Modafinil Improves Symptoms of Attention-Deficit/Hyperactivity Disorder across Subtypes in Children and Adolescents

Feb 19, 2008The Journal of pediatrics

Modafinil helps reduce ADHD symptoms in children and teenagers across different types

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Abstract

A total of 638 patients with ADHD received either modafinil or placebo over 7 to 9 weeks.

Modafinil significantly reduced ADHD symptoms in patients diagnosed with the inattentive and combined subtypes, as measured by teacher and parent assessments.
In the inattentive subtype, the mean score reduction on the ADHD Rating Scale-IV (School) was -15.7 for modafinil compared to -7.1 for placebo.
For the combined subtype, the mean score reduction on the ADHD Rating Scale-IV (School) was -16.5 for modafinil versus -8.8 for placebo.
Greater improvements were observed with modafinil on the Clinical Global Impression of Improvement scale and on the Conners' Parent Rating Scale in the inattentive and combined subtypes.

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OBJECTIVE: This secondary analysis evaluated the efficacy of modafinil in children and adolescents by subtype of attention-deficit/hyperactivity disorder (ADHD) using pooled data from 3 double-blind, placebo-controlled studies.

STUDY DESIGN: The patients were boys and girls age 6 to 17 years. ADHD subtype diagnoses (ie, inattentive, hyperactive-impulsive, combined) were based on criteria published in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Patients received modafinil (170 to 425 mg) or placebo once daily for 7 to 9 weeks. Efficacy assessment used the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV) School and Home Versions, Clinical Global Impression of Improvement scale (CGI-I), and Conners' Parent Rating Scale-Revised: Short Form (CPRS-R:S).

RESULTS: A total of 638 patients received modafinil (n = 423) or placebo (n = 215). The inattentive, hyperactive-impulsive, and combined subtypes included 187 (30%), 27 (4%), and 403 (65%) patients, respectively. Modafinil (vs placebo) significantly improved mean total scores for the ADHD-RS-IV School and Home Versions for the inattentive (change from baseline: School, modafinil, -15.7, placebo, -7.1; Home, modafinil, -13.8, placebo, -5.9) and combined subtypes (School, -16.5 vs -8.8; Home, -15.7 vs -7.6). Modafinil was associated with greater improvements on the CGI-I and improved CPRS-R:S subscale scores in inattentive and combined subtypes.

CONCLUSIONS: Modafinil improved ADHD symptoms and behaviors in patients with the inattentive and combined subtypes as determined by teachers, investigators, and parents.

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Modafinil Improves Symptoms of Attention-Deficit/Hyperactivity Disorder across Subtypes in Children and Adolescents

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