Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury

Area of Science:

• Neuroscience
• Pharmacology
• Clinical Neurology

Background:

• Fatigue and excessive daytime sleepiness (EDS) are common sequelae of traumatic brain injury (TBI).
• Modafinil is a central nervous system stimulant approved for narcolepsy and shift-work sleep disorder.

Purpose of the Study:

• To evaluate the existing literature on the efficacy of modafinil for treating fatigue and EDS in patients with TBI.

Main Methods:

• A comprehensive literature search was conducted on Medline and PubMed.
• Included studies comprised randomized controlled trials, observational studies, meta-analyses, case reports, and systematic reviews.
• Twenty-three articles were collected, with nine providing relevant data on modafinil use in TBI patients.

Main Results:

• Evidence regarding modafinil's benefit for TBI-related fatigue and EDS is conflicting.
• One study found no significant improvement in wakefulness, while another indicated correction of EDS but not fatigue.
• An observational study suggested modafinil increased alertness in fatigued patients with a history of stroke or multiple sclerosis.

Conclusions:

• Modafinil may offer potential benefits for improving wakefulness in TBI patients.
• Further high-quality, consistent research, such as ongoing trials in stroke patients, is necessary to establish definitive conclusions.
• Current evidence is insufficient to conclusively recommend modafinil for TBI-related fatigue and EDS.