The Annals Evolution of Clinical Pharmacy | Now Available
home help contact us subscription past issues search current issue
QUICK SEARCH:   [advanced]


     

The Annals of Pharmacotherapy: Vol. 37, No. 12, pp. 1807-1809. DOI 10.1345/aph.1D226
© 2003 Harvey Whitney Books Company.
This Article
Right arrow Résumé Freely available
Right arrow Extracto Freely available
Right arrow Full Text
Right arrow PDF
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Articles Ahead of Print
Right arrow [Order Reprint]
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fernandes, P. P
Right arrow Articles by Petty, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fernandes, P. P
Right arrow Articles by Petty, F.

Modafinil for Remitted Bipolar Depression with Hypersomnia

Praveen P Fernandes, MD

Staff Psychiatrist, Omaha Veterans Affairs Medical Center; Assistant Professor of Psychiatry, Creighton University School of Medicine, Omaha, NE

Frederick Petty, PhD MD

Staff Psychiatrist, Omaha Veterans Affairs Medical Center; Professor of Psychiatry and Pharmacology, Vice-Chairman for Research, Creighton University School of Medicine

Reprints: Praveen P Fernandes MD, Mental Health Clinic, Omaha Veterans Affairs Medical Center — 116A1, 4101 Woolworth Ave., Omaha, NE 68105-1850, FAX 402/943-5543, Praveen.Fernandes{at}med.va.gov

OBJECTIVE: To report 2 cases of bipolar disorder with recent depression in remission with prominent residual hypersomnia, responding well to the addition of the psychostimulant modafinil.

CASE SUMMARIES: Two patients with bipolar disorder with recent depressive episodes in remission are presented. Despite the absence of prominent depressive symptoms, both patients had significant hypersomnia, with scores ranging from 15 to 20 (maximum 24) on the Epworth Sleepiness Scale. The addition of modafinil to their medication regimen resulted in a decrease in hypersomnia and improvement in their level of functioning.

DISCUSSION: This is the first report (MEDLINE search, October 7, 2003) demonstrating the use of modafinil in the treatment of hypersomnia in bipolar disorder while mood symptoms were in remission. Hypersomnia frequently occurs in depressive episodes and can be disabling when severe. The patients had optimal mood stabilization with mood stabilizers and antidepressants, but continued to experience excessive daytime sleepiness. Conventional stimulants were not considered because of the risk of triggering mania. The addition of the selective psychostimulant modafinil resulted in significant improvement in the hypersomnia, with improvement in functioning. No adverse effects or mood changes were noted.

CONCLUSIONS: Modafinil may be a well-tolerated and effective alternative to conventional stimulants in the treatment of hypersomnia, especially in bipolar disorder, where there is considerable risk of switch to mania with stimulant medications. Modafinil may be useful even when depressive symptoms are not prominent.

Key Words: bipolar depression, hypersomnia, modafinil

Published Online, October 15, 2003. www.theannals.com, DOI 10.1345/aph.1D226


This article has been cited by other articles:


Home page
 Am. J. PsychiatryHome page
M. A. FRYE
Dr. Frye Replies
Am J Psychiatry, January 1, 2008; 165(1): 135 - 135.
[Full Text] [PDF]


homecopy help contact us subscription past issues search current issue
Copyright © 2003 by Harvey Whitney Books Company.