Modafinil for the treatment of attention-deficit/hyperactivity disorder: A meta-analysis

Sheng Min Wang, Changsu Han, Soo Jung Lee, Tae Youn Jun, Ashwin A. Patkar, Prakash S. Masand, Chi Un Pae

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common and a debilitating neuro-behavior disorder in the pediatric population. Although numerous effective psychostimulants are available, more than 30% of patients still do not show adequate treatment response rendering diverse pharmacological options. We aimed at assessing the efficacy and safety of modafinil in the treatment of children and adolescents with ADHD by conducting a meta-analysis. An extensive search of databases and clinical trial registries resulted in five published short-term randomized, double-blind, placebo-controlled trials. Primary efficacy measures were mean change in ADHD Rating Scale-IV Home (ADHD-RS-IV Home) and School Version (ADHD-RS-IV School) from baseline to study end point. The results showed that modafinil more significantly improved ADHD-RS-IV Home (SMD, −0.77 [95%CI, −1.11 to −0.44]) and School (SMD, −0.71 [95%CI, −0.96 to −0.47]) than placebo. Dropout rate due to adverse event did not significantly differ between two groups. In terms of commonly observed side effects, modafinil showed significantly higher incidence of decreased appetite (RR = 5.02, 95% CIs, 2.55 to 9.89, P < 0.00001) and insomnia (RR = 6.16, 95% CIs, 3.40 to 11.17, P < 0.00001). Modafinil did not cause a clinically significant increase of heart rate, systolic blood pressure, and diastolic blood pressure. Although we found that modafinil may be another treatment option in children and adolescents with ADHD, the results should be interpreted and translated into clinical practice with caution, as the meta-analysis was based on a limited number of clinical trials.

Original languageEnglish
Pages (from-to)292-300
Number of pages9
JournalJournal of Psychiatric Research
Volume84
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Attention Deficit Disorder with Hyperactivity
Meta-Analysis
Blood Pressure
Therapeutics
Placebos
Clinical Trials
Sleep Initiation and Maintenance Disorders
Appetite
modafinil
Attention Deficit Hyperactivity Disorder
Meta-analysis
Mental Disorders
Registries
Heart Rate
Databases
Pharmacology
Pediatrics
Safety
Incidence
Population

Keywords

  • ADHD
  • Clinical trial
  • Efficacy
  • Modafinil
  • Safety
  • Treatment

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Modafinil for the treatment of attention-deficit/hyperactivity disorder : A meta-analysis. / Wang, Sheng Min; Han, Changsu; Lee, Soo Jung; Jun, Tae Youn; Patkar, Ashwin A.; Masand, Prakash S.; Pae, Chi Un.

In: Journal of Psychiatric Research, Vol. 84, 01.01.2017, p. 292-300.

Research output: Contribution to journalArticle

Wang, Sheng Min ; Han, Changsu ; Lee, Soo Jung ; Jun, Tae Youn ; Patkar, Ashwin A. ; Masand, Prakash S. ; Pae, Chi Un. / Modafinil for the treatment of attention-deficit/hyperactivity disorder : A meta-analysis. In: Journal of Psychiatric Research. 2017 ; Vol. 84. pp. 292-300.
@article{c411782dd5234379b16b062e9d339df9,
title = "Modafinil for the treatment of attention-deficit/hyperactivity disorder: A meta-analysis",
abstract = "Attention-deficit/hyperactivity disorder (ADHD) is one of the most common and a debilitating neuro-behavior disorder in the pediatric population. Although numerous effective psychostimulants are available, more than 30{\%} of patients still do not show adequate treatment response rendering diverse pharmacological options. We aimed at assessing the efficacy and safety of modafinil in the treatment of children and adolescents with ADHD by conducting a meta-analysis. An extensive search of databases and clinical trial registries resulted in five published short-term randomized, double-blind, placebo-controlled trials. Primary efficacy measures were mean change in ADHD Rating Scale-IV Home (ADHD-RS-IV Home) and School Version (ADHD-RS-IV School) from baseline to study end point. The results showed that modafinil more significantly improved ADHD-RS-IV Home (SMD, −0.77 [95{\%}CI, −1.11 to −0.44]) and School (SMD, −0.71 [95{\%}CI, −0.96 to −0.47]) than placebo. Dropout rate due to adverse event did not significantly differ between two groups. In terms of commonly observed side effects, modafinil showed significantly higher incidence of decreased appetite (RR = 5.02, 95{\%} CIs, 2.55 to 9.89, P < 0.00001) and insomnia (RR = 6.16, 95{\%} CIs, 3.40 to 11.17, P < 0.00001). Modafinil did not cause a clinically significant increase of heart rate, systolic blood pressure, and diastolic blood pressure. Although we found that modafinil may be another treatment option in children and adolescents with ADHD, the results should be interpreted and translated into clinical practice with caution, as the meta-analysis was based on a limited number of clinical trials.",
keywords = "ADHD, Clinical trial, Efficacy, Modafinil, Safety, Treatment",
author = "Wang, {Sheng Min} and Changsu Han and Lee, {Soo Jung} and Jun, {Tae Youn} and Patkar, {Ashwin A.} and Masand, {Prakash S.} and Pae, {Chi Un}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.jpsychires.2016.09.034",
language = "English",
volume = "84",
pages = "292--300",
journal = "Journal of Psychiatric Research",
issn = "0022-3956",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - Modafinil for the treatment of attention-deficit/hyperactivity disorder

T2 - A meta-analysis

AU - Wang, Sheng Min

AU - Han, Changsu

AU - Lee, Soo Jung

AU - Jun, Tae Youn

AU - Patkar, Ashwin A.

AU - Masand, Prakash S.

AU - Pae, Chi Un

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Attention-deficit/hyperactivity disorder (ADHD) is one of the most common and a debilitating neuro-behavior disorder in the pediatric population. Although numerous effective psychostimulants are available, more than 30% of patients still do not show adequate treatment response rendering diverse pharmacological options. We aimed at assessing the efficacy and safety of modafinil in the treatment of children and adolescents with ADHD by conducting a meta-analysis. An extensive search of databases and clinical trial registries resulted in five published short-term randomized, double-blind, placebo-controlled trials. Primary efficacy measures were mean change in ADHD Rating Scale-IV Home (ADHD-RS-IV Home) and School Version (ADHD-RS-IV School) from baseline to study end point. The results showed that modafinil more significantly improved ADHD-RS-IV Home (SMD, −0.77 [95%CI, −1.11 to −0.44]) and School (SMD, −0.71 [95%CI, −0.96 to −0.47]) than placebo. Dropout rate due to adverse event did not significantly differ between two groups. In terms of commonly observed side effects, modafinil showed significantly higher incidence of decreased appetite (RR = 5.02, 95% CIs, 2.55 to 9.89, P < 0.00001) and insomnia (RR = 6.16, 95% CIs, 3.40 to 11.17, P < 0.00001). Modafinil did not cause a clinically significant increase of heart rate, systolic blood pressure, and diastolic blood pressure. Although we found that modafinil may be another treatment option in children and adolescents with ADHD, the results should be interpreted and translated into clinical practice with caution, as the meta-analysis was based on a limited number of clinical trials.

AB - Attention-deficit/hyperactivity disorder (ADHD) is one of the most common and a debilitating neuro-behavior disorder in the pediatric population. Although numerous effective psychostimulants are available, more than 30% of patients still do not show adequate treatment response rendering diverse pharmacological options. We aimed at assessing the efficacy and safety of modafinil in the treatment of children and adolescents with ADHD by conducting a meta-analysis. An extensive search of databases and clinical trial registries resulted in five published short-term randomized, double-blind, placebo-controlled trials. Primary efficacy measures were mean change in ADHD Rating Scale-IV Home (ADHD-RS-IV Home) and School Version (ADHD-RS-IV School) from baseline to study end point. The results showed that modafinil more significantly improved ADHD-RS-IV Home (SMD, −0.77 [95%CI, −1.11 to −0.44]) and School (SMD, −0.71 [95%CI, −0.96 to −0.47]) than placebo. Dropout rate due to adverse event did not significantly differ between two groups. In terms of commonly observed side effects, modafinil showed significantly higher incidence of decreased appetite (RR = 5.02, 95% CIs, 2.55 to 9.89, P < 0.00001) and insomnia (RR = 6.16, 95% CIs, 3.40 to 11.17, P < 0.00001). Modafinil did not cause a clinically significant increase of heart rate, systolic blood pressure, and diastolic blood pressure. Although we found that modafinil may be another treatment option in children and adolescents with ADHD, the results should be interpreted and translated into clinical practice with caution, as the meta-analysis was based on a limited number of clinical trials.

KW - ADHD

KW - Clinical trial

KW - Efficacy

KW - Modafinil

KW - Safety

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=84994259819&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994259819&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2016.09.034

DO - 10.1016/j.jpsychires.2016.09.034

M3 - Article

C2 - 27810669

AN - SCOPUS:84994259819

VL - 84

SP - 292

EP - 300

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

SN - 0022-3956

ER -