Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation

Aims: Bipolar depression remains a major therapeutic challenge, particularly in elderly populations where treatment options are constrained by comorbidities and medication tolerability. Despite pharmacological advancements, many patients experience persistent depressive symptoms, even after multiple...

Full description

Saved in:
Bibliographic Details
Main Authors: Arinze Mbanusi, Muhammad-Kazim Kanani
Format: Article
Language:English
Published: Cambridge University Press 2025-06-01
Series:BJPsych Open
Online Access:https://www.cambridge.org/core/product/identifier/S2056472425107485/type/journal_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849316377872039936
author Arinze Mbanusi
Muhammad-Kazim Kanani
author_facet Arinze Mbanusi
Muhammad-Kazim Kanani
author_sort Arinze Mbanusi
collection DOAJ
description Aims: Bipolar depression remains a major therapeutic challenge, particularly in elderly populations where treatment options are constrained by comorbidities and medication tolerability. Despite pharmacological advancements, many patients experience persistent depressive symptoms, even after multiple trials of mood stabilizers, antipsychotics, and antidepressants. Lithium, while effective, is associated with nephrotoxicity, limiting its use in the elderly. Modafinil, a wakefulness-promoting agent primarily used for narcolepsy, has emerged as a potential adjunctive treatment for treatment-resistant bipolar depression (TRBD). Its broad neurochemical effects, targeting multiple pathways, suggest promise in addressing refractory mood symptoms. However, its role in elderly patients remains underexplored.
format Article
id doaj-art-4ffccac501de40b3abd3ebe6c3cf6cfd
institution Kabale University
issn 2056-4724
language English
publishDate 2025-06-01
publisher Cambridge University Press
record_format Article
series BJPsych Open
spelling doaj-art-4ffccac501de40b3abd3ebe6c3cf6cfd2025-08-20T03:51:44ZengCambridge University PressBJPsych Open2056-47242025-06-0111S311S31110.1192/bjo.2025.10748Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil AugmentationArinze MbanusiMuhammad-Kazim Kanani0Tees, Esk and Wear Valleys Foundation NHS Trust, Durham, United KingdomAims: Bipolar depression remains a major therapeutic challenge, particularly in elderly populations where treatment options are constrained by comorbidities and medication tolerability. Despite pharmacological advancements, many patients experience persistent depressive symptoms, even after multiple trials of mood stabilizers, antipsychotics, and antidepressants. Lithium, while effective, is associated with nephrotoxicity, limiting its use in the elderly. Modafinil, a wakefulness-promoting agent primarily used for narcolepsy, has emerged as a potential adjunctive treatment for treatment-resistant bipolar depression (TRBD). Its broad neurochemical effects, targeting multiple pathways, suggest promise in addressing refractory mood symptoms. However, its role in elderly patients remains underexplored.https://www.cambridge.org/core/product/identifier/S2056472425107485/type/journal_article
spellingShingle Arinze Mbanusi
Muhammad-Kazim Kanani
Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
BJPsych Open
title Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
title_full Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
title_fullStr Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
title_full_unstemmed Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
title_short Challenges of Treatment-Resistant Bipolar Depression in the Elderly: A Case Study of Successful Modafinil Augmentation
title_sort challenges of treatment resistant bipolar depression in the elderly a case study of successful modafinil augmentation
url https://www.cambridge.org/core/product/identifier/S2056472425107485/type/journal_article
work_keys_str_mv AT arinzembanusi challengesoftreatmentresistantbipolardepressionintheelderlyacasestudyofsuccessfulmodafinilaugmentation
AT muhammadkazimkanani challengesoftreatmentresistantbipolardepressionintheelderlyacasestudyofsuccessfulmodafinilaugmentation