Hypersomnia and fatigue in depression. Treatment with modafinil
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2005, Vol 22, Issue 6
Abstract
Depression is a fairly prevalent condition, manifests usually as a major depressive episode or as dysthymia. Both types of depression create a considerable burden for the patient, for his/her family, and for society. Insomnia is one of the common symptoms of depression; if, however, depression is "atypical", then it may be accompanied by sleepiness, hypersomnia and fatigue. These symptoms may also appear among patients with the typical form of the disease, either as side effects of antidepressant treatment or as residual symptoms in patients who are treatment refractory. Successful management of these symptoms aims at improving both the overall functioning of the patients and their compliance with treatment, and at reducing their vulnerability to future depressive episodes. The management of hypersomnia and fatigue, as well as that of treatment-resistant depression, is based on antidepressant augmentation with various combinations of antidepressants or with the addition of other drugs such as lithium, thyroxin or buspirone. Drugs with dopaminergic and/or noradrenergic properties have also been considered lately. Such a drug is modafinil, a central nervous system stimulant used for the treatment of narcolepsy and of other conditions with sleepiness and fatigue, and which is not associated with the tolerance and dependence characteristic of the amphetamines. Results from case reports and open studies, as well as of one double-blind study on 136 treatment-refractory depressive patients, have shown that adding modafinil to the antidepressant agent already being taken is effective in reducing hypersomnia and fatigue in depression.
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D. DIKEOS
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