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

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

American journal of Alzheimer's disease and other dementias (2012-08-16)
Eduardo Prado, Pongsatorn Paholpak, Myha Ngo, Verna Porter, Liana G Apostolova, Rogério Marrocos, John M Ringman
ABSTRACT

Dementia with Lewy bodies (DLB) is commonly associated with excessive daytime somnolence (EDS). Modafinil is a wakefulness-promoting agent that is considered to have limited interaction with the dopaminergic system. As individuals with DLB are predisposed to psychotic symptoms that might be exacerbated by dopaminergic stimulation, modafinil is considered to be an attractive option for the treatment of EDS in DLB. We describe 2 cases in which administration of modafinil exacerbated agitation and hallucinations in DLB, and we also review data that may explain the mechanisms underlying this effect. In both cases, psychotic symptoms emerged concomitantly with modafinil administration and remitted following its discontinuation. Although definitive data regarding the benefits and adverse effects of modafinil for the treatment of EDS in DLB await controlled prospective randomized studies, our observations warrant caution regarding its use in this context.

MATERIALS
Product Number
Brand
Product Description

Supelco
Modafinil solution, 1.0 mg/mL in acetonitrile, ampule of 1 mL, certified reference material, Cerilliant®
Sigma-Aldrich
Modafinil, ≥98% (HPLC)