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Mdf5.0
Modafinil – Forschung
Überwiegend Mechanismus / Beobachtung
7 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Modafinil sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus mittelwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 1998–2020 mit einer typischen Studiengröße von 283 Teilnehmenden.
Basierend auf 7 Studien · 1 Meta-Analyse · 4 RCTs · 492 Teilnehmende insgesamt
Konfidenz
Mittlere Konfidenz
Nach Outcome
Cognition & executive function
Überwiegend Mechanismus / Beobachtung7 Studien
Sleepiness & sleep disorders
Überwiegend Mechanismus / Beobachtung4 Studien
Safety profile
Zu wenige bewertete Studien2 Studien
Focus & attentionVerbessert die objektive Wachheit bei Narkolepsie, Schichtarbeitersyndrom und behandelter OSA deutlich; bei gesunden Erwachsenen ist ein moderater, aufgabenabhängiger kognitiver Nutzen am konsistentesten unter anspruchsvollen Bedingungen bzw. bei Schlafentzug · Stunden pro Dosis; Wochen für einen stabilen Nutzen
Zu wenige bewertete Studien1 Studie
Ältere Forschungsbasis
Neueste Studie von 2020 · Neueste Meta-Analyse: 2020
199820092020
1RCTn=283 · medium study1998
Modafinil significantly reduced all measures of sleepiness and was a very well tolerated and effective wake-promoting agent in narcolepsy.
US Modafinil in Narcolepsy Multicenter Study Group · Annals of neurology (1998)
Pivotal placebo-controlled, double-blind, 18-center RCT in 283 narcolepsy patients (modafinil 200 or 400 mg vs placebo)
Significantly reduced objective (MSLT/MWT) and subjective (Epworth) sleepiness and improved clinical global impression
Excellent safety/tolerability over up to 40 weeks of open-label use, with efficacy maintained (no tolerance)
Both doses of modafinil significantly improved sleep latency on the Maintenance of Wakefulness Test versus placebo, confirming it is a useful adjunct for residual sleepiness in nCPAP-treated OSA.
Black, Hirshkowitz · Sleep (2005)
12-week, multicenter, double-blind, placebo-controlled RCT of modafinil 200 or 400 mg as adjunct in CPAP-treated OSA with residual sleepiness
Both doses significantly improved objective wakefulness (MWT), Epworth scores, and clinical global impression
Did not adversely affect nighttime sleep or CPAP adherence
There was an overall effect of modafinil (SMD=0.12) … there is a user perception that these drugs are effective cognitive enhancers, but this is not supported by the evidence so far.
Roberts, Jones, Sumnall, Gage, Montgomery · European neuropsychopharmacology (2020)
Meta-analysis pooling 14 modafinil studies (64 effect sizes) in healthy non-sleep-deprived adults vs placebo
Overall effect small (SMD=0.12); a significant benefit only for memory updating (SMD=0.28)
Concludes the popular cognitive-enhancer reputation outruns the evidence
Modafinil exhibits robust effects on catecholamines, serotonin, glutamate, GABA, orexin, and histamine systems, and at well-tolerated doses improves working and episodic memory; it appears well-tolerated with a low liability to abuse.
Minzenberg, Carter · Neuropsychopharmacology (2008)
Comprehensive review of modafinil's neurochemistry and cognitive effects across animals, healthy adults, and patients
Wake-promotion is driven by cortical catecholamine effects, engaging orexin and histamine arousal systems
Improves prefrontal-dependent cognition (working/episodic memory) at well-tolerated doses
When more complex assessments are used, modafinil appears to consistently engender enhancement of attention, executive functions, and learning. Importantly, we did not observe any preponderances for side effects or mood changes.
Battleday RM, Brem AK. · European Neuropsychopharmacology (2015)
MODAFINIL (parent), NOT FLADRAFINIL: a systematic review of modafinil for cognitive neuroenhancement in healthy non-sleep-deprived adults — included here to show what the RELATED drug does, not what fladrafinil does
Found modest, task-dependent benefits to attention, executive function and learning with modafinil, especially on more complex tasks
Cited by fladrafinil vendors as if it were fladrafinil evidence — it is NOT; fladrafinil is a different fluorinated analogue/prodrug with no human cognition trials
Treatment with modafinil resulted in significant improvement in two objective measures of EDS ... The most frequent adverse experience was headache ... The data indicate that modafinil has an excellent safety profile and is very well tolerated.
US Modafinil in Narcolepsy Multicenter Study Group. · Neurology (2000)
MODAFINIL (parent), NOT FLADRAFINIL: a large multicenter randomized placebo-controlled trial of modafinil for excessive daytime somnolence in narcolepsy — parent-drug human evidence
Modafinil improved objective wakefulness vs placebo; the most frequent adverse event was headache — the kind of symptom extrapolated to fladrafinil
Reinforces the modafinil-class effect AND its typical adverse-event profile in supervised humans, for the PARENT compound only