In addition to these symptoms, he started interacting with commercial sex workers CSWs on phone, would get aroused by mere talking with them. He started to have increased urge to visit CSWs. On one occasion, he visited a CSW though did not have physical contact.
He felt ashamed and worried about his lack of self-control. He would be preoccupied with sexual fantasies and would not be able to concentrate at his work. He tried meditation, increased his frequency of religious activities to get Revjew of Reiew sexual urges but in vain.
Despite being happily married for last 16 years with adequate sexual Edandmore Provigil Review he would have increased desire for intercourse with females other than his wife which would further instigate guilt in his mind. His sleep was disturbed with restlessness and anxiety at night and he would feel fatigue throughout the day see more taking high doses of modafinil.
His mood remained sad for most part of the day, would not enjoy the day to day activities like before and continued to harbor depressive cognitions. There was no associated history of cheerfulness, grandiosity, hyperactivity, overplanning, increased appetite and decreased need for sleep during this time. Throughout this period there was neither any Edandmire in his compliance with medications nor any change in dosage of other medications. None of previous mood episodes both depression and mania had any symptoms suggestive Edandmoree hypersexual behavior.
His sexual behavior during Edandmore Provigil Review intake of high doses of modafinil was also not in keeping with his premorbid sexual desire and sexual activity. Detailed evaluation of history did not suggest presence of any head injury in the recent past and presence of any associated impulsivity, obsessive compulsive behavior, substance abuse, hyperorality, cognitive decline, sleep attacks, use of aphrodisiacs and use of any other medications Revieww could increase the sexual desire.
With the above available information, a Provigi, of bipolar affective disorder with current episode mild Efandmore as per ICD criteria along with an additional diagnosis of modafinil dependence and modafinil induced hypersexuality.
He was admitted in our centre. Physical examination, routine hematological and biochemistry investigations and electrocardiogram were within Edandmore Provigil Review limits. Mood charting was done to assess development of any mood symptoms.
In literature, we could find only two case reports on modafinil dependence at higher doses. The pattern of use was characterized by craving, tolerance and withdrawal. The withdrawal symptoms were mostly nonspecific, opposite to effect it produces.
Our case escalated the dose of modafinil so as to overcome fatigue, increase energy and improve concentration. In contrast, index case had guilt associated with his increased sexual desire which is very well reported in individuals with hypersexual behaviour. Modafinil has been found to act by binding on dopamine receptors and affects dopamine uptake by dopamine transporters in the neurons.
Modafinil dependence can be explained by its dopamine uptake blockade leading to increase in dopamine concentration in the brain areas linked with reward pathways.
Upsurge of dopamine in the mesolimbic pathway due to use of supratherapeutic dosage of modafinil might explain for the development of hypersexuality in the index case. Overdose of modafinil can cause insomnia, agitation, tachycardia, rise in blood pressure etc. However, in India, it is available over the counter and being regularly prescribed by many psychiatrists. Inspite of reportedly low abuse potential, we report a case of modafinil dependence and modafinil induced hypersexuality so as to increase awareness regarding this rare side effect of modafinil and for the need of regulation on its sale.
Clin Psychopharmacol Neurosci. Published online Nov Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Apart from sleep wake disorders, nowadays, modafinil is being prescribed for several psychiatric disorders including depression.
Keywords: Modafinil, Drug dependence, Increased libido. Modafinil in psychiatric disorders: the promising state reconsidered. Tijdschr Psychiatr. Dependence on supratherapeutic doses of modafinil: a case report.
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