Case report reveals psychotic symptoms after modafinil use in a patient with recurrent depression, indicating need for caution.
BACKGROUND: Modafinil is the first FDA-designated “wakefulness-promoting agent” and is approved for use as an adjuvant in mood disorders. In depressive disorders, it is reported to be effective in alleviating fatigue and related symptoms. The molecule is widely used today. Since it belongs to the group of stimulants, theoretically, it can cause psychosis. CASE REPORT: We report the case of a 48-year-old woman with recurrent depressive disorder who developed psychotic symptoms, including visual and auditory hallucinations, within two days of initiating modafinil (100 mg/day) for fatigue. Symptoms worsened following venlafaxine addition but entirely resolved within five days of modafinil discontinuation, with no recurrence over six months. CONCLUSION: This case highlights the risk of modafinil-induced psychosis, even at standard doses, and suggests a possible interaction with venlafaxine. Clinicians should monitor for psychotic symptoms in vulnerable patients, warranting further investigation into modafinil’s neurobiological effects.
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