Document Detail

Modafinil elicits sympathomedullary activation.
MedLine Citation:
PMID:  15753235     Owner:  NLM     Status:  MEDLINE    
The autonomic effects of modafinil (Provigil), a psychostimulant widely used to attenuate fatigue and promote wakefulness, are currently unexplored. We assessed the effect of modafinil on autonomic nervous system. We compared oral modafinil (400 mgx1) versus placebo in 12 healthy hospitalized normal subjects in a randomized double-blind, placebo-controlled cross-over study for 3 days each with subjects in 150 mEq sodium, 70 mEq potassium balance at the Vanderbilt General Clinical Research Center. Modafinil increased resting heart rate (9.2+/-2.0 bpm; mean [+/-SE]; 95% confidence interval [CI], 4.7 to 13.6; P=0.001), resting systolic blood pressure (7.3+/-3.2 mm Hg; 95% CI, 0.2 to 14.4; P=0.044), and resting diastolic blood pressure (5.3+/-1.7 mm Hg; 95% CI, 1.4 to 9.1 mm Hg; P<0.012). Modafinil elicited a 42% higher orthostatic increase in plasma norepinephrine (0.8+/-0.3 nmol/L; 95% CI, 0.2 to 1.3; P=0.01), and caused a 33% increase in urine norepinephrine (5.1+/-1.1 nmol/L creatinine per day; 95% CI, 2.7 to 7.4, P=0.001), and an 81% increase in urine epinephrine (1.3+/-0.2 nmol/L creatinine per day; 95% CI, 1 to 2; P<0.001). The peroneal microneurographic sympathetic activity was attenuated by modafinil during orthostatic tilt (P<0.001). alpha1-Adrenoreceptor function was maintained. Modafinil substantially perturbs autonomic cardiovascular regulation by increase in heart rate and blood pressure. Autonomic changes of this magnitude encourage caution in use of modafinil in patients with cardiovascular disease.
Indu Taneja; Andre Diedrich; Bonnie K Black; Daniel W Byrne; Sachin Y Paranjape; David Robertson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2005-03-07
Journal Detail:
Title:  Hypertension     Volume:  45     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-25     Completed Date:  2005-10-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  612-8     Citation Subset:  IM    
Autonomic Dysfunction Center, Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University, Nashville, Tenn 37232-2195, USA.
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MeSH Terms
Adrenal Medulla / drug effects*,  physiology*
Benzhydryl Compounds / pharmacology*
Cardiovascular System / drug effects
Catecholamines / blood,  urine
Central Nervous System Stimulants / pharmacology*
Cross-Over Studies
Diuresis / drug effects
Double-Blind Method
Electrolytes / urine
Middle Aged
Muscle, Skeletal / innervation
Reference Values
Sympathetic Nervous System / drug effects*,  physiology*
Grant Support
Reg. No./Substance:
0/Benzhydryl Compounds; 0/Catecholamines; 0/Central Nervous System Stimulants; 0/Electrolytes; 68693-11-8/modafinil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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