Acute Modafinil Effects on Attention and Inhibitory Control in Methamphetamine-Dependent Humans

Abstract

ABSTRACT. Objective: Individuals who are methamphetamine dependent exhibit higher rates of cognitive dysfunction than healthy people who do not use methamphetamine, and this dysfunction may have a negative effect on the success of behavioral treatments for the disorder. Therefore, a medication that improves cognition, such as modafi nil (Provigil), may serve as a useful adjunct to behavioral treatments for methamphetamine dependence. Although cognitive-enhancing effects of modafi nil have been reported in several populations, little is known about the effects of modafi nil in methamphetamine-dependent individuals. We thus sought to evaluate the effects of modafi nil on the cognitive performance of methamphetamine-dependent and healthy individuals. Method: Seventeen healthy subjects and 24 methamphetamine-dependent subjects participated in this randomized, double-blind, placebo-controlled, crossover study. Effects of modafi nil (200 mg, single oral dose) were assessed on participants' performance on tests of inhibitory control, working memory, and processing speed/attention. Results: Across subjects, modafi nil improved performance on a test of sustained attention, with no signifi cant improvement on any other cognitive tests. However, within the methamphetamine-dependent group only, participants with a high baseline frequency of methamphetamine use demonstrated a greater effect of modafi nil on tests of inhibitory control and processing speed than those participants with low baseline use of methamphetamine. Conclusions: Although modafi nil produced limited effects across all participants, methamphetamine-dependent participants with a high baseline use of methamphetamine demonstrated signifi cant cognitive improvement on modafi nil relative to those with low baseline methamphetamine use. These results add to the fi ndings from a clinical trial that suggested that modafi nil may be particularly useful in methamphetamine-dependent subjects who use the drug frequently. (J. Stud. Alcohol Drugs, 72, 943-953, 2011)

Cognitive enhancement as a treatment for drug addictions

“…In a small inpatient study, 7 days of modafinil treatment improved immediate verbal memory function (Hester et al, 2010). In another study a single 200 mg oral dose of modafinil improved sustained attention (Dean et al, 2011). Furthermore, treatment with 400 mg/day of modafinil for 3 days improved working memory function in methamphetamine dependent individuals who had impaired working memory function at baseline (Kalechstein et al, 2010).…”

The neurobiology of modafinil as an enhancer of cognitive performance and a potential treatment for substance use disorders

“…Moreover, treatment (or adjunctive treatment) of neuropsychological disorders such as drug abuse and addiction with cognitive enhancers such as MOD or R-MOD may be more effective than current strategies (Brady et al 2011). This idea is particularly appealing for the treatment of cocaine and/or methamphetamine abuse, as there are no effective medications currently available (Dean et al 2011; Ghahremani et al 2011). …”

Excessive Daytime Sleepiness in Patients With ADHD—Diagnostic and Management Strategies

“…In this model, motor hyperactivity, at least in some ADHD children, may be a counter-behavior for staying awake [73]. The use of stimulant medication to treat ADHD and the improvement of ADHD symptoms with modafinil, which is commonly used to treat narcolepsy [74][75][76][77], strengthen the idea of a deficit in alertness in ADHD. Moreover, some of the therapeutic effects of stimulant medication in ADHD could be due to their effect on EDS, which interrupts the autoregulatory hyperactivity behavior [7].…”