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Armodafinil in the treatment of excessive sleepiness

Authors Rosenberg R, Bogan R

Published 8 July 2010 Volume 2010:2 Pages 95—105

DOI https://doi.org/10.2147/NSS.S6728

Review by Single-blind

Peer reviewer comments 3

Russell Rosenberg1, Richard Bogan2

1NeuroTrials Research, Atlanta, Georgia, USA; 2SleepMed of South Carolina, Columbia, South Carolina, USA

Abstract: Excessive sleepiness (ES) is a widespread condition, commonly the result of a sleep/wake disorder such as obstructive sleep apnea (OSA), shift-work disorder (SWD), or narcolepsy. ES poses significant health and safety concerns in patients. Numerous interventions are available to treat the underlying causes of ES and ES itself, including behavioral measures, mechanical devices, and pharmacologic agents. This review explores the evidence supporting the use of armodafinil to treat ES associated with OSA, SWD, and narcolepsy. Armodafinil is an oral non-amphetamine wake-promoting agent, the R-isomer of racemic modafinil. Armodafinil and modafinil share many clinical and pharmacologic properties and are distinct from central nervous system stimulants; however, the mechanisms of action of modafinil and armodafinil are poorly characterized. Compared with modafinil, the wake-promoting effects of armodafinil persist later in the day. It is for this reason that armodafinil may be a particularly appropriate therapy for patients with persistent ES due to OSA, SWD, or narcolepsy.

Keywords: excessive sleepiness, obstructive sleep apnea, shift-work disorder, narcolepsy, wakefulness-promoting agent

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