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Modafinil lacks withdrawal symptoms, researchers say

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The Pharmaceutical Journal Vol 264 No 7090p504
April 1, 2000 Clinical

Modafinil lacks withdrawal symptoms, researchers say

Patients receiving modafinil (Provigil), a drug used in the treatment of narcolepsy, experienced a significant improvement in their symptoms and did not suffer withdrawal effects, according to a study published in Neurology (2000;54:1166).
Dr Paul Gross (Lahey clinic, Burlington, Massachusetts, US) and colleagues report that there was no pattern of amphetamine-like withdrawal symptoms - dysphoria with additional symptoms, such as vivid dreams, insomnia, and agitation. They say: "The major risks of withdrawal symptoms . . . do not appear to be an issue with modafinil."
Dr Gross and colleagues undertook an 11-week study involving 271 patients with narcolepsy. They divided the subjects into three groups and gave two groups 100mg modafinil daily and one group placebo. After seven days, the doses were increased to 200mg in one treatment group and 400mg in the other, all for a further eight weeks. For the following two weeks, 80 per cent of the patients taking modafinil were given placebo to see whether they suffered withdrawal symptoms. The remainder continued on their allotted modafinil dose.
The researchers found that mean sleep latency (ie, the ability to stay awake) improved for the two modafinil groups compared with both the baseline and placebo group but did not differ significantly from each other. The effects seen in patients who had received modafinil 200mg but then took placebo regressed to baseline. Patients in the 400mg group suffered a rebound sleepiness that appeared to exceed baseline levels. The overall incidence of side effects was probably reduced by increasing the dose of modafinil gradually, the authors say.

Citation: The Pharmaceutical Journal URI: 20000995

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