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The effect of modafinil on self-esteem in spinal cord injury patients: a report of 2 cases and review of the literature.

Mukai A, Costa JL

Department of Physical Medicine and Rehabilitation, Northwestern University, McGraw Medical Center, and Rehabilitation Institute of Chicago, Chicago, IL 60611, USA. aimukai355@yahoo.com

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.

Published 26 September 2005 in Arch Phys Med Rehabil, 86(9): 1887-9.
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