Modafinil

Abstract

Lack of efficacy: case report A 31-year-old man exhibited lack of efficacy with modafinil for type 2 narcolepsy. The man, who had depression, had been treated with sertraline. He also had a prior history of severe obstructive sleep apnoea diagnosed at an outside facility. He presented to the clinic for residual excessive daytime sleepiness. He exhibited adequate adherence to continuous positive airway pressure over a period of one year, adequate sleep duration and good sleep hygiene. On presentation, he also reported vivid dreams and sleep paralysis in the past. His therapy with sertraline was held 2 weeks prior to the study. Based on the clinical presentation and laboratory findings, a diagnosis of coexisting type 2 narcolepsy was made. Therefore, he received treatment with modafinil [dosage and route not stated]. Despite treatment, his symptoms of excessive daytime sleepiness (EDS) persisted, indicating lack of efficacy with modafinil. Therefore, the man’s therapy with modafinil was switched to methylphenidate. As a result, subsequent improvement in narcolepsy was noted.