New Onset of Compulsive Gambling Associated With Modafinil: A Case Report

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To the Editor: We describe a case of compulsive gambling associated with the use of modafinil in a patient with idiopathic hypersomnia. Modafinil is a wakefulness-promoting agent that is approved by the US Food and Drug Administration for hypersomnolence associated with narcolepsy, obstructive sleep apnea, shift work sleep disorder, and fatigue associated with multiple sclerosis. Modafinil prescribing information reports psychiatric adverse experiences including mania, delusions, hallucinations, suicidal ideation, and depression. Tarrant and colleagues have described a case of a patient with minor gambling, who reported a 10-fold increase in his slot-machine use after taking modafinil.’ ‹