Effect of modafinil on fatigue,
mood, and health-related quality of life in patients with narcolepsy.
Becker PM, Schwartz JR, Feldman
NT, Hughes RJ.
Department of Psychiatry,
University of Texas Southwestern Medical Center
Dallas, Texas, USA
pbecker@sleepmed.com
Psychopharmacology (Berl). 2004 Jan; 171(2): 133-9.
Abstract
INTRODUCTION. In addition to excessive
sleepiness, patients with narcolepsy often have significant fatigue, depressed
mood, and decreased quality of life. OBJECTIVE. To determine whether treatment
with modafinil for excessive sleepiness improves fatigue, mood, and
health-related quality of life (HRQOL) in patients with narcolepsy.
MATERIALS AND METHODS. Outpatients with narcolepsy underwent a 14-day washout
of psychostimulants and then were enrolled in this 6-week, open-label,
multicenter study. Patients received modafinil starting at 200 mg once daily
for week 1, and then 200 or 400 mg daily for weeks 2 through 6. Efficacy was
evaluated using the Medical Outcomes Study 36-Item Short-Form Health Survey
(SF-36) and the Profile of Mood States (POMS). Safety was assessed by
monitoring adverse events (AE).
RESULTS. At baseline, 151 patients had moderate to severe excessive sleepiness
(mean Epworth Sleepiness Scale score=17.8+/-4.4). Most patients (>/=70% of 123
who completed the study) received 400 mg modafinil once daily during weeks 2
through 6. Modafinil significantly improved HRQOL, based on SF-36 measures of
mental and physical component summary scores and subdomain scores of
role-physical, social functioning, and vitality (each P<0.001). Modafinil
treatment was also associated with significantly reduced fatigue and
significantly improved vigor and cognition as assessed by the POMS (each
P<0.001) from weeks 1 through 6. The most frequent AE with modafinil treatment
were headache, nausea, and insomnia; most AE were mild or moderate in nature.
Only seven patients (5%) withdrew from the study because of AE.
CONCLUSION. In narcolepsy patients who were switched from psychostimulants,
modafinil therapy improved health-related quality of life and subjective
feelings of vigor and cognitive functioning and reduced fatigue.
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
