A prospective trial of modafinil as an
adjunctive treatment of major depression

DeBattista C, Lembke A, Solvason HB,
Ghebremichael R, Poirier J.
J Clin Psychopharmacol ; 24(1): 87-90


SUMMARY: Modafinil is a wake-promoting agent approved by the Federal Drug Administration for the treatment of narcolepsy. Preliminary evidence indicates that modafinil may improve fatigue and excessive sleepiness associated with a variety of conditions. The purpose of this study was to investigate the utility of modafinil as an adjunctive treatment of depressed patients. Subjects with a history of major depression with partial response on a stable therapeutic dose of an antidepressant were eligible to participate. All subjects endorsed complaints of significant fatigue and/or excessive sleepiness on clinical assessment. Modafinil was added to their existing regimen at a dose of 100 to 400 mg/d for 4 weeks. Subjects were assessed at 2-week intervals for improvement using the standard depression scales (HDRS, BDI, CGI), fatigue scales (VASF, FSI), and a neuropsychologic battery. Thirty-five subjects were entered and 31 subjects completed the 4-week trial. Significant improvements were seen across all 3 measures of depression (HDRS, BDI, CGIS) and both measures of fatigue (VASF, FSI). On the neurocognitive battery, significant gains in the Stroop Interference Test were seen at 4 weeks, whereas the other cognitive tests showed no change. Modafinil may be a useful and a well-tolerated adjunctive agent to standard antidepressants in the treatment of major depression.

Modafinil: review
Modafinil: structure
Modafinil and serotonin
Modafinil and the marmoset
Excessive daytime sleepiness
Modafinil as an antidepressant
Modafinil versus amphetamine
Modafinil versus methylphenidate
Modafinil, amphetamine and sleep
Fatigue, sleepiness in major depression
Modafinil plus selective serotonin reuptake inhibitoes

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