Modafinil and cognitive enhancement in schizophrenia and healthy volunteers: the effects of test battery in a randomised controlled trial

Lees, Jane; Michalopoulou, Panayiota G.; Lewis, Shôn; Preston, Sally; Bamford, Charlie; Collier, Tracy; Kalpakidou, Anastasia K.; Wykes, Til; Emsley, Richard; Pandina, Gahan; Kapur, Shitij; Drake, Richard

doi:10.1017/s0033291717000885

Cited by 32 publications

(35 citation statements)

References 46 publications

(83 reference statements)

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“…Reviewing evidence reported subsequence to this review supports these findings [15]. Evidence reviews have concluded that improvement in cognitive functions induced by modafinil could have a beneficial effect on broader aspects of patients' lives, including functional outcomes, quality of life and wellbeing [14].…”

Section: Modafinil and Schizophreniasupporting

confidence: 59%

“…Research has shown that modafinil can enhance cognitive function in schizophrenia [14] [15] and has potential to enhance real life functioning [16] and reduce negative symptoms [17]. This potential requires further research.…”

Section: Discussionmentioning

confidence: 99%

“…There has been insufficient consistent evidence on which to base a recommendation for modafinil as adjunctive therapy in schizophrenia [30], but the evidence for its value has been growing [15]. Clinicians can prescribe modafinil "off label" as a treatment in people with a diagnosis of schizophrenia, but there is little evidence that this is happening.…”

Section: Considerations For Clinical Usementioning

confidence: 99%

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The Effects of Modafinil in People with a Diagnosis of Schizophrenia

Griffiths¹,

Girardi²

2018

OJPsych

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This review seeks to describe the use and effects of the drug modafinil. Specifically, it presents the research of the impact of modafinil for people with diagnosis and experience of schizophrenia. Recent reviews have shown that modafinil can positively impact on cognitive function in people with a diagnosis of schizophrenia. There is emerging evidence for the positive impact of modafinil on negative symptoms, functioning, quality of life, wellbeing, and body mass index (BMI) for people with schizophrenia. Compared to other central nerve stimulant (CNS) drugs, modafinil has a low risk of dependency and few negative side effects; but there are risks of triggering positive symptoms in schizophrenia. A well designed and sufficiently large randomised control trial is required to test the potential of the impact of modafinil in the lives of people with a diagnosis of schizophrenia. Future research should report participant's perspective of the value of modafinil connected to what concerns them and what they want to achieve in their lives.

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Section: Modafinil and Schizophreniasupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Considerations For Clinical Usementioning

confidence: 99%

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The Effects of Modafinil in People with a Diagnosis of Schizophrenia

Griffiths¹,

Girardi²

2018

OJPsych

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“…It improves memory [ 31 ], executive function [ 32 ], and increases alertness and response accuracy in healthy subjects [ 25 ]. Importantly, the cognitive enhancer effect of modafinil has also been reported in a number of different neurological conditions including schizophrenia [ 33 , 34 ] and attention deficit hyperactivity disorder [ 35 ]. Modafinil has also been shown to be effective when given as an adjunct to standard treatment for treating mood disorders [ 36 , 37 ].…”

Section: Introductionmentioning

confidence: 99%

Wake-Promoting and EEG Spectral Effects of Modafinil After Acute or Chronic Administration in the R6/2 Mouse Model of Huntington's Disease

et al. 2020

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Huntington's disease (HD) is characterised by progressive symptoms including cognitive deficits and sleep/wake disturbances reflected in an abnormal electroencephalography (EEG). Modafinil, a wake-promoting and cognitive-enhancing drug, has been considered as a treatment for HD. We used HD (R6/2) mice to investigate the potential for using modafinil to treat sleep-wake disturbance in HD. R6/2 mice show sleep-wake and EEG changes similar to those seen in HD patients, with increased rapid eye movement sleep (REMS), decreased wakefulness/increased non-REMS (NREMS), and pathological changes in EEG spectra, particularly an increase in gamma power. We recorded EEG from R6/2 and wild-type mice treated with modafinil acutely (with single doses between 25 and 100 mg/kg; at 12 and 16 weeks of age), or chronically (64 mg/kg modafinil/day from 6 to 15 weeks). Acutely, modafinil increased wakefulness in R6/2 mice and restored NREMS to wild-type levels at 12 weeks. It also suppressed the pathologically increased REMS. This was accompanied by decreased delta power, increased peak frequency of theta, and increased gamma power. At 16 weeks, acute modafinil also restored wakefulness and NREMS to wild-type levels. However, whilst REMS decreased, it did not return to normal levels. By contrast, in the chronic treatment group, modafinil-induced wakefulness was maintained at 15 weeks (after 9 weeks of treatment). Interestingly, chronic modafinil also caused widespread suppression of power across the EEG spectra, including a reduction in gamma that increases pathologically in R6/2 mice. The complex EEG effects of modafinil in R6/2 mice should provide a baseline for further studies to investigate the translatability of these result to clinical practice.

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“…It has been shown that modafinil improves episodic memory in patients with schizophrenia. This agent has also been reported to selectively improve spatial working memory and emotional processing (e.g.…”

mentioning

confidence: 99%