Cognitive dysfunction is known to be a core symptom of depression that tends to persist even after mood improves. A study published in Biological Psychiatry suggests that modafinil—a wake-promoting agent approved to treat patients with narcolepsy—might be able to help patients with remitted depression who are experiencing cognitive deficits.
Past studies have highlighted the cognitive-enhancing effects of modafinil in patients with schizophrenia and attention-deficit/hyperactivity disorder as well as healthy controls, but few have looked at the potential of the medication to treat cognitive deficits in patients with remitted depression.
For the current study, Barbara Sahakian, Ph.D., of the University of Cambridge and colleagues recruited patients in remission from depression (score of less than 12 on the Montgomery–Asberg Depression Rating Scale for at least two months). A total of 60 patients (48 were taking antidepressants) were evaluated using the Cambridge Neuropsychological Test Automated Battery, which includes tests of episodic memory, working memory, planning, and attention. One week after baseline evaluation of cognitive function, patients were randomized to receive either a single dose of modafinil (200 mg) or placebo, followed by another round of cognitive tests two hours after treatment.
The researchers found that the modafinil group significantly outperformed the placebo group on episodic memory and working memory tests. There were no differences between the groups in regards to improvements in planning and attention.
Although none of the study participants reported significant adverse events during the testing or 24 hours after the study, two patients taking modafinil reported sleep disturbances on the night of the study session.
“Cognitive deficits in remitted depression have detrimental effects on life functioning and pose a risk for relapse,” the authors wrote. “Modafinil may have potential as a therapeutic agent to help remitted depressed patients with persistent cognitive difficulties.”
For related information, see the Psychiatric News article “Is Modafinil a ‘Smart’ Choice to Treat Cognitive Problems in Psychiatric Disorders?”
Live Mentally Healthy,
Dr. Jennie Byrne