ALERTNESS-ENHANCING DRUGS AS A COUNTERMEASURE TO FATIGUE IN IRREGULARWORK HOURS

Irregular work/rest patterns frequently cause disturbed sleep and exce ssive sleepiness and accidents. This review is focused on four pharmac ological countermeasures-the ''new'' drugs modafinil and pemoline, the traditional caffeine, and, as a reference, amphetamine. It is conclud ed that there is still too little data available to decide whether sys tematic use of alertness-enhancing drugs is feasible in occupational s ettings. D-Amphetamine is ruled out because of its abuse potential and mood effects. Modafinil and pemoline have not been tested in field si tuations, whereas caffeine certainly is used to improve alertness duri ng work, but the use is spontaneous/ad hoc, and there is still a lack of data on its systematic application. Particularly, the optimal amoun t and pattern of administration need elucidation.