Modafinil for the treatment of cocaine dependence
Open accessAbstract
Aim Modafinil was tested for efficacy in facilitating abstinence in cocaine-dependent patients, compared to placebo.Methods This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 4-week follow-up. Six outpatient substance abuse treatment clinics participated in the study. There were 210 treatment-seekers randomized, having a diagnosis of cocaine dependence; 72 participants were randomized to placebo, 69 to modafinil 200mg, and 69 to modafinil 400mg, taken once daily on awakening. Participants came to the clinic three times per week for assessments and urine drug screens, and had one hour of individual psychotherapy weekly. The primary outcome measure was the weekly percentage of cocaine non-use days.Results The GEE regression analysis showed that for the total sample, there was no significant difference between either modafinil group and placebo in the change in average weekly percent of cocaine non-use days over the 12-week treatment period (p>0.79). However, two secondary outcomes showed significant effects by modafinil 200mg: the maximum number of consecutive non-use days for cocaine (p=0.02), and a reduction in craving (p=0.04). Also, a post hoc analysis showed a significant effect of modafinil that increased the weekly percentage of non-use days in the subgroup of those cocaine patients who did not have a history of alcohol dependence (p<0.02).Conclusions These data suggest that modafinil, in combination with individual behavioral therapy, was effective for increasing cocaine non-use days in participants without co-morbid alcohol dependence, and in reducing cocaine craving.
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Stimulant use disorder is associated with moderate cognitive deficits.
“In addition, StUD is associated with moderate cognitive deficits.224”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [224]
The Introduction says modafinil improves cognition, but does not say that stimulant use disorder is associated with cognitive deficits or describe their severity. The Methods list assessments of cocaine use, craving, and dependence severity, not cognitive deficits. Searches for moderate cognitive deficits and cognitive impairment in cocaine-dependent patients found no passage addressing the claim. (LLM, conf=0.76)
Experimental — accuracy not yet measuredModafinil has moderate effectiveness for the treatment of cocaine dependence and possibly methamphetamine dependence.
“Modafinil is a non-amphetamine stimulant with DA and glutamatergic effects, and with moderate effectiveness for the treatment of cocaine dependence [178] and possibly methamphetamine dependence [179].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [178]
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- Authors
- Anderson, A. L., Reid, M. S., Li, S.-H., Holmes, T., Shemanski, L., Slee, A., Smith, E. V., Kahn, R., Chiang, N., Vocci, F., Ciraulo, D., Dackis, C., Roache, J. D., Salloum, I. M., Somoza, E., Urschel, H. C., & Elkashef, A. M.
- Affiliations
- National Institutes of Health (US)
- New York University (US)
- Stanford Medicine (US)
- Boston University (US)
- University of Pennsylvania (US)
- The University of Texas at San Antonio Health Science Center (US)
- University of Miami (US)
- Corresponding author
- Anderson, Ann L.
- ORCID
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2009-09
- Volume
- 104
- Issue
- 1-2
- Pages
- 133-139
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC2818032
- OpenAlex
- W2140991283
- Cited by
- 235
- References
- 27
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 15 · 2023: 10 · 2022: 10 · 2021: 15 · 2020: 8 · 2019: 9 · 2018: 7 · 2017: 4 · 2016: 20 · 2015: 15 · 2014: 20 · 2013: 15 · 2012: 28
- FWCI
- 15.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 DA999999)
- National Institute on Drug Abuse (N01DA-3-8838)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- modafinil, cocaine dependence, cocaine abstinence, cocaine craving, stimulant use disorder, individual psychotherapy
- MeSH terms
- Modafinil, Adult, Alcoholism, Central Nervous System Stimulants, Benzhydryl Compounds, Combined Modality Therapy, Double-Blind Method, Ethnicity, Female, Humans, Male, Patient Compliance, Psychiatric Status Rating Scales, Psychotherapy, Risk Factors, Socioeconomic Factors, Urinalysis, Treatment Outcome, Cocaine-Related Disorders
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