Initiating treatment with modafinil for control of excessive daytime sleepiness in patients switching from methylphenidate: an open-label safety study assessing three strategies

• Published in: Psychopharmacologia 2003-06, Vol.167 (4), p.380-385
• Main Authors: THORPY, Michael J, SCHWARTZ, Jonathan R. L, KOVACEVIC-RISTANOVIC, Ruzica, HAYDUK, Roza
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Benzhydryl Compounds - therapeutic use; Biological and medical sciences; Central Nervous System Stimulants - therapeutic use; Drug Administration Schedule; Female; Humans; Male; Medical sciences; Methylphenidate - therapeutic use; Middle Aged; Narcolepsy - drug therapy; Neuropharmacology; Pharmacology. Drug treatments; Psychiatric Status Rating Scales; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Treatment Outcome; Wakefulness - drug effects
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-002-1343-4

Modafinil is a first-line wake-promoting medication and a useful therapeutic alternative to psychostimulant medications for excessive daytime sleepiness. This 5-week, randomized, open-label study evaluated three strategies for switching patients from methylphenidate, a commonly used psychostimulant, to modafinil. Patients ( n=40) with excessive daytime sleepiness related to narcolepsy, who had received previous treatment with methylphenidate, were switched from methylphenidate to modafinil (200 mg/day followed by 400 mg/day) without a washout period between treatments, with a 2-day washout period between treatments, or by using a taper-down/titrate-up protocol. Adverse events were recorded throughout the study, and Epworth Sleepiness Scale scores were determined at the end of the study. The majority of patients (95%) were successfully switched to modafinil. At the study end point, mean Epworth Sleepiness Scale scores were