Use of modafinil in co-existing major depression and erectile dysfunction: A case report

Abstract

Erectile dysfunction is a sexual dysfunction which is commonly comorbid with major depression. Antidepressant treatment does not always improve comorbid sexual dysfunctions in major depression. In fact, sexual dysfunction may worsen or get complicated following the introduction of antidepressants. Modafinil is a drug with stimulant effect on the central nervous system by binding to norepinephrine and dopamine transporters and consequently increasing synaptic norepinephrine and dopamine levels. Modafinil is primarily used in the treatment of narcolepsy and chronic fatigue syndrome. In addition, it is known for its effectiveness in attention deficit hyperactivity disorder and as an add-on option for major depression. In this paper, we report the case of a 39-year-old man with major depression whose comorbid erectile dysfunction improved after addition of modafinil to antidepressant treatment. Fluoxetine 20mg/day was initiated and despite the improvement of most of the depressive symptoms and the sexual desire, his complaints of fatigue, weakness and erectile dysfunction continued. With the addition of modafinil (200 mg /day), improvement was observed not only in psychomotor symptoms but also in erectile dysfunction of the patient.