Modafinil for atypical depression: effects of open-label and double-blind discontinuation treatment

J Clin Psychopharmacol. 2006 Aug;26(4):373-8. doi: 10.1097/01.jcp.0000227700.263.75.39.

Abstract

Atypical depression, with features of hypersomnia, hyperphagia, anergia, and rejection sensitivity, is a common presentation of major depressive disorder. There are few available effective therapies for this disorder. We test modafinil, a novel wake-promoting agent, as monotherapy for atypical depression in a double-blind, placebo-controlled, relapse prevention trial after open-label treatment. We found that modafinil significantly improved atypical depression symptoms during 12 weeks of open-label treatment (mean +/- SD Hamilton Depression Scale (29-item version) score changed from 34 +/- 8.2 at baseline to 9.7 +/- 9.3, P < 0.0001), and that benefits were maintained alike in both the continuation and placebo arms during the double-blind treatment phase (P = 0.92). Modafinil was well tolerated and the drug was associated with significant weight loss compared with placebo (P = 0.01).

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Benzhydryl Compounds / administration & dosage
  • Benzhydryl Compounds / adverse effects
  • Benzhydryl Compounds / therapeutic use*
  • Central Nervous System Stimulants / administration & dosage
  • Central Nervous System Stimulants / adverse effects
  • Central Nervous System Stimulants / therapeutic use
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / pathology
  • Disorders of Excessive Somnolence / drug therapy
  • Double-Blind Method
  • Female
  • Headache / chemically induced
  • Humans
  • Hyperphagia / drug therapy
  • Male
  • Middle Aged
  • Modafinil
  • Nausea / chemically induced
  • Patient Dropouts
  • Patient Selection
  • Thirst / drug effects
  • Time Factors
  • Treatment Outcome
  • Weight Loss / drug effects
  • Withholding Treatment

Substances

  • Benzhydryl Compounds
  • Central Nervous System Stimulants
  • Modafinil