Editing Modafinil (section)

==Overdose==
An [[Drug overdose|overdose]] of modafinil can lead to a range of symptoms and complications. Psychiatric symptoms may include [[psychosis]], [[mania]], [[hallucination]]s, and suicidal ideation, which can occur even in individuals without a history of mental illness and may persist after discontinuation of the drug.<ref name="pmid31422705">{{cite journal | vauthors = Reinert JP, Dunn RL | title = Management of overdoses of loperamide, gabapentin, and modafinil: a literature review | journal = Expert Review of Clinical Pharmacology | volume = 12 | issue = 9 | pages = 901–908 | date = September 2019 | pmid = 31422705 | doi = 10.1080/17512433.2019.1657830 | s2cid = 201063075 }}</ref> Neurological complications, such as seizures, tremors, [[dystonia]], and [[dyskinesia]], may arise from modafinil's interaction with various neurotransmitter systems.<ref name="pmid31422705" />

Allergic reactions such as rash, [[angioedema]], [[anaphylaxis]], and [[Stevens–Johnson syndrome]] may rarely be triggered by an immunological response to modafinil or its metabolites.<ref name="pmid29028129">{{cite journal | vauthors = Prince V, Philippidou M, Walsh S, Creamer D | title = Stevens-Johnson syndrome induced by modafinil | journal = Clinical and Experimental Dermatology | volume = 43 | issue = 2 | pages = 191–192 | date = March 2018 | pmid = 29028129 | doi = 10.1111/ced.13282 | s2cid = 204987385 }}</ref><ref name="Reactions-Weekly-2018-Overdose">{{cite journal|doi=10.1007/s40278-018-42202-6 |title=Modafinil overdose |journal=Reactions Weekly |date=2018 |volume=1690 |page=136 |s2cid=195079873 }}</ref> Cardiovascular complications like hypertension, [[tachycardia]], chest pain, and [[arrhythmia]]s may also be observed due to modafinil's sympathomimetic action.<ref name="pmid31422705"/>

In animal studies, the median lethal dose (LD<sub>50</sub>) of modafinil varies among species and depends on the route of administration. In mice and rats, the LD<sub>50</sub> is approximately {{Val|1250|u=mg/kg}} if administered via an injection, but the oral LD<sub>50</sub> for rats is {{Val|3400|u=mg/kg}}.<ref name="adrafinil1999">{{cite journal |title=Adrafinil: A Novel Vigilance Promoting Agent|vauthors=Milgram NW, Callahan H, Siwak C|date=September 1999|journal=CNS Drug Reviews|volume=5|issue=3|pages=193–212|doi=10.1111/j.1527-3458.1999.tb00100.x }}</ref><ref name="modafinil-mesenchymal-2020">{{cite journal | vauthors = Nazarian S, Abdolmaleki Z, Torfeh A, Shirazi Beheshtiha SH | title = Mesenchymal stem cells with modafinil (gold nanoparticles) significantly improves neurological deficits in rats after middle cerebral artery occlusion | journal = Experimental Brain Research | volume = 238 | issue = 11 | pages = 2589–2601 | date = November 2020 | pmid = 32886135 | doi = 10.1007/s00221-020-05913-9 | s2cid = 221495887 }}</ref> The LD<sub>50</sub> value for humans have not been established. Human clinical trials have involved total daily doses up to {{Val|1200|u=mg/day}} for 7–21&nbsp;days. Acute one-time total overdoses up to {{Val|4500|u=mg}} have not been life-threatening but resulted in symptoms like [[psychomotor agitation|agitation]], [[insomnia]], [[tremor]], [[palpitations]], and [[gastrointestinal disturbances]].<ref name="Provigil FDA label" /><ref name="pmid23757186">{{cite journal | vauthors = Spiller HA, Hays HL, Aleguas A | title = Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management | journal = CNS Drugs | volume = 27 | issue = 7 | pages = 531–543 | date = July 2013 | pmid = 23757186 | doi = 10.1007/s40263-013-0084-8 }}</ref>

The management of modafinil overdose involves supportive care, monitoring of vital signs, and treatment of specific complications. In cases of recent consumption, [[activated charcoal]], [[gastric lavage]], or [[hemodialysis]] may be used.<ref name="pmid31422705"/> There is no specific antidote for modafinil overdose.<ref name="pmid23757186" /><ref name="Reactions-Weekly-2018-Misuse-Abuse">{{cite journal|doi=10.1007/s40278-018-52897-7|title=Modafinil overdose/misuse/abuse|journal=Reactions Weekly|volume=1723|page=215|year=2018|s2cid=195081462 }}</ref><ref name="pmid18787992">{{cite journal | vauthors = Spiller HA, Borys D, Griffith JR, Klein-Schwartz W, Aleguas A, Sollee D, Anderson DA, Sawyer TS | title = Toxicity from modafinil ingestion | journal = Clinical Toxicology | volume = 47 | issue = 2 | pages = 153–156 | date = February 2009 | pmid = 18787992 | doi = 10.1080/15563650802175595 | s2cid = 12421545 }}</ref> The main way to deal with modafinil overdose is supportive care, which includes sedating the patient and stabilizing their blood pressure, and muscle activity in case of manifestations such as agitation or tremor.<ref name="pmid23757186"/>