Back to Browse Journals » Nature and Science of Sleep » Volume 2

Ready for takeoff? A critical review of armodafinil and modafinil for the treatment of sleepiness associated with jet lag

Authors David E McCarty

Published Date May 2010 Volume 2010:2 Pages 85—94

DOI http://dx.doi.org/10.2147/NSS.S6680

Published 17 May 2010

David E McCarty

Sleep Medicine Program, Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
Abstract: Jet lag syndrome (JLS) is a clinical syndrome of disrupted nocturnal sleep and daytime neurocognitive impairment which occurs in the context of rapid transmeridian travel. Many strategies for treatment of JLS exist, and include hypnotics to enhance nocturnal sleep, chronotherapeutic approaches (eg, light therapy, melatonin, or gradual schedule shifting), and alerting agents to counter daytime sleepiness. Safety concerns have prompted renewed interest in managing JLS-associated excessive daytime sleepiness (JLSAEDS). Off-label use of the newer alerting agents modafinil and armodafinil is increasing for this indication, often at the specific request of patients. In order to better evaluate the potential risks and benefits of these medications for the management of JLSAEDS, clinicians must be aware of what is known – and still not known. In this article, the pharmacology and pharmacokinetics of modafinil and armodafinil are reviewed, along with evidence for their efficacy in treating sleepiness associated with narcolepsy, obstructive sleep apnea and shift work sleep disorder. Clinical trial data for use of alerting agents in the management of JLSAEDS are limited to one three-day trial involving armodafinil, dosed in the morning to treat JLSAEDS in the setting of eastbound transmeridian travel. This study showed improvement in objective measures of daytime sleepiness at doses of 50 and 150 mg per day. However, global impression of clinical severity of symptom scores only improved on day 1 for those patients receiving 150 mg, and were otherwise not superior to placebo. Consideration for the use of modafinil or armodafinil for the treatment of sleepiness associated with JLS involves careful integration of patient-reported goals, a review of medical contraindications, and an awareness of rare adverse events. More research is needed in order to identify those who are most likely to benefit from this intervention and better define the risk-benefit ratio for this indication.


Keywords: jet lag syndrome, modafinil, armodafinil
 

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Other article by this author:

Nonspecific pain is a marker for hypovitaminosis D in patients undergoing evaluation for sleep disorders: a pilot study

McCarty DE, Reddy A, Keigley Q, Kim PY, Cohen S, Marino AA

Nature and Science of Sleep 2013, 5:37-42

Published Date: 9 March 2013

Readers of this article also read:

Design and in vivo evaluation of oxycodone once-a-day controlled-release tablets

Kim JY, Lee SH, Park CW, Rhee YS, Kim DW, Park J, Lee M, Seo JW, Park ES

Drug Design, Development and Therapy 2015, 9:695-706

Published Date: 30 January 2015

Progressive osseous heteroplasia: diagnosis, treatment, and prognosis

Pignolo RJ, Ramaswamy G, Fong JT, Shore EM, Kaplan FS

The Application of Clinical Genetics 2015, 8:37-48

Published Date: 30 January 2015

Gastrointestinal robotic surgery: challenges and developments

Bencini L, Annecchiarico M, Di Marino M, Moraldi L, Perna F, Coratti A

Robotic Surgery: Research and Reviews 2015, 2:11-27

Published Date: 30 January 2015

Diabetes reversal via gene transfer: building on successes in animal models

Gerace D, Martiniello-Wilks R, Simpson AM

Research and Reports in Endocrine Disorders 2015, 5:15-29

Published Date: 29 January 2015

Corneal laceration caused by river crab

Vinuthinee N, Azreen-Redzal A, Juanarita J, Zunaina E

Clinical Ophthalmology 2015, 9:203-206

Published Date: 29 January 2015

Population pharmacokinetics of olprinone in healthy male volunteers

Kunisawa T, Kasai H, Suda M, Yoshimura M, Sugawara A, Izumi Y, Iida T, Kurosawa A, Iwasaki H

Clinical Pharmacology: Advances and Applications 2014, 6:43-50

Published Date: 4 March 2014