine withdrawal in mechanically ventilated patients

Modafinil has been used to treat methamphetamine dependence, and the medication's stimulant properties have also been shown to alleviate methamphetamine withdrawal symptoms. We present two cases of patients with history of methamphetamine use who required intubation and mechanical ventilation, one in the setting of opiate withdrawal, and the other with severe asthma exacerbation causing cardiac arrest. Both patients remained somnolent after intubation and mechanical ventilation. Given suspected methamphetamine withdrawal, they both received modafinil and wakefulness greatly improved allowing them to be extubated. These cases demonstrate that there needs to be further investigation into the use of modafinil for methamphetamine withdrawal, especially in the setting of mechanical ventilation.