Modafinil for people with schizophrenia or related disorders

Ortiz-Orendain, Javier; Covarrubias-Castillo, Sergio Armando; Vázquez‐Álvarez, Alan Omar; Castiello, Santiago; Quiñones, Gustavo E Arias; Seegers, Maya; Colunga‐Lozano, Luis Enrique

doi:10.1002/14651858.cd008661.pub2

Cited by 5 publications

(9 citation statements)

References 92 publications

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“…Ortiz-Orendain 2019 showed that compared to placebo, adjunctive modafinil did not result in a clear benefit for any of the seven outcomes measures. In light of the methodological heterogeneity, low statistical power, and short duration of the clinical trials included in this review, the authors concluded that most of the evidence collated was of very low or low quality.…”

Section: Discussionmentioning

confidence: 97%

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

Oyesanya

Al‐Juffali²

2022

BJPsych advances

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SUMMARYAntipsychotics are the cornerstone of schizophrenia management but they are not adequate in treating the negative and cognitive symptoms of the illness. The Cochrane review discussed in this commentary examines the safety and effectiveness of the wakefulness-promoting agent, modafinil, as an adjunct to standard care in the mitigation of negative and cognitive symptoms of schizophrenia. Add-on modafinil, compared to add-on placebo and standard treatment, did not result in a clear benefit. Due to the heterogenous body of evidence, the quality of which ranged from very low to moderate, the review's conclusions are equivocal.

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Section: Discussionmentioning

confidence: 97%

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

Oyesanya

Al‐Juffali²

2022

BJPsych advances

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“… 49 Additionally, pro-dopaminergic medications such as modafinil have been trialed in the treatment of negative symptoms of schizophrenia, including daytime sleepiness, but studies conducted to date have not yielded a consensus on potential for benefit due to methodological issues. 50 , 51…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Major Cardiovascular Disease Events Among People Diagnosed With Schizophrenia Who Have Sleep Disturbance, Sedentary Behavior, or Muscular Weakness

Berry

Yung

Carr

et al. 2021

Schizophrenia Bulletin Open

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Objective To estimate prevalence of major cardiovascular events among people with schizophrenia who had experience of sleep disturbance, sedentary behavior or muscular weakness, and assess evidence for raised prevalence in these individuals compared to people with schizophrenia without these characteristics. Methods UK Biobank data on individuals diagnosed with schizophrenia (n = 1544) were used to examine the prevalence of major cardiovascular events, specifically myocardial infarction, stroke, heart failure and cardiovascular death, among participants with candidate risk factors. Generalized linear models were fitted to estimate prevalence ratios (PRs) for major cardiovascular events among participants with self-reported sleep disturbance, self-reported sedentary behavior, and muscular weakness measured using a handgrip dynamometer. These ratios were adjusted for QRISK3 score—a validated cardiovascular risk prediction algorithm for the UK population. Results Prevalence of major cardiovascular events was significantly higher among participants with daytime sleepiness, independent of QRISK3 score, and snoring, a proxy for sleep-disordered breathing (adjusted PR 1.26; 95% CI 1.03, 1.55, P = .03). Prevalence was also independently higher among participants with low muscular strength (adjusted PR1.36; 95% CI 1.05, 1.75, P = .02). The adjusted prevalence ratios among participants with short or prolonged sleep duration, insomnia, or sedentary behavior did not indicate independently raised prevalence among these groups. Conclusion Prevalence of major cardiovascular events among people with schizophrenia was higher in participants with muscular weakness and sleep disturbance evidenced by daytime sleepiness. Further research is required to determine how these factors can be routinely identified and addressed in the clinical management of cardiovascular risk among patients with schizophrenia.

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“…Although it has been classified as a dopamine reuptake inhibitor, modafinil also modulates norepinephrine and serotonin transport, enhances glutamatergic neurotransmission and blocks GABAergic signaling [ 203 ]. It was suggested that modafinil improved cognitive functions in animal models of schizophrenia [ 204 ], but a recent systematic review by Ortiz-Orendain et al concludes that the evidence for the efficacy of modafinil in alleviating cognitive deficit in schizophrenic patients is weak [ 116 ].…”

Section: Treatment Of Cognitive Deficit In Schizophreniamentioning

confidence: 99%

Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments

Martínez

Brea

Rico

et al. 2021

IJMS

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Schizophrenia is a major mental illness characterized by positive and negative symptoms, and by cognitive deficit. Although cognitive impairment is disabling for patients, it has been largely neglected in the treatment of schizophrenia. There are several reasons for this lack of treatments for cognitive deficit, but the complexity of its etiology—in which neuroanatomic, biochemical and genetic factors concur—has contributed to the lack of effective treatments. In the last few years, there have been several attempts to develop novel drugs for the treatment of cognitive impairment in schizophrenia. Despite these efforts, little progress has been made. The latest findings point to the importance of developing personalized treatments for schizophrenia which enhance neuroplasticity, and of combining pharmacological treatments with non-pharmacological measures.

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Modafinil for people with schizophrenia or related disorders

Cited by 5 publications

References 92 publications

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

Is modafinil an effective adjunct to standard care in the treatment of schizophrenia-spectrum disorders?

Prevalence of Major Cardiovascular Disease Events Among People Diagnosed With Schizophrenia Who Have Sleep Disturbance, Sedentary Behavior, or Muscular Weakness

Cognitive Deficit in Schizophrenia: From Etiology to Novel Treatments

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