Agitation and psychosis associated with dementia with lewy bodies exacerbated by modafinil use

Eduardo Prado, Pongsatorn Paholpak, Myha Ngo, Verna Porter, Liana G. Apostolova, Rogério Marrocos, John M. Ringman

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


Dementia with Lewy bodies (DLB) is commonly associated with excessive daytime somnolence (EDS). Modafinil is a wakefulness-promoting agent that is considered to have limited interaction with the dopaminergic system. As individuals with DLB are predisposed to psychotic symptoms that might be exacerbated by dopaminergic stimulation, modafinil is considered to be an attractive option for the treatment of EDS in DLB. We describe 2 cases in which administration of modafinil exacerbated agitation and hallucinations in DLB, and we also review data that may explain the mechanisms underlying this effect. In both cases, psychotic symptoms emerged concomitantly with modafinil administration and remitted following its discontinuation. Although definitive data regarding the benefits and adverse effects of modafinil for the treatment of EDS in DLB await controlled prospective randomized studies, our observations warrant caution regarding its use in this context.

Original languageEnglish (US)
Pages (from-to)468-473
Number of pages6
JournalAmerican Journal of Alzheimer's Disease and Other Dementias
Issue number7
StatePublished - Nov 2012


  • agitation
  • dementia with Lewy bodies
  • excessive daytime somnolence
  • modafinil
  • psychosis

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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