Modafinil for atypical depression: effects of open-label and double-blind discontinuation treatment.
Atypical depression, with features of hypersomnia, hyperphagia, anergia, and rejection sensitivity, is a common presentation of major depressive disorder. There are few available effective therapies for this disorder. We test modafinil, a novel wake-promoting agent, as monotherapy for atypical depression in a double-blind, placebo-controlled, relapse prevention trial after open-label treatment. We found that modafinil significantly improved atypical depression symptoms during 12 weeks of open-label treatment (mean +/- SD Hamilton Depression Scale (29-item version) score changed from 34 +/- 8.2 at baseline to 9.7 +/- 9.3, P < 0.0001), and that benefits were maintained alike in both the continuation and placebo arms during the double-blind treatment phase (P = 0.92). Modafinil was well tolerated and the drug was associated with significant weight loss compared with placebo (P = 0.01).
Vaishnavi
Sandeep
S
Duke University Medical Center, Durham, NC 27710, USA.
Gadde
Kishore
K
Alamy
Sayed
S
Zhang
Wei
W
Connor
Kathryn
K
Davidson
Jonathan R T
JR
D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000473:pathology; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D006963:Hyperphagia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D000077408:Modafinil; D009325:Nausea / Q000139:chemically induced; D010352:Patient Dropouts; D018579:Patient Selection; D013894:Thirst / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects; D028761:Withholding Treatment
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil