What is the role of modafinil in the treatment of narcolepsy?

Updated: Sep 04, 2019
  • Author: Sagarika Nallu, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Modafinil is a novel wake-promoting agent. [52] The mechanism of action is not understood, but it does not appear to involve altering levels of dopamine or norepinephrine. Unlike traditional medications, modafinil does not appear to affect total sleep time or suppress rapid eye movement (REM) sleep; the most common adverse effect is headache. [53] Its safety in children has not been established.

In a meta-analysis of 9 randomized controlled trials including 1054 patients, modafinil was shown to provide significant benefit to narcoleptic patients with respect to eliminating excessive daytime sleepiness (EDS) and decreasing sleep attacks, naps, and the duration and periods of somnolence each day, in comparison with placebo. [54] Whereas modafinil improved the quality of life in narcoleptic patients as compared with placebo, it did not diminish the number of attacks of cataplexy.


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