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Effects of modafinil in children with attention-deficit/hyperactivity disorder: an open-label study
1Department of Pediatrics, Helping Hands Development Center, Marshall University School of Medicine, Huntington, WV, USA. rugino@marshall.edu
Insights
Once-daily modafinil improved attention-deficit/hyperactivity disorder (ADHD) symptoms in children. This stimulant medication showed significant benefits in clinical and objective measures for pediatric ADHD treatment.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Pharmacology
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Current ADHD treatments often require multiple daily doses, posing adherence challenges.
- Modafinil, a stimulant with a long duration of action, has potential for once-daily ADHD management.
Purpose of the Study:
- To evaluate the efficacy of once-daily modafinil in treating the clinical features of ADHD in children.
- To assess the impact of modafinil on objective measures of attention and behavior in pediatric ADHD.
Main Methods:
- An open-label study involving 11 children (ages 5-15) diagnosed with ADHD.
- Participants were assessed using the Conners Parent and Teacher Rating Scale-Revised (CPRS, CTRS), ADHD Rating Scale-IV, and Test of Variables of Attention (TOVA).
- Assessments were conducted with and without once-daily modafinil treatment over an average of 4.6 weeks.
Main Results:
- Significant improvements were observed in TOVA ADHD scores (2.43 SD, p = .0009).
- CPRS and CTRS ADHD index T scores improved by 17.7 points (p = .001) and 14.1 points (p = .0009), respectively.
- ADHD Rating Scale-IV scores improved from the 88th to the 75th percentile (p = .047); side effects were mild and manageable.
Conclusions:
- Once-daily modafinil demonstrates potential as an effective treatment for ADHD in children.
- The medication was generally well-tolerated, with mild side effects.
- Further investigation with double-blind, placebo-controlled trials is warranted to confirm these findings.
Objective:
To examine the effect of once-daily dosing of modafinil, a stimulant that has a long duration of action, on clinical features of attention-deficit/hyperactivity disorder (ADHD) in children.
Method:
An open-label design was used to compare the Conners Parent and Teacher Rating Scale-Revised (L) (CPRS, CTRS), the ADHD Rating Scale-IV, and the Test of Variables of Attention (TOVA), without and with medication, in children with ADHD. Eleven children with ADHD, ranging in age from 5 to 15 years, took modafinil for an average of 4.6 weeks.
Results:
Average TOVA ADHD scores improved by 2.43 SD (p = .0009). CTRS and CPRS ADHD index T scores improved by an average of 14.1 (p = .0009) and 17.7 points (p = .001), respectively. The mean ADHD Rating Scale-IV scores improved from the 88th percentile to the 75th percentile (p = .047). One subject withdrew from the study because of an adverse event that was resolved completely with medication withdrawal. Other side effects were mild and responded to dose adjustment. No subjects required more than one dose per day.
Conclusions:
Modafinil may be a useful once-daily treatment for children with ADHD. Further study using a double-blind, placebo-controlled design is needed.