Modafinil Dependence and Hypersexuality: A Case Report and Review of the Evidence

Sahoo, Swapnajeet; Subodh, BN; Gupta, Gopila

doi:10.9758/cpn.2016.14.4.402

Cited by 10 publications

(8 citation statements)

References 8 publications

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“…However, our and other findings emphasize that when taken at higher doses, such as in recreational use, modafinil could have abuse potential in humans. In fact, two recent case report studies have described that patients who started treatment with modafinil with increasing doses reported withdrawal symptoms similar to those experienced during abstinence of psychostimulant drugs upon discontinuation of modafinil ( Swapnajeet et al, 2016 ; Alacam et al, 2018 ).…”

Section: Discussionmentioning

confidence: 98%

Participation of Dopamine D1 and D2 Receptors in the Rapid-Onset Behavioral Sensitization to Modafinil

et al. 2019

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Studies on the abuse potential of modafinil, a psychostimulant-like drug used to treat narcolepsy, are still controversial. While some studies claim no potential for abuse, increasing evidence suggests that modafinil induces abuse-related effects, including rapid-onset behavioral sensitization (i.e., a type of sensitization that develops within hours from the drug priming administration). The rapid-onset sensitization paradigm is a valuable tool to study the neuroplastic changes that occur quickly after drug administration, and shares neuroadaptations with drug abuse in humans. However, the mechanisms involved in the rapid-onset behavioral sensitization induced by modafinil are uncertain. Our aim was to investigate the possible involvement of dopamine D1 and D2 receptors on acute modafinil-induced hyperlocomotion and on the induction and expression of rapid-onset behavioral sensitization induced by modafinil in male Swiss mice. Treatment with the D1 receptor antagonist SCH 23390 or the D2 receptor antagonist sulpiride attenuated the acute modafinil-induced hyperlocomotion in a dose-dependent manner. Pretreatment with either antagonist before the priming injection of modafinil prevented the development of sensitization in response to a modafinil challenge 4 h later. However, only SCH 23390 decreased the expression of modafinil-induced rapid-onset behavioral sensitization. Taken together, the present findings provide evidence of the participation of D1 and D2 receptors on the development of rapid-onset behavioral sensitization to modafinil, and point to a prominent role of D1 receptors on the expression of this phenomenon.

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Section: Discussionmentioning

confidence: 98%

Participation of Dopamine D1 and D2 Receptors in the Rapid-Onset Behavioral Sensitization to Modafinil

et al. 2019

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“…Upsurge of dopamine in the mesolimbic pathway after a supratherapeutic dosage of modafinil might explain for the development of hypersexuality in this case, although the exact pathophysiological mechanism is unknown. 194 Lastly, a 23-year old man with methamphetamine dependence history was prescribed modafinil 200 mg as an adjunctive treatment for daytime hypersomnolence and fatigue associated to methamphetamine withdrawal. The patient was admitted 6 months later with a methamphetamine induced psychosis and he had also been using modafinil at a self-increased dose of 400 mg per day .…”

Section: Abuse Potential Dependence and Withdrawalmentioning

confidence: 99%

“…The withdrawal symptoms are mostly nonspecific and subsided when the dose is decreased in a controlled environment. 191 , 192 , 194 On the other hand, at recommended doses it has not shown the propensity to produce dependence, tolerance and withdrawal like those associated with chronic amphetamine and cocaine use. 62 , 118 Modafinil should be prescribed cautiously, and clinicians should be aware of its possible abuse potential if used incorrectly, especially in patients with psychiatric disorders or with a history of drug abuse.…”

Section: Abuse Potential Dependence and Withdrawalmentioning

confidence: 99%

“…226 , 227 Overdose of modafinil is usually associated with insomnia, agitation, dizziness, tremors, tachycardia and rise in blood pressure. 194 A retrospective multi-poison center study in 11 USA states found 137 cases of single-substance overdose with modafinil between 2000 and 2007. 228 Effects of modafinil overdose were generally mild with predominantly tachycardia and CNS toxicity, including insomnia, agitation, dizziness and anxiety.…”

Section: Intoxicationsmentioning

confidence: 99%

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Article Commentary: Pharmacokinetic and Pharmacodynamic of the Cognitive Enhancer Modafinil: Relevant Clinical and Forensic Aspects

Sousa

Dinis-Oliveira

2020

Substance Abuse

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Modafinil is a nonamphetamine nootropic drug with an increasingly therapeutic interest due to its different sites of action and behavioral effects in comparison to cocaine or amphetamine. A review of modafinil (and of its prodrug adrafinil and its R-enantiomer armodafinil) chemical, pharmacokinetic, pharmacodynamic, toxicological, clinical and forensic aspects was performed, aiming to better understand possible health problems associated to its unconscious and unruled use. Modafinil is a racemate metabolized mainly in the liver into its inactive acid and sulfone metabolites, which undergo primarily renal excretion. Although not fully clarified, major effects seem to be associated to inhibition of dopamine reuptake and modulation of several other neurochemical pathways, namely noradrenergic, serotoninergic, orexinergic, histaminergic, glutamatergic and GABAergic. Due its wake-promoting effects, modafinil is used for the treatment of daily sleepiness associated to narcolepsy, obstructive sleep apnea and shift work sleep disorder. Its psychotropic and cognitive effects are also attractive in several other pathologies and conditions that affect sleep structure, induce fatigue and lethargy, and impair cognitive abilities. Additionally, in health subjects, including students, modafinil is being used off-label to overcome sleepiness, increase concentration and improve cognitive potential. The most common adverse effects associated to modafinil intake are headache, insomnia, anxiety, diarrhea, dry mouth and raise in blood pressure and heart rate. Infrequently, severe dermatologic effects in children, including maculopapular and morbilliform rash, erythema multiforme and Stevens-Johnson Syndrome have been reported. Intoxication and dependence associated to modafinil are uncommon. Further research on effects and health implications of modafinil and its analogs is steel needed to create evidence-based policies.

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“…For instance, differences have been reported in the whole brain, cortical thickness (CTh), lobar volumes, grey and white matter volumes, corpus callosum size and connectivity profiles, and it is shown that they are correlated with distinctive cognitive abilities of males and females regarding visuospatial processing and language. 1 – 8) Motivated by this category of studies, many researchers have attempted to investigate the human brain in the gender identity disorder or more recently in gender dysphoria (GD) in the past few years (actually, GD replaced gender identity disorder since the publication of the 5th edition of the DSM in 2013). Individuals with GD are called transgender and they often feel an emotional and social pressure.…”

Section: Introductionmentioning

confidence: 99%

Transsexualism: A Different Viewpoint to Brain Changes

Mohammadi

Khaleghi

2018

Clin Psychopharmacol Neurosci

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Transsexualism refers to a condition or belief which results in gender dysphoria in individuals and makes them insist that their biological gender is different from their psychological and experienced gender. Although the etiology of gender dysphoria (or transsexualism) is still unknown, different neuroimaging studies show that structural and functional changes of the brain result from this sexual incongruence. The question here is whether these reported changes form part of the etiology of transsexualism or themselves result from transsexualism culture, behaviors and lifestyle. Responding to this question can be more precise by consideration of cultural neuroscience concepts, particularly the culture–behavior–brain (CBB) loop model and the interactions between behavior, culture and brain. In this article, we first review the studies on the brain of transgender people and then we will discuss the validity of this claim based on the CBB loop model. In summary, transgender individuals experience change in lifestyle, context of beliefs and concepts and, as a result, their culture and behaviors. Given the close relationship and interaction between culture, behavior and brain, the individual’s brain adapts itself to the new condition (culture) and concepts and starts to alter its function and structure.

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Modafinil Dependence and Hypersexuality: A Case Report and Review of the Evidence

Cited by 10 publications

References 8 publications

Participation of Dopamine D1 and D2 Receptors in the Rapid-Onset Behavioral Sensitization to Modafinil

Participation of Dopamine D1 and D2 Receptors in the Rapid-Onset Behavioral Sensitization to Modafinil

Article Commentary: Pharmacokinetic and Pharmacodynamic of the Cognitive Enhancer Modafinil: Relevant Clinical and Forensic Aspects

Transsexualism: A Different Viewpoint to Brain Changes

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