DiSciullo Alexander A, English Clayton D, Horn William T
University of Vermont Medical Center, USA.
Albany College of Pharmacy and Health Sciences, USA.
Case Rep Psychiatry. 2018 Oct 17;2018:3732958. doi: 10.1155/2018/3732958. eCollection 2018.
Modafinil has been used as an adjunctive medication in the treatment of bipolar 1 depression with reported success. Case reports have been published demonstrating modafinil induced mania in bipolar patients and modafinil induced psychosis in schizophrenic patients. To our knowledge, we report the only case of modafinil induced psychosis in a patient with bipolar depression treated with both mood stabilizers and antipsychotics. In addition, it is the quickest onset to psychosis (2 days) at the lowest dosage of modafinil (100 mg/day) reported in the literature. Although favorable outcomes using modafinil for treatment of bipolar depression have been reported in literature, clinicians should remain cautious of the potential to rapidly induce psychosis with modafinil at low dosages in patients with bipolar depression despite being treated with mood stabilizers and antipsychotics.
莫达非尼已被用作治疗双相I型抑郁症的辅助药物，且有报道称取得了成功。已有病例报告发表，显示莫达非尼可诱发双相情感障碍患者出现躁狂，以及诱发精神分裂症患者出现精神病症状。据我们所知，我们报告了唯一一例在同时使用心境稳定剂和抗精神病药物治疗的双相抑郁症患者中，由莫达非尼诱发精神病的病例。此外，这是文献报道中使用莫达非尼最低剂量（100毫克/天）时出现精神病症状最快的病例（2天）。尽管文献中报道了使用莫达非尼治疗双相抑郁症取得了良好效果，但临床医生仍应谨慎，对于双相抑郁症患者，尽管正在接受心境稳定剂和抗精神病药物治疗，莫达非尼仍有可能在低剂量时迅速诱发精神病。
