Pharmacokinetic evaluation of  armodafinil  for the treatment of bipolar depression.
BACKGROUND
Bipolar disorder is a psychiatric illness with recurring episodes of mania and depression. Armodafinil , the R-enantiomer of modafinil, approved for treating excessive sleepiness associated with narcolepsy, obstructive sleep apnea and shift work disorder, is possibly effective as an adjunctive treatment for bipolar depression.


METHODS
This review covers the pharmacokinetics of armodafinil, with an emphasis on its use in bipolar depression. Its clinical efficacy in the treatment of bipolar depression is evaluated, along with current data regarding its safety and tolerability.


CONCLUSIONS
One placebo-controlled trial is available, in which armodafinil was efficacious as an adjunctive treatment in bipolar depression. Armodafinil shows a linear pharmacokinetic profile over a broad dose range of 50 - 400 mg (maximal plasma concentration and area under concentration-time curve). Compared with modafinil, an equivalent dose of armodafinil attains higher blood concentrations 4 - 6 h post-dose. The possibility of drug interactions is generally low, although interactions have been shown with some drugs used in bipolar disorder, through mild CYP3A4-induction and CYP2C19-inhibition. Armodafinil is well tolerated and presents a possible new treatment option for bipolar depression. However, further investigation is still needed in order to confirm its efficacy and to clarify its role in the treatment of bipolar depression.
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium. peter.niemegeers@ua.ac.be
Peter
P
Niemegeers
Kristof E
KE
Maudens
Manuel
M
Morrens
Lisbeth
L
Patteet
Leen
L
Joos
Hugo
H
Neels
Bernard Gc
BG
Sabbe
D001559:Benzhydryl Compounds / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000493:pharmacokinetics*; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D006801:Humans; D000077408:Modafinil
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil