title: The effect of modafinil on self-esteem in spinal cord injury patients: a report of 2 cases and review of the literature.
abstract: We report on 2 cases of the effect of modafinil on the self-esteem of patients with spinal cord injury (SCI). The first patient was a 33-year-old man with history of polysubstance abuse and a C6 American Spinal Injury Association (ASIA) grade A injury, who presented for follow-up to the outpatient rehabilitation clinic for depression, decreased motivation, and lowered self-esteem. The patient had tried a selective serotonin reuptake inhibitor (SSRI) without success, and reported increasing social and legal stressors. Within 1 month of starting on modafinil, he reported increased self-esteem and motivation, as well as decreased self-consciousness. The second patient was a 36-year-old woman with history of depression and a T11 ASIA grade A injury. She tried various SSRIs for depression and adjustment issues before she was started on modafinil. She lost weight and became more assertive and less self-conscious within 1 month after starting on modafinil. These 2 cases suggest that modafinil should be studied as a therapeutic option for treating lowered self-esteem in patients with SCI.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Northwestern University, McGraw Medical Center, and Rehabilitation Institute of Chicago, Chicago, IL 60611, USA. aimukai355@yahoo.com
authors.forename: Ai
authors.initials: A
authors.lastname: Mukai
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Costa
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000077408:Modafinil; D010264:Paraplegia / Q000175:diagnosis / Q000523:psychology; D011782:Quadriplegia / Q000175:diagnosis / Q000523:psychology; D018570:Risk Assessment; D012649:Self Concept; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil