Modafinil Improves Cognition and Attentional Set Shifting in Patients with Chronic Schizophrenia

Turner, Danielle C.; Clark, Luke; Pomarol‐Clotet, Edith; McKenna, Peter J.; Robbins, Trevor W.; Sahakian, Barbara J.

doi:10.1038/sj.npp.1300457

Cited by 240 publications

(187 citation statements)

References 74 publications

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“…Although this dose has been shown to improve cognitive function in other MA-dependent, psychiatric, and healthy subject samples (Hester et al, 2010;Müller et al, 2004;Turner et al, 2003Turner et al, , 2004aTurner et al, , 2004bWalsh et al, 2004), higher doses (e.g., 400 mg) have been shown to be safe in MA-dependent participants (Heinzerling et al, 2010) and may produce a more pronounced cognitive effect. In addition, compared with our single-dose design, use of a multiple-dose design would have been preferable for the detection of a dose-response relationship between modafi nil and cognitive performance.…”

Section: Discussionmentioning

confidence: 99%

“…In healthy adults, modafi nil has been shown to improve working memory (Müller et al, 2004;Turner et al, 2003), sustained attention (Randall et al, 2005b), processing speed/reaction time (Baranski et al, 2004;Randall et al, 2004), and recognition memory (Turner et al, 2003), with particular benefi ts in individuals who were sleep deprived (Gill et al, 2006;Grady et al, 2010;Hart et al, 2006;Walsh et al, 2004;Wesensten et al, 2002). Positive effects of modafi nil on various cognitive functions, particularly sustained attention and working memory, have also been noted in some psychiatric groups, such as individuals with schizophrenia (Rosenthal and Bryant, 2004;Turner et al, 2004b), major depression (DeBattista et al, 2004), and attention-defi cit/hyperactivity disorder (ADHD; Greenhill et al, 2006;Turner et al, 2004a). Of note, modafi nil has additionally been shown to improve performance on tests of inhibitory control, such as the stop-signal task and Stroop color-naming test, in both healthy individuals and psychiatric patients (DeBattista et al, 2004;Randall et al, 2004;Turner et al, 2003).…”

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

Dean¹,

Sevak²,

Monterosso³

et al. 2011

J. Stud. Alcohol Drugs

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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)

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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

Dean¹,

Sevak²,

Monterosso³

et al. 2011

J. Stud. Alcohol Drugs

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“…Such an agent (eg, modafinil) has been used with psychotropic medications to reduce sedation and cognitive impairment. 9,10,49,67,68,74 New cognitive enhancers are on the horizon as researchers test cholinergic agents, biogenic amines, and neuropeptides to treat learning and memory deficits associated with neurodegenerative states. Psychostimulants, excitatory amino acids, and a heterogeneous group of compounds of diverse chemical composition that allegedly facilitate learning and memory or overcome natural or induced cognitive impairments 50 might someday be useful in combination with cannabis or cannabinoids currently thought to be undesirable because of the depressant effects on the central nervous system that limit their use.…”

Section: Discussionmentioning

confidence: 99%

A Randomized, Placebo-Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain

Wilsey

Marcotte

Tsodikov

et al. 2008

The Journal of Pain

270

244

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The Food and Drug Administration (FDA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute for Drug Abuse (NIDA) report that no sound scientific studies support the medicinal use of cannabis. Despite this lack of scientific validation, many patients routinely use "medical marijuana," and in many cases this use is for pain related to nerve injury. We conducted a double-blinded, placebo-controlled, crossover study evaluating the analgesic efficacy of smoking cannabis for neuropathic pain. Thirty-eight patients with central and peripheral neuropathic pain underwent a standardized procedure for smoking either high-dose (7%), low-dose (3.5%), or placebo cannabis. In addition to the primary outcome of pain intensity, secondary outcome measures included evoked pain using heat-pain threshold, sensitivity to light touch, psychoactive side effects, and neuropsychological performance. A mixed linear model demonstrated an analgesic response to smoking cannabis. No effect on evoked pain was seen. Psychoactive effects were minimal and well-tolerated, with some acute cognitive effects, particularly with memory, at higher doses. KeywordsNeuropathic pain; analgesia; cannabis; clinical trial; neuropsychological testingThe case for the clinical utility of cannabis as an analgesic derives from experimental studies as well as anecdotal reports. Activation of the endocannabinoid system suppresses HHS Public AccessAuthor manuscript J Pain. Author manuscript; available in PMC 2016 August 01. Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript behavioral responses to acute and persistent noxious stimulation through both central 71 and peripheral 45 mechanisms. Cannabinoid receptors are localized in neuroanatomic regions intimately involved with transmission and modulation of pain signals: The periaqueductal gray (PAG), the rostral ventromedial medulla (RVM), 40,66 and the dorsal horn of the spinal cord. 66 Animal experimentation has clearly demonstrated that synthetic and endogenous cannabinoids not only produce analgesia but also interact in some manner to potentiate opioids, 18,70 particularly in neuropathic pain. 41 Surveys involving the use of medicinal marijuana reveal that pain, sleep, and mood improve with only modest side effects. 72,73 In one human pain experiment, subjects had a significant dose-dependent antinociception (increased finger withdrawal latency) effect that was not reversed by opioid antagonism. 31 In a somewhat contradictory manner, hyperalgesic activity and enhancement of the perception of pain on acute exposure in chronic users of marijuana was reported. 20 Experience with cancer pain revealed that 120 mg codeine and 20 mg delta-9-tetrahydrocannabinol (9-THC) were similar to each other and significantly superior to placebo for the sum of the pain intensity differences and total pain relief. 55,56 However, there was a clear dose-response relationship for sedation, mental clouding, and other central nervous system (CNS) related side effects f...

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“…The dosage was determined on the basis of prior studies showing significant effects on cognition in patients with ADHD and schizophrenia with a single dose of this magnitude (Turner et al, 2004a;Turner et al, 2004b). The time between modafinil administration and testing was calculated on the basis of human pharmacokinetic data showing peak plasma levels at 2-4 h after a single dose (Robertson and Hellriegel, 2003).…”

Section: Research Participants and Methodsmentioning

confidence: 99%

Effect of Modafinil on Learning and Task-Related Brain Activity in Methamphetamine-Dependent and Healthy Individuals

Ghahremani

Tabibnia

Monterosso

et al. 2011

Neuropsychopharmacol

108

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Methamphetamine (MA)-dependent individuals exhibit deficits in cognition and prefrontal cortical function. Therefore, medications that improve cognition in these subjects may improve the success of therapy for their addiction, especially when cognitive behavioral therapies are used. Modafinil has been shown to improve cognitive performance in neuropsychiatric patients and healthy volunteers. We therefore conducted a randomized, double-blind, placebo-controlled, cross-over study, using functional magnetic resonance imaging, to examine the effects of modafinil on learning and neural activity related to cognitive function in abstinent, MA-dependent, and healthy control participants. Modafinil (200 mg) and placebo were administered orally (one single dose each), in counterbalanced fashion, 2 h before each of two testing sessions. Under placebo conditions, MA-dependent participants showed worse learning performance than control participants. Modafinil boosted learning in MA-dependent participants, bringing them to the same performance level as control subjects; the control group did not show changes in performance with modafinil. After controlling for performance differences, MAdependent participants showed a greater effect of modafinil on brain activation in bilateral insula/ventrolateral prefrontal cortex and anterior cingulate cortices than control participants. The findings suggest that modafinil improves learning in MA-dependent participants, possibly by enhancing neural function in regions important for learning and cognitive control. These results suggest that modafinil may be a suitable pharmacological adjunct for enhancing the efficiency of cognitive-based therapies for MA dependence. Neuropsychopharmacology (2011) 36, 950-959;

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Modafinil Improves Cognition and Attentional Set Shifting in Patients with Chronic Schizophrenia

Cited by 240 publications

References 74 publications

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

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

A Randomized, Placebo-Controlled, Crossover Trial of Cannabis Cigarettes in Neuropathic Pain

Effect of Modafinil on Learning and Task-Related Brain Activity in Methamphetamine-Dependent and Healthy Individuals

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