Intractability of Deficit Syndrome of Schizophrenia Against Adjunctive Modafinil

Negative symptoms are a significant barrier to successful functional outcome and recovery in individuals with schizophrenia, and their management is not easy. Prior tryouts with antidepressants and some cognitive enhancers were not really encouraging, and experiments with modafinil had mixed and indecisive results. The objective of the present study was to assess modafinil's efficacy on subjective and objective aspects of negative symptoms of schizophrenia.

This study was an 8-week randomized, placebo-controlled trial of modafinil, as an adjective to haloperidol, in treatment of 50 schizophrenic patients. Scale for the Assessment of Negative Symptoms (SANS) was used as the primary outcome measure, and Scale for Assessment of Positive Symptoms, Clinical Global Impressions-Severity Scale, Schedule for Assessment of Insight, Simpson Angus Scale, Psychological General Well-Being Schedule, and Nurses Observation Scale for Inpatient Evaluation were used as secondary measures.

According to the findings, while more cases in the modafinil group (n = 14) showed a positive response in some of the subscales of SANS, in comparison with the placebo group (n = 6; P < 0.04), the intractability of the deficit syndrome of schizophrenia against augmentative modafinil was obvious because there was no significant decrease in the mean total score of SANS in the target group in comparison with the placebo group at the end of the assessment (P < 0.08). In addition, while no significant alteration in most of the secondary measures was evident, a significant improvement in Psychological General Well-Being Schedule (P < 0. 04) and Nurses Observation Scale for Inpatient Evaluation (P < 0. 05) was obvious at the end of the trial.

According to the results, despite the fact that a remarkable influence by adjunctive modafinil was visible as regards the subjective measures, no significant improvement was evident with respect to deficit syndrome per se.