title: Effects of modafinil on cognitive functions in first episode psychosis.
abstract: BACKGROUND
  Cognitive impairments are important determinants of functional outcome in psychosis, which are inadequately treated by antipsychotic medication. Modafinil is a wake-promoting drug that has been shown to improve attention, memory and executive function in the healthy population and in patients with schizophrenia.
  
  
  OBJECTIVE
  We aimed to establish modafinil's role in the adjunctive treatment of cognitive impairments in the first episode of psychosis, a time when symptoms may be more malleable than at chronic stages of the disease.
  
  
  METHODS
  Forty patients with a first episode of psychosis participated in a randomised, double-blind, placebo-controlled crossover design study assessing the effects of a single dose of 200 mg modafinil on measures of executive functioning, memory, learning, impulsivity and attention.
  
  
  RESULTS
  Modafinil improved verbal working memory (d = 0.24, p = 0.04), spatial working memory errors (d = 0.30, p = 0.0004) and strategy use (d = 0.23, p = 0.03). It also reduced discrimination errors in a task testing impulsivity. Modafinil showed no effect on impulsivity measures, sustained attention, attentional set-shifting, learning or fluency.
  
  
  CONCLUSIONS
  Modafinil selectively enhances working memory in first episode psychosis patients, which could have downstream effects on patients' social and occupational functioning.
authors: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Cambridge Biomedical Campus, Cambridge, CB2 0SZ, UK. ls387@cam.ac.uk
authors: Linda
authors: L
authors: Scoriels
authors: Jennifer H
authors: JH
authors: Barnett
authors: Praveen K
authors: PK
authors: Soma
authors: Barbara J
authors: BJ
authors: Sahakian
authors: Peter B
authors: PB
authors: Jones
mesh_terms: D000328:Adult; D001288:Attention / Q000187:drug effects; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D061345:Early Medical Intervention / Q000379:methods / Q000706:statistics & numerical data*; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000150:complications / Q000188:drug therapy; D007858:Learning; D008297:Male; D008568:Memory / Q000187:drug effects; D000077408:Modafinil; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000150:complications / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil