Use of modafinil in the treatment of narcolepsy
Besset A, Chetrit M, Carlander B, Billiard M.
Service de neurologie B,
hopital Gui-de-Chauliac, Montpellier, France
Neurophysiol Clin 1996;26(1):60-6
ABSTRACT
One hundred and forty patients (104 male and 36 female) aged 42.26 19.19 (range = 8 to 79.5 years) with narcolepsy-cataplexy were given modafinil (200 to 400 mg) at the Montpellier sleep disorders center from 1984 onwards. The follow-up focused on the reduction of excessive daytime somnolence (EDS), side effects and duration of treatment. In order to determine if any clinical aspect of narcolepsy could be involved in modafinil discontinuation, patients were divided into two groups according to continued or interrupted treatment. When modafinil effect on EDS was evaluated according to a scale varying from 0 (no effect) to 3 (excellent effect), 64.1% of the subjects, scored good or excellent. The mean duration of treatment was 22.05 months 24.9, ranging from 1 to 114 months. Dependency signs were never observed
OBJECTIVE: The principal
objective was to determine whether prophylactic doses of modafinil would
attenuate decrements in aviator performance and arousal throughout 2 days
and 1 night without sleep.
METHODS: Six pilots were exposed
to two 40-h periods of continuous wakefulness. In one, three 200-mg doses of
modafinil were given and in the other, matching placebos were administered.
Helicopter simulator flights, resting EEGs, and Profile of Mood States (POMS)
questionnaires were evaluated.
RESULTS: Modafinil attenuated
sleep deprivation effects on four of six flight maneuvers, reduced slow-wave
EEG activity, and lessened self-reported problems with mood and alertness in
comparison to placebo. The most noticeable benefits occurred between 0330
and 1130 hours, when the combined impact of sleep loss and the circadian
trough was most severe. The most frequently observed drug side effects were
vertigo, nausea, and dizziness. These could have been related to: 1) the
motion-based testing, 2) the use of a simulator rather than an actual
aircraft (i.e., "simulator sickness"), and/or 3) the
administration of more than 400 mg modafinil.
CONCLUSIONS: Modafinil is a
promising countermeasure for sleep loss in normals; however, additional
studies aimed at reducing side effects are needed before it should be used
in aviators.
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
