Impact of armodafinil on cognition in multiple sclerosis: a randomized, double-blind crossover pilot study

Cogn Behav Neurol. 2012 Sep;25(3):107-14. doi: 10.1097/WNN.0b013e31826df7fd.

Abstract

Objective: Examine the efficacy of armodafinil in improving cognition in patients with multiple sclerosis (MS).

Background: Many patients with MS experience cognitive difficulties. Armodafinil has shown promise as a cognitive enhancer in other patient populations. No studies have examined whether armodafinil improves cognition in patients with MS.

Methods: We conducted a double-blind, placebo-controlled, crossover study testing the efficacy of armodafinil in reducing cognitive problems in patients with MS. We randomized 17 patients to receive a dose of lactose placebo about 2 hours before they underwent a neuropsychological testing session. After a week-long washout period, we gave them a single 250-mg dose of armodafinil about 2 hours before testing them a second time. We randomized another 16 patients to receive the active drug first, then the placebo. We excluded 3 of the participants before analyzing the data.

Results: After correcting for multiple comparisons of the 8 neuropsychological dependent measures, we found that the patients had significantly improved delayed memory on a list-learning task after they took armodafinil (P = 0.0005), but no improvement on measures of executive function, visual memory, processing speed, or self-reported fatigue.

Conclusions: Results provide preliminary evidence that armodafinil may improve delayed verbal recall in patients with MS. A larger trial showing enhanced memory among patients taking long-term armodafinil could serve as a foundation for its possible clinical use as a memory enhancer in patients with MS.

Publication types

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

MeSH terms

  • Adult
  • Benzhydryl Compounds / pharmacology*
  • Benzhydryl Compounds / therapeutic use
  • Cognition / drug effects*
  • Cognition Disorders / complications
  • Cognition Disorders / drug therapy*
  • Cross-Over Studies
  • Double-Blind Method
  • Executive Function / drug effects
  • Fatigue / complications
  • Fatigue / drug therapy
  • Fatigue / psychology
  • Female
  • Humans
  • Male
  • Memory / drug effects
  • Middle Aged
  • Modafinil
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / psychology*
  • Neuropsychological Tests
  • Nootropic Agents / pharmacology*
  • Nootropic Agents / therapeutic use
  • Pilot Projects
  • Treatment Outcome

Substances

  • Benzhydryl Compounds
  • Nootropic Agents
  • Modafinil