Effects of modafinil on emotional processing in first episode psychosis.
BACKGROUND
Emotional impairments are important determinants of functional outcome in psychosis, and current treatments are not particularly effective. Modafinil is a wake-promoting drug that has been shown to improve emotion discrimination in healthy individuals and attention and executive function in schizophrenia. We aimed to establish whether modafinil might have a role in the adjuvant treatment of emotional impairments in the first episode of psychosis, when therapeutic endeavor is arguably most vital.


METHODS
Forty patients with a first episode of psychosis participated in a randomized, double-blind, placebo-controlled crossover design study testing the effects of a single dose of 200 mg modafinil on neuropsychological performance. Emotional functions were evaluated with the emotional face recognition test, the affective go-no go task, and the reward and punishment learning test. Visual analogue scales were used throughout the study to assess subjective mood changes.


RESULTS
Modafinil significantly improved the recognition of sad facial expressions (z = 2.98, p = .003). In contrast, there was no effect of modafinil on subjective mood ratings, on tasks measuring emotional sensitivity to reward or punishment, or on interference of emotional valence on cognitive function, as measured by the affective go-no go task.


CONCLUSIONS
Modafinil improves the analysis of emotional face expressions. This might enhance social function in people with a first episode of psychosis.
Department of Psychiatry, University of Cambridge, Robinson Way, Cambridge, UK. ls387@cam.ac.uk
Linda
L
Scoriels
Jennifer H
JH
Barnett
Graham K
GK
Murray
Srinivasarao
S
Cherukuru
Mark
M
Fielding
Frances
F
Cheng
Belinda R
BR
Lennox
Barbara J
BJ
Sahakian
Peter B
PB
Jones
D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D018592:Cross-Over Studies; D003627:Data Interpretation, Statistical; D004192:Discrimination, Psychological / Q000187:drug effects / Q000502:physiology; D004311:Double-Blind Method; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007858:Learning / Q000187:drug effects; D008032:Limbic System / Q000502:physiology; D008297:Male; D000077408:Modafinil; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D011678:Punishment; D021641:Recognition, Psychology / Q000187:drug effects; D012201:Reward; D012938:Social Perception; D055815:Young Adult
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil