Modafinil augmentation therapy in unipolar and bipolar depression: a systematic review and meta-analysis of randomized controlled trials.

@article{Goss2013ModafinilAT,
  title={Modafinil augmentation therapy in unipolar and bipolar depression: a systematic review and meta-analysis of randomized controlled trials.},
  author={Alexander J. Goss and M. Kaşer and S. Costafreda and B. Sahakian and C. H. Fu},
  journal={The Journal of clinical psychiatry},
  year={2013},
  volume={74 11},
  pages={
          1101-7
        }
}
OBJECTIVE Current pharmacologic treatments for a depressive episode in unipolar major depressive disorder (MDD) and bipolar depression are limited by low rates of remission. [...] Key MethodDATA SOURCES MEDLINE/PubMed, PsycINFO, 1980-April 2013 were searched using the following terms: (modafinil or armodafinil) and (depressi* or depressed or major depressive disorder or major depression or unipolar or bipolar or dysthymi*).Expand
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Abstract Introduction: Depression is a burdening disease state where up to 30% of individuals do not respond to first-line treatment. Adjunctive use of psychostimulants has been investigated for the… Expand
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References

SHOWING 1-10 OF 39 REFERENCES
Psychostimulants in moderate to severe affective disorder: A systematic review of randomized controlled trials
TLDR
Clearly larger well designed placebo-controlled studies with longer follow-up accompanied by evaluations of tolerance/dependence are warranted before psychostimulants can be recommended in routine clinical practice for the treatment of MDD. Expand
Use of adjunctive stimulants in adult bipolar depression.
TLDR
An updated perspective on the use of stimulants and stimulant-like medications in adult bipolar depression is provided, considering not only recent randomized controlled trials, but also open naturalistic studies, in order to clarify the strengths and limitations of using these agents. Expand
A multicenter, placebo-controlled study of modafinil augmentation in partial responders to selective serotonin reuptake inhibitors with persistent fatigue and sleepiness.
TLDR
Modafinil is a well-tolerated and potentially effective augmenting agent for SSRI partial responders with fatigue and sleepiness despite selective serotonin reuptake inhibitor (SSRI) monotherapy. Expand
Modafinil augmentation of selective serotonin reuptake inhibitor therapy in MDD partial responders with persistent fatigue and sleepiness.
TLDR
Results of this pooled analysis provide further evidence suggesting that modafinil is an effective and well-tolerated augmentation therapy for partial responders to SSRI therapy, particularly when patients continue to experience fatigue and excessive sleepiness. Expand
Open-label study of adjunct modafinil for the treatment of patients with fatigue, sleepiness, and major depression treated with selective serotonin reuptake inhibitors
TLDR
Results of this preliminary, open-label trial suggest that modafinil may be effective in augmenting ongoing SSRI treatment for a portion of patients with major depression who have residual fatigue and sleepiness. Expand
Adjunct modafinil for the short-term treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study.
TLDR
Modafinil rapidly improved fatigue and daytime wakefulness, with significantly greater mean improvements from baseline than placebo in fatigue (FSS) scores at week 2 and sleepiness (ESS) Scores at week 1; the differences between modaf inil and placebo at week 6 were not statistically significant. Expand
Modafinil Augmentation of SSRI Therapy in Patients with Major Depressive Disorder and Excessive Sleepiness and Fatigue: A 12-Week, Open-label, Extension Study
TLDR
Twelve weeks of modafinil augmentation relieved excessive sleepiness, reduced fatigue, and improved patients' overall clinical condition, including mood. Expand
A placebo-controlled evaluation of adjunctive modafinil in the treatment of bipolar depression.
TLDR
These data suggest that adjunctive modafinil at doses of 100-200 mg a day may improve depressive symptoms in patients with bipolar disorder. Expand
Modafinil for Remitted Bipolar Depression with Hypersomnia
TLDR
Modafinil may be a well-tolerated and effective alternative to conventional stimulants in the treatment of hypersomnia, especially in bipolar disorder, where there is considerable risk of switch to mania with stimulant medications. Expand
Modafinil augmentation of antidepressant treatment in depression.
TLDR
Modafinil appears to be a drug with promise as an augmenter of antidepressants, especially in patients with residual tiredness or fatigue, and is a particularly attractive alternative to other stimulants because of its low abuse potential and Schedule IV status. Expand
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