Modafinil in the treatment of
excessive daytime sleepiness in children.
Ivanenko A, Tauman R, Gozal
D.
Division of Sleep Medicine
Department of Pediatrics
University of Louisville School of Medicine
Louisville, KY 40202, USA.
Sleep Med. 2003 Nov; 4(6): 579-82
Abstract
BACKGROUND: Modafinil is an alerting agent
approved for the treatment of narcolepsy in adults. There are no studies
examining the long-term effects and safety profile of modafinil in children
with excessive daytime somnolence (EDS). OBJECTIVES: To determine the effects
of modafinil on clinical manifestations of narcolepsy and idiopathic
hypersomnia.
METHODS: A systematic chart review was conducted for 13 children (mean age
11.0+/-5.3 years, six males, 10 with narcolepsy and three with idiopathic
hypersomnia) receiving modafinil. RESULTS: The mean modafinil dose was
346+/-119 mg/day, with a mean treatment duration of 15.6+/-7.8 months. For
approximately 90% of the children treated, parents reported a favorable
response with the reduction in sudden sleep attacks, as documented by
sleep-wake diaries. One child failed to improve on 400 mg/day modafinil and
was switched to methylphenidate. Two other children showed only partial
improvement and required additional stimulant medication to control EDS
symptoms. Seven children underwent repeated nocturnal polysomnography and
multiple sleep latency tests (MSLT). Compared to baseline MSLT measures (mean
sleep latency: 6.6+/-3.7 min), modafinil prolonged mean sleep latency
(10.2+/-4.8 min, p=0.02) without significant alteration in nocturnal
polysomnographic measures. However, a trend towards REM sleep reduction was
noted (16.8+/-5.1%TST vs. 11.8+/-6.2%TST). Exacerbation of seizures and
psychotic symptoms was reported with modafinil therapy in two children with
preexisting conditions. Hematological and hepatic functions assessed every 3
months remained unaltered.
CONCLUSION: Modafinil has a modest, yet significant effect on EDS in children
and appears to be safe and well tolerated.
1. Modafinil for
sustaining the alertness of helicopter pilots
2. Modafinil augmentation
of antidepressant treatment
3. Modafinil the
unique properties of a new stimulant
4. Modafinil children
with attention-deficit/hyperactivity disorder
5. Modafinil dosage
and safety
6. Modafinil successful
treatment of hypersomnia & narcolepsy
7. Modafinil narcolepsy:
symptoms and management
8. Modafinil
amplification of cortical serotonin release
9. Modafinil
treatment of alcoholic organic brain syndrome
10. Modafinil
effect on melatonin, cortisol, and growth hormone
11. Modafinil
in obstructive sleep apnea-hypopnea syndrome
12. Modafinil
vs dextroamphetamine in treatment of adult ADHD
13. Modafinil
efficacy in narcolepsy
14. Modafinil
switching from narcolepsy drugs to modafinil
15. Modafinil
dopaminergic transmission mediates CNS stimulants
