Psychostimulants and Wakefulness-Promoting Agents

Abstract

The safety and efficacy of stimulants for the treatment of ADHD have been established. Modafinil and armodafinil are also firmly established as efficacious as wakefulness promoting agents in narcolepsy, sleep apnea, and shift work sleep disorder. The utility of these drugs in other areas is being examined. Although there is intense interest in the potential use of stimulants and modafinil in other psychiatric and neurobehavioral conditions, controlled studies on their safety and efficacy are limited. It is unclear why stimulants have not been extensively investigated for clinical utility over the years, except for the treatment of ADHD. The approval of armodafinil, as the newest of the wakefulness promoting compounds, may perhaps spur further research. Large-scale well-designed controlled trials are needed to define and characterize the role of stimulants and modafinil in various psychiatric illnesses. It is hoped that this will be an area of continued interest and development, from the elucidation of the molecular mechanisms of stimulants and modafinil to the demonstration through controlled trials of their potential clinical safety and benefits. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (chapter)