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A double-blind, placebo-controlled investigation of the efficacy of modafinil for sustaining the alertness and performance of aviators: a helicopter simulator study.

Caldwell JA, Caldwell JL, Smythe NK, Hall KK

Aeromedical Research Laboratory, 
Fort Rucker, AL 36362-0577 
John.Caldwell@se.amedd.army.mil
Psychopharmacology (Berl) 2000 Jun;150(3):272-82

ABSTRACT

RATIONALE: In 1998, the FDA approved modafinil for treating excessive daytime sleepiness in narcoleptics, and this has raised questions about the appropriateness of this compound for enhancing alertness in sleep-deprived controls. This study explored the efficacy of modafinil for maintaining the performance of volunteers required to accomplish highly demanding tasks despite sleep loss. 

OBJECTIVE: The principal objective was to determine whether prophylactic doses of modafinil would attenuate decrements in aviator performance and arousal throughout 2 days and 1 night without sleep. 

METHODS: Six pilots were exposed to two 40-h periods of continuous wakefulness. In one, three 200-mg doses of modafinil were given and in the other, matching placebos were administered. Helicopter simulator flights, resting EEGs, and Profile of Mood States (POMS) questionnaires were evaluated. 

RESULTS: Modafinil attenuated sleep deprivation effects on four of six flight maneuvers, reduced slow-wave EEG activity, and lessened self-reported problems with mood and alertness in comparison to placebo. The most noticeable benefits occurred between 0330 and 1130 hours, when the combined impact of sleep loss and the circadian trough was most severe. The most frequently observed drug side effects were vertigo, nausea, and dizziness. These could have been related to: 1) the motion-based testing, 2) the use of a simulator rather than an actual aircraft (i.e., "simulator sickness"), and/or 3) the administration of more than 400 mg modafinil. 

CONCLUSIONS: Modafinil is a promising countermeasure for sleep loss in normals; however, additional studies aimed at reducing side effects are needed before it should be used in aviators.

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 4.   Modafinil  efficacy in narcolepsy
 5.   Modafinil  narcolepsy: symptoms and management
 6.   Modafinil  successful treatment of hypersomnia & narcolepsy
 7.   Modafinil  drug of choice for narcolepsy
 8.   Modafinil  in the treatment of narcolepsy
 9.   Modafinil  effect on narcolepsy
10.  Modafinil  a narcolepsy study
11.  Modafinil  switching from narcolepsy drugs to modafinil
12.  Modafinil  and naps as counter measures in sleep deprivation
13.  Modafinil  as a treatment for excessive daytime sleepiness
14.  Modafinil  use in a sleep deprivation experiment
15.  Modafinil  excessive sleepiness in Parkinson's disease
16.  Modafinil  the unique properties of a new stimulant 
17.  Modafinil  for sustaining the alertness of helicopter pilots
18.  Modafinil  dosage and safety
19.  Modafinil  treatment of alcoholic organic brain syndrome
20.  Modafinil  effect on melatonin, cortisol, and growth hormone
21.  Modafinil  in obstructive sleep apnea-hypopnea syndrome
22.  Modafinil  vs dextroamphetamine in treatment of adult ADHD
23.  Modafinil  dopaminergic transmission mediates CNS stimulants
24.  Modafinil  for daytime sleepiness in sleep apnea
25.  Modafinil  treatment of residual excessive daytime sleepiness
26.  Modafinil  amplification of cortical serotonin release
27.  Modafinil  for the treatment of multiple sclerosis

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