MODAFINIL, D-AMPHETAMINE AND PLACEBO DURING 64 HOURS OF SUSTAINED MENTAL WORK .1. EFFECTS ON MOOD, FATIGUE, COGNITIVE PERFORMANCE AND BODY-TEMPERATURE

Modafinil is an alerting substance that is considered safer than amphe tamine with fewer side effects. Although modafinil has been used succe ssfully to treat narcolepsy, relatively little is known about its abil ity to ameliorate fatigue and declines in mental performance due to sl eep deprivation (SD) in a normal population. Forty-one military subjec ts received either 300 mg of modafinil, 20 mg of d-amphetamine, or pla cebo on 3 separate occasions during 64 hours of continuous cognitive w ork and sleep loss. Three drug treatments were given: at 23.30 hours a nd 05.30 hours during the first and second SD nights, respectively, an d once at 15.30 hours during the third day of continuous work. Subject ive estimates of mood, fatigue and sleepiness, as well as objective me asures of reaction time, logical reasoning and short-term memory clear ly showed better performance with both modafinil and amphetamine relat ive to placebo. Both modafinil and amphetamine maintained or increased body temperature compared to the natural circadian cycle observed in the placebo group. Also, from subject debriefs at the end of the study , modafinil elicited fewer side-effects than amphetamine, although mor e than the placebo group. Modafinil appears to be a good alternative t o amphetamine for counteracting the debilitating mood and cognitive ef fects of sleep loss during sustained operations.