Effects of the atypical stimulant modafinil on a brief gambling episode in pathological gamblers with high vs. low impulsivity
Zack M, Poulos CX.
Clinical Neuroscience,
Centre for Addiction and Mental Health,
Toronto, Ontario, Canada.
J Psychopharmacol. 2008 Jun 26.


Pathological gambling (PG) is a serious psychiatric disorder afflicting 1-3% of the general population. Experimental evidence indicates shared neurochemical substrates for PG and psychostimulant addiction. Impulsivity characterizes one key subtype of PG. Therefore, medications that ameliorate psychostimulant addiction and impulsive syndromes might also benefit impulsive PG subjects. The atypical stimulant, modafinil reduces cocaine abuse and impulsivity in patients with ADHD. The present study sought to determine if modafinil (200 mg) would reduce the reinforcing effects of slot machine gambling in PG subjects, and if this effect was stronger in high (H-I) vs. low (L-I) impulsivity subjects (N = 20). A placebo-controlled, double-blind, counterbalanced, repeated measures design was employed. Apart from bet size, which declined uniformly in both groups under drug, modafinil had bi-directional effects in the two groups. In H-I subjects, the drug decreased desire to gamble, salience of Gambling words, disinhibition and risky decision-making. In L-I subjects, modafinil increased scores on these indices. Modafinil also differentially affected blood pressure response to the game in the two groups. These findings for modafinil appear to fit well with a growing literature demonstrating bi-directional effects of D2 agonists as a function of trait impulsivity. Impulsivity could critically moderate medication response in PG.

The sleep-switch
Modafinil: structure
Atypical depression
Modafinil and the aviator
Modafinil: pharmacokinetics
Modafinil and the marmoset
Modafinil wakes up sleepy flies
Modafinil versus amphetamine
Modafinil versus methylphenidate
Modafinil v amphetamine v placebo
Fatigue, sleepiness in major depression
Modafinil plus SSRIs for depression and fatigue
Dosing regimen effects of modafinil in narcolepsy
Mood-lifting effect of caloric restriction is mediated by orexin
Modafinil plus selective serotonin reuptake inhibitors (SSRIs)
Modafinil: a dual noradrenergic-dopaminergic mechanism of action?

and further reading

Purchase Modafinil

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family