Modafinil as a Stimulant for Military Aviators

Area of Science:

• Aerospace Medicine
• Pharmacology
• Military Health

Background:

• Modafinil is an approved wakefulness-promoting stimulant for Republic of Singapore Air Force (RSAF) aircrew fatigue management since 2011.
• Pre-operational ground testing is mandatory to identify adverse drug effects.
• This study details RSAF's modafinil ground testing outcomes over seven years.

Purpose of the Study:

• To describe the outcomes of modafinil ground testing in RSAF aircrew.
• To assess the incidence of adverse drug effects in this population.

Main Methods:

• Retrospective case series of 243 RSAF aircrew.
• Involved modafinil 100-mg test dosing over a 7-year period (September 2011 to September 2018).

Main Results:

• 97.5% of aircrew (237/243) were medically cleared for operational modafinil use.
• 2.47% (6/243) failed ground testing due to side effects: headache (1.65%), anxiety (0.41%), diarrhea (0.41%), insomnia (0.41%).
• No major adverse drug events were reported.

Conclusions:

• Modafinil ground testing in RSAF aircrew shows a low incidence of adverse drug effects.
• Findings support the safe operational use of modafinil as a fatigue countermeasure in this cohort.
• This is the largest case series on modafinil ground testing outcomes in Asian military aviators.