A double-blind,
placebo-controlled investigation of the efficacy of modafinil for sustaining
the alertness and performance of aviators: a helicopter simulator study.
Caldwell JA, Caldwell JL, Smythe NK, Hall KK
Aeromedical Research Laboratory,
Fort Rucker, AL 36362-0577
John.Caldwell@se.amedd.army.mil
Psychopharmacology (Berl) 2000 Jun;150(3):272-82
ABSTRACT
RATIONALE: In 1998, the FDA
approved modafinil for treating excessive daytime sleepiness in
narcoleptics, and this has raised questions about the appropriateness of
this compound for enhancing alertness in sleep-deprived controls. This study
explored the efficacy of modafinil for maintaining the performance of
volunteers required to accomplish highly demanding tasks despite sleep loss.
OBJECTIVE: The principal
objective was to determine whether prophylactic doses of modafinil would
attenuate decrements in aviator performance and arousal throughout 2 days
and 1 night without sleep.
METHODS: Six pilots were exposed
to two 40-h periods of continuous wakefulness. In one, three 200-mg doses of
modafinil were given and in the other, matching placebos were administered.
Helicopter simulator flights, resting EEGs, and Profile of Mood States (POMS)
questionnaires were evaluated.
RESULTS: Modafinil attenuated
sleep deprivation effects on four of six flight maneuvers, reduced slow-wave
EEG activity, and lessened self-reported problems with mood and alertness in
comparison to placebo. The most noticeable benefits occurred between 0330
and 1130 hours, when the combined impact of sleep loss and the circadian
trough was most severe. The most frequently observed drug side effects were
vertigo, nausea, and dizziness. These could have been related to: 1) the
motion-based testing, 2) the use of a simulator rather than an actual
aircraft (i.e., "simulator sickness"), and/or 3) the
administration of more than 400 mg modafinil.
CONCLUSIONS: Modafinil is a
promising countermeasure for sleep loss in normals; however, additional
studies aimed at reducing side effects are needed before it should be used
in aviators.
1. Modafinil augmentation
of antidepressant treatment
2. Modafinil children
with attention-deficit/hyperactivity disorder
3. Modafinil in
fibromyalgia treatment
4. Modafinil
efficacy in narcolepsy
5. Modafinil narcolepsy:
symptoms and management
6. Modafinil successful
treatment of hypersomnia & narcolepsy
7. Modafinil
drug of choice for narcolepsy
8. Modafinil
in the treatment of
narcolepsy
9. Modafinil
effect on narcolepsy
10. Modafinil
a narcolepsy study
11. Modafinil
switching from narcolepsy drugs to modafinil
12. Modafinil
and naps as counter measures in sleep deprivation
13. Modafinil
as a treatment for excessive daytime sleepiness
14. Modafinil
use in a sleep deprivation experiment
15. Modafinil excessive sleepiness in Parkinson's disease
16. Modafinil the
unique properties of a new stimulant
17. Modafinil for
sustaining the alertness of helicopter pilots
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and safety
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treatment of alcoholic organic brain syndrome
20. Modafinil
effect on melatonin, cortisol, and growth hormone
21. Modafinil
in obstructive sleep apnea-hypopnea syndrome
22. Modafinil
vs dextroamphetamine in treatment of adult ADHD
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dopaminergic transmission mediates CNS stimulants
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for daytime sleepiness in sleep apnea
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treatment of residual excessive daytime sleepiness
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amplification of cortical serotonin release
27. Modafinil for the treatment of
multiple sclerosis