Modafinil for Cognitive Dysfunction in Narcolepsy

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Modafinil is a wakefulness-promoting medication used to treat excessive daytime sleepiness associated with narcolepsy. It increases levels of norepinephrine and dopamine in the brain, thereby increasing alertness.

Modafinil 200 Australia is FDA approved for the treatment of narcolepsy and has been extensively tested in a number of double-blind, placebo controlled studies. EEG-tomographic studies using LORETA show that modafinil improves vigilance in patients with narcolepsy.

A single dose of modafinil reduces the auditory evoked potential latency in the scalp, and thereby increases attention and reaction time. It induces a dose-dependent decrease in GABA in the cortex, medial preoptic area and posterior hypothalamus, striatum and globus pallidus, and hippocampus.

What is Narcolepsy?

Narcolepsy is a chronic neurological (nervous system) condition that causes extreme daytime sleepiness and disrupts normal sleep patterns. It can make it hard to work, go to school or participate in social activities. It may also increase the risk of serious accidents and injuries like car crashes when it causes sudden, irresistible episodes of sleepiness.

The cause of narcolepsy is unknown, but it probably involves a deficiency in hypocretin, which is produced by neurons (brain cells) in the brain’s hypothalamus region. People with type 1 narcolepsy have very low levels of this neurotransmitter, and they often experience sudden episodes of muscle weakness called cataplexy, which can look like seizure activity. People with type 2 narcolepsy have normal levels of hypocretin and do not experience cataplexy.

Doctors diagnose narcolepsy by taking a detailed medical history and doing a physical exam. They can also use lab tests to test for narcolepsy and its symptoms. Treatment options include drugs that help control sleepiness and antidepressants that can control cataplexy.

Narcolepsy Symptoms

People with narcolepsy often feel sleepy all the time and have trouble staying awake. They may have episodes, called sleep attacks, in which they fall asleep during a task, such as driving or working, then wake up without remembering what happened. They may also have a sudden loss of muscle tone, called cataplexy, which causes slurred speech or weakness.

Excessive daytime sleepiness can make it hard to learn or keep a job and to maintain relationships. It can also cause problems with driving, using power tools or other machinery, and swimming. People with narcolepsy can be at increased risk for accidents when their drowsiness or sleepiness interferes with their ability to pay attention.

Several studies show that Modalert Australia improves alertness in people with narcolepsy. In one study, it improved performance on a test that requires attention and inhibiting control (Stroop interference) in subjects with narcolepsy. (Moron et al, 2007) It also helped people with narcolepsy do better on tests that require memory and learning.

Narcolepsy Causes

Many people with narcolepsy experience excessive daytime sleepiness (EDS), in which they feel an irresistible urge to sleep. They may fall asleep during the day and wake up with a headache, sore muscles, or a memory problem. They also may have lapses of attention or "sleep attacks" that can last several minutes.

Some people with narcolepsy have cataplexy, a sudden loss of muscle tone. This can be triggered by laughter, fear, anger, or other intense emotions and can range from drooping eyelids to complete body collapse.

The cause of narcolepsy is not known, but it may result from damage to part of the brain that produces hypocretin/orexin. Those with Type 1 narcolepsy have low levels of this neurotransmitter, which helps you stay awake. Symptoms may interfere with work and school, and they can make you seem unfocused or rude. They can also increase your risk of accidents. People with narcolepsy often feel stigma. They should talk to family and friends about their condition and seek support and understanding.

Narcolepsy Treatment

Modafinil is a wakefulness-promoting medication used to treat excessive daytime sleepiness associated with narcolepsy. It increases levels of norepinephrine and dopamine in the brain, thereby increasing alertness. It has also been shown to improve cognitive functioning in animal models. For example, modafinil dose-dependently enhances working memory performance on a delayed alternation task in mice (Beracochea et al, 2001).

In clinical trials (9 weeks with open label up to 40 weeks), modafinil reduced daytime sleepiness and was well tolerated. It improved average sleep latencies on the Maintenance of Wakefulness Test (MWT) and overall narcolepsy disease severity as measured by evaluators using a clinical global impression of change score.

Unlike other drugs commonly prescribed to treat narcolepsy such as amphetamine and methylphenidate, modafinil does not appear to have abuse potential. However, like other wakefulness-promoting medications, it may cause side effects such as nausea, headache, diarrhea, stomach pain and increased heart rate. Individuals with preexisting heart conditions or high blood pressure should not take this drug.

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