Effect of Modafinil Administration on the Level of Consciousness in Patients with Brain Injuries of Moderate Severity

Moghadam, Omid Moradi; Nima, N.; Abad, Ebadallah Shiri Malek; Hasani, Valiolah; Tabibkhooei, Alireza; Sheikhvatan, Mehrdad; Lahiji, Mohammad Niakan

doi:10.5812/traumamon.61505

Cited by 1 publication

(8 citation statements)

References 29 publications

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“…40 Generally, studies show that amantadine and modafinil improve patients' level of consciousness with acute TBI. 33,40,[46][47][48][49][50][51][52][53]55,56 However, amantadine seems to be associated with a higher overall response rate. In contrast, modafinil is associated with the most remarkable change in GCS score during treatment.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, modafinil is associated with the most remarkable change in GCS score during treatment. 33,45 Modafinil was explicitly examined in only one study. 33 In addition, according to the results of this study, modafinil did not have much effect on the level of consciousness (Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…33,45 Modafinil was explicitly examined in only one study. 33 In addition, according to the results of this study, modafinil did not have much effect on the level of consciousness (Table 4). For this reason, it is impossible to draw a general conclusion about the effect of modafinil in this study, and more investigations are needed.…”

Section: Resultsmentioning

confidence: 99%

“…A double-blind clinical trial on 60 patients indicated no significant difference in mean GCS on days 1 and 8 after administration of modafinil and placebo ( P > 0.05). 33 However, in a case report study, modafinil was used to treat a patient with complaints of problems in daily routine functioning, especially in getting out of bed, doing volunteer work, holding a job, and spending quality time with his daughter. The patient reported significant improvements in his depressive symptoms and ability to perform daily living activities.…”

Section: Discussionmentioning

confidence: 99%

“…31 Modafinil is a novel CNS stimulant initially Food and Drug Administration approved for excessive daytime sleepiness. 32,33 Its exact mechanism of action is unknown; however, it has been proposed that this drug affects both the dopaminergic and noradrenergic systems and interacts with orexin and histamine-induced alertness. 34 Modafinil also increases extracellular glutamate in several areas of the brain (ie, thalamus, hippocampus, striatum, medial preoptic area, and posterior hypothalamus) in a dose-dependent manner while decreasing γaminobutyric acid.…”

mentioning

confidence: 99%

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Consciousness Recovery in Traumatic Brain Injury: A Systematic Review Comparing Modafinil and Amantadine

Seifi,

Hassannezhad,

Mosaddeghi-Heris

et al. 2023

Clin Neuropharm

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Objectives Acute traumatic brain injury is one of the most common causes of death and disability. Reduction in the level of consciousness is a significant complication that can impact morbidity. Glasgow Coma Scale (GCS) is the most widely used method of assessing the level of consciousness. Neurostimulants such as amantadine and modafinil are common pharmacologic agents that increase GCS in patients with brain trauma. This study aimed to compare the effectiveness of these 2 drugs. Methods This systematic review obtained articles from Google Scholar, PubMed, Scopus, Embase, and MEDLINE databases. Extensive searches were conducted separately by 4 individuals in 3 stages. Ultimately, 16 clinical trials, cohort studies, case reports, and case series articles were obtained after reading the title, abstract, and full text and considering the exclusion criteria. The data of the final article were entered into the analysis table. This study was registered with PROSPERO (registration number CRD42022334409) and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results Amantadine seems to be associated with a higher overall response rate. In contrast, modafinil is associated with the most remarkable change in GCS score during treatment. However, the number of clinical trials with high quality and sample size has not been satisfactory to compare the effectiveness of these 2 drugs and their potential side effects. Conclusions The authors recommend additional double-blind clinical trials are needed to be conducted with a larger sample size, comparing amantadine with modafinil to delineate the efficacy and adverse effects, both short and long term.

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