Modafinil reduces microsleep during partial sleep deprivation in depressed patients

Fast BDNF serum level increase and diurnal BDNF oscillations are associated with therapeutic response after partial sleep deprivation

“…An improvement of at least 30% from baseline was required to determine a PSD response. The modafinil group consisted of eight men and six women, age 46.2 ± 12.2 years (n ¼ 14, HDRS 21-items before PSD 21.71 ± 6.56 and at day after PSD 15.71 ± 9.12; 6-items before PSD 9.43 ± 2.79 and at day after PSD 6.50 ± 3.69) and the placebo group of five men and nine women, age 43.9 ± 12.2 years (n ¼ 14, HDRS 21-items before PSD 21.79 ± 4.72 and at day after PSD 12.64 ± 8.38; 6-items before PSD 8.71 ± 2.40 and at day after PSD 5.07 ± 3.85; values of all ratings were not different compared to modafinil) (Beck et al, 2010). Compared to placebo, modafinil was efficient in reducing daytime microsleep following partial sleep deprivation but did not enhance the antidepressive effects of PSD and did not stabilize antidepressive effects over two weeks (Beck et al, 2010).…”

“…Twenty-eight in-and out-patients (13 men, 15 women, age 45.1 ± 12.1 years; range 19e65 years) with the diagnosis of major depression (DSM-IV and ICD-10) and according to the SCID (Wittchen et al, 1987) participated in this study as previously published (Beck et al, 2010). Study design details, inclusion and exclusion criteria were previously described in details by Beck et al (2010).…”

“…Study design details, inclusion and exclusion criteria were previously described in details by Beck et al (2010). The investigation was carried out in accordance with the latest version of the Declaration of Helsinki and the study protocol was approved by the local ethics committee.…”

“…Inclusion criteria comprised an HDRS-score of !15 and the presence of significant daytime sleepiness and severity of depression was evaluated by the 21-Item version of Hamilton Depression Rating Scale (HDRS) (Hamilton, 1967). In brief, all participants were naïve to sleep deprivation therapy and randomly assigned to either additional modafinil or placebo treatment, to test the effect of modafinil (200 mg/d) on microsleep during PSD (Beck et al, 2010). According to ethical considerations, all patients were treated with a monotherapy of 30 mg mirtazapine daily at 9 pm throughout the study, which started already 1 week before PSD intervention to ensure an adequate stabilization period in all patients.…”

“…Other than SD the whole night, partial sleep deprivation (PSD) in the second half of the night has also shown comparable antidepressant effects in patients with major depression (Giedke and Schwarzler, 2002). However, the underlying molecular and cellular mechanisms of SD are not well understood, especially those explaining the rapid, although transient, antidepressant effect of SD, since a relapse into depression occurs in most patients following the recovery night (Beck et al, 2010). Recent evidence indicates that an up-regulation of BDNF gene expression after SD in rats might be relevant for its mode of action (Conti et al, 2007;Hairston et al, 2004).…”