title: Toxicity from modafinil ingestion.
abstract: BACKGROUND
  Modafanil, a non-amphetamine stimulant, is used for narcolepsy, sleep apnea, and shift work sleep disorder. There is little available information on the toxicity of modafinil overdose.
  
  
  METHODS
  We performed a retrospective multi-poison center chart review of patients from 11 states who had a single substance ingestion of modafanil with follow up to a known outcome for the years 2000-2007. Data collected included age, gender, dose ingested, clinical effects, length of hospital stay, and medical outcome.
  
  
  RESULTS
  There were 137 patients, of whom 85 (63%) were female. Ages ranged from 1 to 82 years with a mean and median of 22 years (+18) and 20 years, respectively, with 43 patients (31%) aged <6 years. Most frequently reported clinical effects were tachycardia (n = 38), insomnia (n = 33), agitation (n = 27), dizziness (n = 25), and anxiety (n = 24). Forty-five patients were managed at home and 92 in a health-care setting, with only 23 (17%) requiring a medical admission. Therapies included benzodiazepines (n = 14), diphenhydramine (n = 5), beta-blockers (n = 3), haloperidol (n = 2), IV fluid hydration (n = 2), and one each of nitroglycerin, epinephrine, benztropine, and promethazine.
  
  
  CONCLUSIONS
  In this case series, clinical effects of modafinil overdoses were generally mild with predominantly tachycardia and CNS toxicity. However, clinically significant effects warranting specific therapy occurred in a minority of patients.
authors.affiliation: Kentucky Regional Poison Center, Louisville, USA. henry.spiller@nortonhealthcare.org
authors.forename: Henry A
authors.initials: HA
authors.lastname: Spiller
authors.forename: Douglas
authors.initials: D
authors.lastname: Borys
authors.forename: Jill R K
authors.initials: JR
authors.lastname: Griffith
authors.forename: Wendy
authors.initials: W
authors.lastname: Klein-Schwartz
authors.forename: Alfred
authors.initials: A
authors.lastname: Aleguas
authors.forename: Dawn
authors.initials: D
authors.lastname: Sollee
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Anderson
authors.forename: Tama S
authors.initials: TS
authors.lastname: Sawyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001559:Benzhydryl Compounds / Q000506:poisoning*; D000697:Central Nervous System Stimulants / Q000506:poisoning*; D002648:Child; D002675:Child, Preschool; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D020258:Neurotoxicity Syndromes / Q000209:etiology / Q000628:therapy; D011039:Poison Control Centers / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013610:Tachycardia / Q000139:chemically induced / Q000628:therapy; D013997:Time Factors; D014481:United States; D055815:Young Adult
chemical_list: D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil