title: Effect of modafinil on cognitive functions in alcohol dependent patients: a randomized, placebo-controlled trial.
abstract: Cognitive deficits are highly prevalent in alcohol-dependent (AD) patients and may have a detrimental impact on treatment response and treatment outcome. Enhancing cognitive functions may improve treatment success. Modafinil is a promising compound in this respect. Therefore, a randomized double-blind placebo-controlled trial was conducted with modafinil (300 mg/d) or placebo in 83 AD patients for 10 weeks. Various cognitive functions (digit span task, Tower of London task, Stroop task) were measured at baseline, during and after treatment. Compared to placebo, modafinil improved verbal short-term memory (number of forward digit spans) (p=0.030), but modafinil exerted a negative effect on the working memory score of the digit span task (p=0.003). However, subgroup analyses revealed that modafinil did improve both working memory and verbal short-term memory in AD patients with a poor working memory ability at baseline (25% worst performers), whereas no significant treatment effect of modafinil was found on these two dependent variables in patients with good working memory skills at baseline (25% best performers). No effect of modafinil was found on measures of planning (Tower of London task) and selective attention (Stroop task). Further research is needed to better understand the relationship between cognitive remediation and treatment outcome in order to design targeted treatments.
authors.affiliation: 1Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Wilrijk, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Joos
authors.forename: Anna E
authors.initials: AE
authors.lastname: Goudriaan
authors.forename: Lianne
authors.initials: L
authors.lastname: Schmaal
authors.forename: Wim
authors.initials: W
authors.lastname: van den Brink
authors.forename: Bernard G C
authors.initials: BG
authors.lastname: Sabbe
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000188:drug therapy*; D001288:Attention / Q000187:drug effects; D001559:Benzhydryl Compounds / Q000494:pharmacology* / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D008875:Middle Aged; D000077408:Modafinil; D009483:Neuropsychological Tests; D064690:Wakefulness-Promoting Agents / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D001559:Benzhydryl Compounds; D064690:Wakefulness-Promoting Agents; D000077408:Modafinil
keywords: Modafinil; alcohol dependence; cognitive functions; digit span; working memory