Effects of armodafinil: A Synthesis of Findings from 18 Studies

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Original Abstract of the Article

Main research findings

Armodafinil is an effective treatment for excessive daytime sleepiness (EDS) associated with narcolepsy, obstructive sleep apnea (OSA), and shift work sleep disorder. 15 Armodafinil is a wake-promoting agent that works by inhibiting the reuptake of dopamine and norepinephrine, which are neurotransmitters that promote wakefulness. 11 Armodafinil has also been shown to improve cognitive function in sleep-deprived individuals. 6 In addition, armodafinil may be helpful in treating cancer-related fatigue. 5 It is important to note that armodafinil should be used with caution in pregnant women. The long-term effects of armodafinil are not yet fully understood. 16

Benefits and risks

Benefits summary

Armodafinil is an effective treatment for EDS associated with narcolepsy, OSA, and shift work sleep disorder. 15 Armodafinil may also improve cognitive function in sleep-deprived individuals. 6 Armodafinil may be helpful in treating cancer-related fatigue. 5

Risks summary

Armodafinil can cause side effects such as headache, insomnia, anxiety, diarrhea, dry mouth, increased blood pressure, and increased heart rate. 16 Armodafinil should be used with caution in pregnant women. The long-term effects of armodafinil are not yet fully understood. 16

Comparison of studies

Commonalities of studies

Many studies have shown that armodafinil is effective in treating EDS associated with narcolepsy, OSA, and shift work sleep disorder. 15 11 16 Armodafinil has also been shown to improve cognitive function in sleep-deprived individuals. 6 Armodafinil may be helpful in treating cancer-related fatigue. 5

Differences between studies

The effects of armodafinil may vary from person to person. 11 The side effects of armodafinil may also vary from person to person. 16

Consistency and contradictions of the results

The results of studies on armodafinil may vary. 11 This may be due to differences in study design, participant characteristics, dosage of armodafinil, and other factors. 5 Armodafinil does not work for everyone. 11 The side effects of armodafinil may also vary from person to person. 16

Cautions for application in real life

Armodafinil should be taken as directed by a doctor. 16 It is important to talk to your doctor before taking armodafinil, as it may interact with other medications. 16 Pregnant and breastfeeding women should talk to their doctor before taking armodafinil.

Limitations of current research

More research is needed on the long-term effects of armodafinil. 16 More research is also needed on identifying the patients who benefit from armodafinil, reducing the side effects of armodafinil, determining the optimal dosage of armodafinil, and investigating the interactions of armodafinil with other medications. 16 Additional research is needed on the safety of armodafinil for pregnant and breastfeeding women.

Future research directions

More research is needed on the long-term effects of armodafinil. 16 More research is also needed on identifying the patients who benefit from armodafinil, reducing the side effects of armodafinil, determining the optimal dosage of armodafinil, and investigating the interactions of armodafinil with other medications. 16 Additional research is needed on the safety of armodafinil for pregnant and breastfeeding women.

Conclusion

Armodafinil is an effective treatment for EDS associated with narcolepsy, OSA, and shift work sleep disorder. 15 11 16 However, armodafinil can cause side effects. 16 It is important to talk to your doctor before taking armodafinil. 16

Literature analysis of 18 papers
Positive Content
16
Neutral Content
1
Negative Content
1
Article Type
1
3
3
9
18
1.

High-dose armodafinil in treatment-refractory bipolar depression.

Author: KwokWan Y, StephensVictoria, NasrallahHenry A

Bipolar depression treatment

Bipolar depression is a challenging condition with a high risk of morbidity and suicidality. Standard antidepressants are ineffective, and while five agents are approved for treatment, resistance remains a concern. Modafinil and armodafinil have been investigated for treatment-resistant bipolar depression, but results are inconsistent.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Comparative Efficacy and Safety of Wakefulness-Promoting Agents for Excessive Daytime Sleepiness in Patients With Obstructive Sleep Apnea : A Systematic Review and Network Meta-analysis.

Author: PitreTyler, MahJasmine, RobertsSarah, DesaiKairavi, GuYusing, RyanClodagh, BusseJason W, ZeraatkarDena

Improved MWT
Reduced EDS
Increased discontinuation due to adverse events

Solriamfetol, armodafinil-modafinil, and pitolisant are effective in reducing daytime sleepiness for patients with obstructive sleep apnea (OSA) already on conventional therapy. Solriamfetol appears to be superior to the other two medications, but all three may increase the risk for discontinuation due to adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

pitolisant, a novel histamine-3 receptor competitive antagonist, and inverse agonist, in the treatment of excessive daytime sleepiness in adult patients with narcolepsy.

Author: SarfrazNoeen, OkuampaDavid, HansenHannah, AlvarezMark, CornettElyse M, KakazuJuyeon, KayeAdam M, KayeAlan D

Cataplexy treatment
EDS treatment

Pitolisant, a novel histamine-3 receptor (H3R) antagonist, has shown promising results in treating excessive daytime sleepiness (EDS) and cataplexy in adults with narcolepsy. Studies have indicated that Pitolisant is non-inferior to Modafinil in treating EDS but superior in reducing cataplexy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Efficacy of Treatment With Armodafinil for Cancer-Related Fatigue in Patients With High-grade Glioma: A Phase 3 Randomized Clinical Trial.

Author: PorterAlyx B, LiuHeshan, KohliSadhna, CerhanJane L, SloanJeff, McMurrayRyan P, Le-RademacherJennifer, LoprinziCharles L, VillanoJohn L, KizilbashSani H, MehtaMinesh P, JaeckleKurt A, BrownPaul D

Fatigue reduction
Insomnia

A phase 3 clinical trial found no meaningful benefit of armodafinil in reducing cancer-related fatigue in patients with high-grade glioma (HGG). Armodafinil did not significantly improve fatigue scores compared to placebo. The study highlights the need for further research into effective treatments for fatigue in patients with HGG.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

7.

[Adrenal crisis associated with modafinil use].

Author: AquinosBrenda M, García ArabehetyJulia, CanterosTeresa M, de MiguelValeria, ScibonaPaula, Fainstein-DayPatricia

Modafinil adrenal crisis

This case report describes an 85-year-old woman with secondary adrenal insufficiency who developed symptoms compatible with adrenal crisis after starting modafinil treatment. This suggests that modafinil may precipitate adrenal crisis by increasing steroid clearance.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

8.

Drugs for patients with epilepsy and excessive daytime sleepiness.

Author: ZaccaraGaetano, BartoliniEmanuele, TramacereLuciana, LattanziSimona

Epilepsy treatment
Sleepiness reduction
Cardiovascular events
Drug interactions
Psychiatric symptoms

This review discusses the management of excessive daytime sleepiness (EDS) and attentional deficits in patients with epilepsy. The review suggests that lamotrigine, lacosamide, and perhaps eslicarbazepine may be less sedative than other ASMs. The review also discusses the advantages and risks of using psychostimulants in patients with severe EDS or ADHD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Indirect treatment comparison of solriamfetol, modafinil, and armodafinil for excessive daytime sleepiness in obstructive sleep apnea.

Author: RonnebaumSarah, BronMorgan, PatelDipen, MennoDiane, BujanoverShay, KratochvilDavid, LucasEleanor, StepnowskyCarl

Excessive daytime sleepiness treatment

This meta-analysis compared the efficacy and safety of medications for treating excessive daytime sleepiness associated with obstructive sleep apnea. Solriamfetol, modafinil, and armodafinil were evaluated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

10.

Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management.

Author: LalChitra, WeaverTerri E, BaeCharles J, StrohlKingman P

Improved quality of life
Reduced sleepiness
Cognitive impairment

Excessive daytime sleepiness (EDS) is a common symptom in patients with obstructive sleep apnea (OSA). While CPAP therapy can reduce EDS, a significant proportion of patients continue to experience it. This review discusses the pathophysiology and clinical management of EDS in patients with OSA.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Pharmacologic Management of Excessive Daytime Sleepiness.

Author: TakenoshitaShinichi, NishinoSeiji

EDS treatment
Stimulant side effects

Excessive daytime sleepiness (EDS) can be treated with amphetamine-like stimulants or modafinil-related compounds. Careful selection and management of these treatments are necessary due to potential side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Update on the pharmacologic management of narcolepsy: mechanisms of action and clinical implications.

Author: ThorpyMichael J, BoganRichard K

Narcolepsy treatment
Abuse potential

This study discusses the mechanisms of action, pharmacokinetics, and abuse potential of medications used to treat narcolepsy. It highlights the importance of combination treatment with medications that act via different neural pathways to maximize efficacy and mitigate adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

Recently Approved and Upcoming Treatments for Narcolepsy.

Author: ThorpyMichael J

Improved wakefulness
Reduced cataplexy
Side effects

Narcolepsy is a chronic, disabling neurologic disorder characterized by excessive daytime sleepiness (EDS) and cataplexy. This review summarizes the mechanisms of action, pharmacokinetics, efficacy, and safety/tolerability of recently approved and emerging treatments for narcolepsy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Pharmacokinetic and pharmacodynamic of the cognitive enhancer modafinil: Relevant clinical and forensic aspects.

Author: SousaAna, Dinis-OliveiraRicardo Jorge

Cognitive enhancement
Wake-promoting effects
Dermatologic effects
Headache
Insomnia

Modafinil is a non-amphetamine nootropic drug with increasing therapeutic interest due to its different effects compared to cocaine or amphetamine. Modafinil is used to treat sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder. While modafinil is generally well-tolerated, common side effects include headache, insomnia, anxiety, diarrhea, and dry mouth. Rare but severe dermatologic reactions have been reported in children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Prodopaminergic Drugs for Treating the Negative Symptoms of Schizophrenia: Systematic Review and Meta-analysis of Randomized Controlled Trials.

Author: SabeMichel, KirschnerMatthias, KaiserStefan

Prodopaminergic agents for negative symptoms

This meta-analysis of prodopaminergic agents for treating negative symptoms in schizophrenia found no significant effect overall. However, modafinil/armodafinil showed a small but significant effect in studies defining a minimum threshold for negative symptom severity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

18.

Excessive sleepiness in shift work disorder: a narrative review of the last 5 years.

Author: SavareseMariantonietta, Di PerriMaria Caterina

Improved performance
Reduced sleepiness

Armodafinil was effective in improving subjective and objective sleepiness, clinical conditions, and global functioning in individuals with shift work sleep disorder (SWSD). The drug improved performance and driving simulator performance tests during the night shift. However, armodafinil only reduced subjective disability in individuals working more than 9 hours.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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