[Modafinil in psychiatric disorders: the promising state reconsidered].
BACKGROUND
For more than two decades psychiatrists have known about and have promoted modafinil, a very promising stimulant that boosts wakefulness in cases of narcolepsy and also enhances cognitive functions. At present, however, we must conclude that modafinil is hardly ever used to treat illness other than narcolepsy.


OBJECTIVE
To review current attitudes and practice with regard to the use and efficacy of modafinil in the treatment of psychiatric disorders.


METHODS
Relevant placebo-controlled studies were retrieved via PubMed (Medline) and Web of Science.


RESULTS
Modafinil is used experimentally to treat ADHD, mood disorders, schizophrenia and substance-dependence. Compared to placebo, modafinil achieves positive but mainly variable results on different clinical and cognitive measures. It achieves results very rapidly, within a week, but over a period of time the results stabilise.


CONCLUSIONS
Modafinil is particularly successful in the treatment of ADHD, depression and cocaine-dependency on measures of attention and hyperactivity, fatigue and cocaine-use respectively. There is a need for further placebo-controlled trials with longer follow-up periods and larger sample size in order to ensure the safety of the product and to refine its area of efficacy.
PC Broeders Alexianen, Boechout, Collaborative Antwerp Psychiatric Research Institute, Universiteit Antwerpen, Belgium. leen.joos@ua.ac.be
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D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D001559:Benzhydryl Compounds / Q000494:pharmacology / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000188:drug therapy; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy*; D000077408:Modafinil; D009290:Narcolepsy / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy; D016896:Treatment Outcome; D014851:Wakefulness / Q000187:drug effects
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil