Modafinil in the treatment of selected mental disorders

Abstract

Modafinil belongs to a class of wakefulness promoting agents. It is widely used in the treatment of sleep disorders. Although narcolepsy is the main indication for its use, hypersomnia from obstructive sleep apnoea and shift work sleep disorder are also indications in some countries. Due to its efficacy in the treatment of hypersomnia, the drug has also been clinically assessed in patients with mental disorders to reduce the severity of symptoms such as fatigue, hypersomnolence and cognitive impairment. The aim of this paper is to present the potential clinical applications of modafinil in the treatment of selected mental disorders. The use of modafinil in depressive disorders to enhance the treatment applied may improve mood, anhedonia and apathy, fatigue, hypersomnolence and executive cognitive impairment. In severe episodes of bipolar depression, modafinil may improve depressive symptoms, fatigue, and hypersomnia. Despite the potential risk of manic symptoms during modafinil treatment, recent studies show no increased risk of switching from depressive to manic phase. In schizophrenia, there is no evidence for the beneficial effect of modafinil on the negative symptoms, but improvement in selected cognitive functions accompanied by exacerbation of psychotic symptoms was observed in some patients. Furthermore, modafinil is used as an alternative to standard therapy in attention-deficit/hyperactivity disorder. Despite lacking evidence for the efficacy of modafinil in cocaine addiction, an analysis of selected studies indicates a potential benefit in the form of maintained abstinence. Modafinil is well tolerated and safe in most cases. The risk of dependence is lower than with other psychostimulants.