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Mdf5.0
Modafinil Research
Mostly mechanism / observational
45 peer-reviewed studies
What the evidence says
Mostly mechanism / observational
Most Modafinil studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.
Most evidence is from high-quality meta-analyses and randomised trials published 1998–2026 with a typical study size of 283 participants.
Based on 45 studies · 12 meta-analyses · 17 RCTs · 7,148 total participants
Confidence
High confidence
By outcome
Cognition & executive function
Mostly mechanism / observational16 studies
Sleepiness & sleep disorders
Mostly mechanism / observational14 studies
Safety profile
Mostly mechanism / observational6 studies
Focus & attentionSignificantly improves objective wakefulness in narcolepsy, shift-work disorder, and treated OSA; in healthy adults, modest task-dependent cognitive benefit most consistent under demanding/sleep-deprived conditions · Hours per dose; weeks for steady benefit
Mostly mechanism / observational3 studies
Active research area
24 studies in the last 5 years · Latest meta-analysis: 2026
199820122026
1Meta-Analysisn=2,000 · very large study2026
In plain English: The results suggest that reductions in stimulant use may serve as meaningful efficacy signals that could be underestimated when relying solely on stringent outcomes, such as abstinence.
Amin-Esmaeili M, Farokhnia M, Mojtabai R, Leggio L, Johnson RM, Susukida R. · JAMA psychiatry (2026)
Results A total of 2000 participants were included (1134 in cocaine RCTs and 866 in methamphetamine RCTs), of whom 587 (29.4%) were women, with a mean (SD) age of 39.7 (8.6) years.
Overall, 446 participants (31.2%, weighted) achieved reduced use, whereas 184 (13.3%, weighted) achieved abstinence at the trial end point.
In analyses of individual medications, cabergoline showed positive effect sizes (Cohen h, 0.352; 95% CI, 0.115-0.590), indicating significantly higher rates of reduced cocaine use with cabergoline than pooled placebo.
In plain English: Funding National Institute for Health and Care Research (NIHR303122).
Nourredine M, Jurek L, Hamza T, Cipriani A, Subtil F, Parlatini V, Farhat LC, Veronesi GF, Efthimiou O, Salanti G, Cortese S. · The lancet. Psychiatry (2026)
The 68 RCTs on children and adolescents included 14 138 participants (9981 [70·6%] males and 4157 [29·4%] females) and the 45 RCTs on adults included 11 016 participants (5958 [54·0%] males and 5056 [46·0%] females).
We found no evidence of intransitivity.
Interpretation Our findings challenge both therapeutic inertia-accepting suboptimal response without further dose titration-and uncritical dose escalation beyond licensed limits, when potential harms outweigh expected benefits.