Effects of dextroamphetamine, caffeine and modafinil on psychomotor vigilance test performance after 44 h of continuous wakefulness.
Prolonged sleep loss impairs alertness, vigilance and some higher-order cognitive and affective capacities. Some deficits can be temporarily reversed by stimulant medications including caffeine, dextroamphetamine, and modafinil. To date, only one study has directly compared the effectiveness of these three compounds and specified the doses at which all were equally effective in restoring alertness and vigilance following 64 h of wakefulness. The present study compared the effectiveness of these same three stimulants/doses following a less extreme period of sleep loss (i.e., 44 h). Fifty-three healthy adults received a single dose of modafinil 400 mg (n = 11), dextroamphetamine 20 mg (n = 16), caffeine 600 mg (n = 12), or placebo (n = 14) after 44 h of continuous wakefulness. After 61 h of being awake, participants obtained 12 h of recovery sleep. Psychomotor vigilance was assessed bi-hourly during waking and following recovery sleep. Relative to placebo, all three stimulants were equally effective in restoring psychomotor vigilance test speed and reducing lapses, although the duration of action was shortest for caffeine and longest for dextroamphetamine. At these doses, caffeine was associated with the highest percentage of subjectively reported side-effects while modafinil did not differ significantly from placebo. Subsequent recovery sleep was adversely affected in the dextroamphetamine group, but none of the stimulants had deleterious effects on postrecovery performance. Decisions regarding stimulant selection should be made with consideration of how factors such as duration of action, potential side-effects, and subsequent disruption of recovery sleep may interact with the demands of a particular operational environment.
Killgore
William D S
WD
Department of Behavioral Biology, Walter Reed Army Institute of Research, Silver Spring, MD, USA. killgore@mclean.harvard.edu
Rupp
Tracy L
TL
Grugle
Nancy L
NL
Reichardt
Rebecca M
RM
Lipizzi
Erica L
EL
Balkin
Thomas J
TJ
D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000187:drug effects*; D001288:Attention / Q000187:drug effects*; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000494:pharmacology*; D002110:Caffeine / Q000009:adverse effects / Q000494:pharmacology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000494:pharmacology*; D034201:Computers, Handheld; D003913:Dextroamphetamine / Q000009:adverse effects / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D000077408:Modafinil; D017286:Polysomnography / Q000187:drug effects; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time / Q000187:drug effects; D012890:Sleep / Q000187:drug effects; D012892:Sleep Deprivation / Q000523:psychology*; D014851:Wakefulness / Q000187:drug effects*; D055815:Young Adult
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D002110:Caffeine; D000077408:Modafinil; D003913:Dextroamphetamine