Pathological Gambling Associated With Modafinil

Tarrant, Nalani; Cavanna, AE; Rickards, Hugh

doi:10.1176/jnp.2010.22.1.123.e27

Cited by 10 publications

(2 citation statements)

References 5 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The compulsive gambling symptoms improved after clomipramine administration and modafinil discontinuation. 7 Zack and Poulos 8 reported that modafinil has a bidirectional effect on patients with pathological gambling and suggested that modafinil increases gambling urges for patients with low impulsivity but decreases gambling urges for those with high impulsivity. In our case, the patient was not examined for impulsivity.…”

Section: Discussionmentioning

confidence: 99%

Pathological Gambling Disorder Associated With Modafinil Therapy in a Patient With Type 1 Narcolepsy

et al. 2023

View full text Add to dashboard Cite

We report the case of a 22-year-old man with type 1 narcolepsy who experienced pathological gambling after modafinil therapy. The patient was administered with modafinil, which improved excessive daytime sleepiness (EDS). However, he experienced heart palpitations and nervousness, eventually developing gambling addiction. After six months of modafinil therapy, he engaged in various online gambling activities, leading to significant financial loss and stress. Consequently, modafinil was replaced with pitolisant, which is a potent and selective antagonist/inverse agonist of histamine H3 receptor. One month after modafinil discontinuation, EDS symptoms were well controlled with pitolisant and gambling urge was resolved. Modafinil is prescribed as a first-line therapy for treating EDS symptoms in patients with narcolepsy. However, it may cause psychiatric side effects via the dopaminergic system. Alternatively, pitolisant could be used to avoid modafinil’s psychiatric side effects in patients with narcolepsy.

show abstract

Section: Discussionmentioning

confidence: 99%

Pathological Gambling Disorder Associated With Modafinil Therapy in a Patient With Type 1 Narcolepsy

et al. 2023

View full text Add to dashboard Cite

show abstract

“…14,15 Moreover, some studies found that medication treatment (psychostimulants) might increase the risk of impulsivity even mania in narcolepsy patients. 16,17 To further explore the role of daytime sleepiness, sleep apnea and DNS in narcolepsy impulsivity, this study was designed to collect data about sleepiness (questionnaire and polysomnography), sleep apnea and DNS (arousal index, sleep efficiency, sleep stage percentage) 1 and other sleep-related parameters in narcolepsy. We hypothesized that daytime sleepiness and other factors, including depression symptoms, onset-age and chronological age, may independently associate with impulsivity in NT1 patients.…”

Section: Introductionmentioning

confidence: 99%

Not Only Excessive Daytime Sleepiness but Also Depression Symptoms, Chronological Age and Onset-Age Were Associated with Impulsivity in Narcolepsy Type 1 Patients

Yang¹,

Zhang²,

Han³

et al. 2022

NSS

View full text Add to dashboard Cite

To detect the factors associated with total and subscales impulsivity scores in narcolepsy and further explore the nonlinear relationship between these factors and impulsivity score. Methods: One hundred and fifty-eight narcolepsy type 1 (NT1) patients were involved in this cross-sectional study. Patients completed questionnaires evaluating impulsivity symptoms (Barratt impulse scale-11, BIS-11), depression symptoms (Center for Epidemiologic Studies Depression Scale for Children, CES-DC or Self-Rating Depression Scale, SDS) and sleepiness (Epworth Sleepiness Scale, ESS). Parameters from polysomnography and multiple sleep latency test were also collected. Linear regression analysis was performed to detect the factors associated with total and subscales impulsivity scores. Then, generalized additive models and smooth curve fitting were performed to explore the non-linear relationship between chronological age and impulsivity scores. Results: Factors associated with higher total impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher attentional impulsivity score were higher ESS, older onset and adolescents. Factors associated with higher motor impulsivity score were higher ESS, younger onset and depression symptoms. Factors associated with higher non-planning impulsivity score were adolescents, older onset and depression symptoms. A non-linear relationship between age and impulsivity scores (total impulsivity score, attentional impulsivity score and non-planning impulsivity score) was detected in NT1 patients. Conclusion: Not only excessive daytime sleepiness but also onset-age, depression symptoms and chronological age were associated with impulsivity in NT1 patients. The non-linear relationship between age and impulsivity scores suggested brain and mental development alterations in NT1 patients.

show abstract