Modafinil for the treatment of cocaine dependence

“N IH -PA Author M anuscript N IH -PA Author M anuscript N IH -PA Author M anuscript administration in rats (Boutrel et al., 2005).”

“Via its actions on the hypocretin/orexin system (Scammell et al., 2000) and the glutamate/GABA (gammaAminobutyric Acid) systems (Ferraro et al., 1997) modafinil could help restore the homeostasis disturbed by chronic cocaine use.”

“Finally, modafinil was safe and well tolerated in Phase I interaction studies with cocaine (Donovan et al., 2005; Dackis et al., 2003), and in a pilot study on cocaine dependence treatment (n = 62) it was superior to placebo at promoting cocaine abstinence (Dackis et al., 2005).”

“Our results are in line with those from other recent clinical trials for treatment of stimulant dependence (Kampman et al., 2004; Elkashef et al., 2008), where no single medication has been shown to help most patients, but rather, some subgroups seem to respond to a specific medication.”

“Modafinil improves cognition and mood (Turner et al., 2004; Taneja et al., 2007), and has shown efficacy in the treatment of child and adult attention deficit hyperactivity disorder (Lindsay et al., 2006).”

“Our results are in line with those from other recent clinical trials for treatment of stimulant dependence (Kampman et al., 2004; Elkashef et al., 2008), where no single medication has been shown to help most patients, but rather, some subgroups seem to respond to a specific medication.”

“Briefly, modafinil has stimulant properties, which could be therapeutic for alleviating some stimulant withdrawal symptoms (Malcolm et al., 2002; Jasinski, 2000), and in human laboratory test paradigms it has been found to attenuate subjective responses to cocaine (Dackis et al., 2003) and the…”

“Finally, modafinil was safe and well tolerated in Phase I interaction studies with cocaine (Donovan et al., 2005; Dackis et al., 2003), and in a pilot study on cocaine dependence treatment (n = 62) it was superior to placebo at promoting cocaine abstinence (Dackis et al., 2005).”

“…for alleviating some stimulant withdrawal symptoms (Malcolm et al., 2002; Jasinski, 2000), and in human laboratory test paradigms it has been found to attenuate subjective responses to cocaine (Dackis et al., 2003) and the priming effect of cocaine for self-administration (Hart et al., 2007).”

“It is as effective as traditional dopamine-acting stimulants for that indication (Roth and Roehrs, 1996), but its pharmacological profile is notably different from the amphetamines, cocaine, or methylphenidate.”

“One possible concern about drinking alcohol with this medication is based on a theory that modafinil may worsen chronic drinking because of its pro-glutamate action (Ferraro et al., 1999).”

“The role of glutamate in the chronic effects of cocaine and the development of cocaine conditioned responding is well established (Kalivas et al., 2003), and recent studies suggest that hypocretin may also enhance the reinstatement of cocaine self- Drug Alcohol Depend.”

“Via its actions on the hypocretin/orexin system (Scammell et al., 2000) and the glutamate/GABA (gammaAminobutyric Acid) systems (Ferraro et al., 1997) modafinil could help restore the homeostasis disturbed by chronic cocaine use.”

“A cocaine-positive self-report day was always accepted as such, but a self-report day of cocaine non-use was confirmed by a negative or decreasing urine BE level, according to the Preston Rules (Preston et al., 1997).”

“Equally important, modafinil has a lower propensity for euphoria and cocaine-like discriminative-stimulus effects than does methylphenidate (Rush et al., 2002).”

“In one 12-year follow-up, those who continued to use cocaine had more criminal justice involvement, and more unemployment and psychiatric problems than those who achieved 5 years of abstinence (Hser et al., 2006).”

“Modafinil improves cognition and mood (Turner et al., 2004; Taneja et al., 2007), and has shown efficacy in the treatment of child and adult attention deficit hyperactivity disorder (Lindsay et al., 2006).”

“Cocaine craving—Total scores for the Brief Substance Craving Scale (BSCS) for cocaine (items 1–8) were ordinal interval transformed to reduce skewness prior to regression analysis (Kyomen et al., 1999).”

“All participants received individual standardized psychosocial therapy, which consisted of manual-guided Cognitive Behavioral Therapy (Longabaugh et al., 2005) once per week during the 12-week treatment period.”

“Briefly, modafinil has stimulant properties, which could be therapeutic for alleviating some stimulant withdrawal symptoms (Malcolm et al., 2002; Jasinski, 2000), and in human laboratory test paradigms it has been found to attenuate subjective responses to cocaine (Dackis et al., 2003) and the…”

“Modafinil improves cognition and mood (Turner et al., 2004; Taneja et al., 2007), and has shown efficacy in the treatment of child and adult attention deficit hyperactivity disorder (Lindsay et al., 2006).”

“The number of 70 in each arm was selected based on previous NIDA studies on cocaine abuse (Kampman et al., 2005) as well as the estimated effect size of the earlier pilot trial which reported a significant effect of modafinil treatment on cocaine abuse (Dackis et al., 2005).”

“Finally, modafinil was safe and well tolerated in Phase I interaction studies with cocaine (Donovan et al., 2005; Dackis et al., 2003), and in a pilot study on cocaine dependence treatment (n = 62) it was superior to placebo at promoting cocaine abstinence (Dackis et al., 2005).”

“Cocaine craving—Total scores for the Brief Substance Craving Scale (BSCS) for cocaine (items 1–8) were ordinal interval transformed to reduce skewness prior to regression analysis (Kyomen et al., 1999).”

“A third trial (Anderson et al., 2009) demonstrated no overall efficacy in the primary outcome measure (total percentage of nonuse days) but post hoc analyses revealed an increased number of consecutive nonuse days, reduced craving, and an increased percentage of nonuse days among patients without a history of alcohol…”

“, [12, 63, 64, 176]), its effects on sleep and its pro-cognitive effects position it as the best candidate at present for a viable pharmacotherapy for cocaine use disorders.”

“for the treatment of cocaine dependence [178] and possibly methamphetamine dependence [179].”

“For example, Modafinil, a catecholaminergic agonist, increases extracellular dopamine in the prefrontal cortex, and has been investigated for its applicability in treating cocaine dependence (Anderson et al., 2009; Dackis et al., 2004).”