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Author: Admin | 2025-04-28
Was treated with low-dose levetiracetam; modafinil was continued, and the dose was actually raised, later, to 400 mg/d. There was no seizure recurrence until death, 6 months later. Three other patients had seizures 5-7 years after modafinil initiation. The authors concluded that, in the clinical setting, the use of modafinil does not appear to be associated with major exacerbation of seizures across a wide variety of neurologic disorders. They suggested that modafinil appears to be safe and may potentially be used in patients with epilepsy who also have fatigue or excessive daytime somnolence.12 Garcia et al13 viewed these findings and conclusions with enthusiasm but expressed a note of caution because the data12 were retrospectively obtained.The fifth and last PubMed paper14 reviewed overdose data on drugs for ADHD. Seizure was not reported in association with modafinil overdose.In summary, it appears that some patients with existing seizure disorder may experience seizures after starting treatment with ar/mod; however, there is no clear indication that this is because of ar/mod as opposed to the existing seizure disorder.OverdoseDrugs that lower the seizure threshold dose-dependently increase the risk of seizures; classical examples of drugs with this action are bupropion,15 clomipramine,16 and clozapine.16 Many drugs that do not trigger seizures at therapeutic doses may do so in overdose; examples are citalopram,17 escitalopram,17 and vilazodone.18 If modafinil carries a seizure risk, the overdose data could unmask the risk. So, what do the data show?The highest overdose for modafinil reported in the prescribing information was 4,000-4,500 mg in adults and 50-63 mg/kg in a 3-year-old boy; this compares favorably with the recommended dose of 100-200 mg/d in adults. There was no report of seizures in association with modafinil overdose. The prescribing information contains no data on overdose with armodafinil.A PubMed search conducted on December 4, 2015, identified 4 relevant articles for overdose with ar/mod. One19 described 137 cases of modafinil overdose. A second20 described a 15-year-old who overdosed with 5 g of modafinil. A third21 reported supratherapeutic modafinil exposures in 87 subjects. None of these articles reported seizures as an adverse outcome. The last article, a review,14 also did
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