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Modafinil: new indications for wake promotion.

Jonathan R L Schwartz1

  • 1Integris Sleep Disorders Center of Oklahoma, Integris Southwest and Baptist Medical Centers, 4200 S. Douglas, Suite 313, Oklahoma City, OK 73109, USA. SchwJR@integris-health.com

Expert Opinion on Pharmacotherapy
|February 16, 2005
PubMed
Summary

Modafinil effectively treats excessive sleepiness (ES) in narcolepsy, obstructive sleep apnea (OSAHS), and shift-work sleep disorder (SWSD). Studies confirm its benefits on objective and subjective sleepiness measures with a favorable safety profile.

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Area of Science:

  • Pharmacology
  • Sleep Medicine
  • Neurology

Background:

  • Excessive sleepiness (ES) is a significant symptom in narcolepsy, obstructive sleep apnea/hypopnoea syndrome (OSAHS), and shift-work sleep disorder (SWSD).
  • Modafinil, a wake-promoting agent, offers a treatment option for ES, with expanded indications beyond narcolepsy.

Purpose of the Study:

  • To review the efficacy and safety of modafinil for treating excessive sleepiness (ES) in narcolepsy, OSAHS, and SWSD.
  • To highlight modafinil's advantages over traditional central nervous system stimulants.

Main Methods:

  • Analysis of five randomized, placebo-controlled studies evaluating modafinil's effects on ES.
  • Assessment of objective measures (e.g., Multiple Sleep Latency Test, Maintenance of Wakefulness Test) and subjective scales (e.g., Epworth Sleepiness Scale).

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Main Results:

  • Modafinil demonstrated statistically significant improvements in objective and subjective measures of ES across all three disorders.
  • Improvements were also noted in overall clinical condition, sustained attention, and reaction time.
  • Headaches were the most common adverse event, typically mild to moderate.

Conclusions:

  • Modafinil is an effective and well-tolerated treatment for ES associated with narcolepsy, OSAHS, and SWSD.
  • Its favorable safety profile and lack of abuse potential distinguish it from other ES medications.
  • Increased awareness of ES and modafinil's therapeutic role is crucial for improved patient management.