ABSTRACT
Modafinil is a non-amphetamine stimulant that is prescribed for narcolepsy-associated sleepiness as well as reported off-licence uses among university students looking to improve wakefulness and focus. There is limited information in the medical literature about supratherapeutic modafinil dosage, symptomatology and management of overdose. We report a case of a healthy 32-year-old man who was found unconscious, having vomited, with an empty modafinil blister strip. At the emergency department, he presented with reduced Glasgow Coma Scale and prolonged episodes of vomiting. This acute presentation was conservatively managed in the intensive care unit. Antibiotics were also given for a suspected aspiration pneumonia. CT of the head showed cerebral oedema and biochemistry investigations revealed hyponatraemia. Result aetiology was unclear, however, it has been theorised to be secondary to a sizeable modafinil overdose.
Subject(s)
Brain Edema/chemically induced , Central Nervous System Stimulants/poisoning , Drug Overdose/complications , Hyponatremia/chemically induced , Modafinil/poisoning , Adult , Brain Edema/diagnosis , Brain Edema/therapy , Humans , Hyponatremia/diagnosis , Hyponatremia/therapy , MaleSubject(s)
Central Nervous System Stimulants/poisoning , Modafinil/poisoning , Psychoses, Substance-Induced/psychology , Psychoses, Substance-Induced/therapy , Suicide, Attempted/psychology , Adolescent , Central Nervous System Stimulants/therapeutic use , Disorders of Excessive Somnolence/drug therapy , Female , Humans , Modafinil/therapeutic useABSTRACT
Introduction: The current emphasis on combatting the opioid epidemic in the United States and across the globe is well warranted, but rates and variations of other drugs and substances of abuse may be inadvertently increasing as well. These drugs and substances deserve equal attention in the literature to equip healthcare practitioners with the knowledge to provide optimal care in overdose patients. Areas covered: This evaluation includes loperamide, gabapentin, and modafinil and was accomplished through a comprehensive literature review of PubMed, MEDLINE, SCOPUS, ProQuest Central, ProQuest Dissertations, and CINAHL. The results of forty-four pieces of literature are included in this evaluation. The objective of this review is to provide a repository of standard and emerging treatment modalities for loperamide, gabapentin and modafinil for the emergency medicine team. Expert opinion: Loperamide, gabapentin, and modafinil are becoming drugs of abuse, and as such, should be on the radar of healthcare providers. Recognizing their unique toxicity profiles is imperative in providing optimal resuscitative care.
