INTENSIVE AND SUSTAINED AIR OPERATIONS - POTENTIAL USE OF THE STIMULANT, PEMOLINE

Background: Intensive and sustained military operations involve long p eriods of overnight work and the occasional use of a stimulant to main tain performance may be beneficial. In this context a dose response st udy was carried out to investigate the effects of pemoline, a dopamime tic agent, on overnight work and to assess potential residual effects on subsequent sleep; Methods: Six healthy volunteers participated in a placebo-controlled, double-blind, cross-over trial involving a 12-h p eriod of work during which subjective alertness and performance on a r ange of tasks were assessed at 1.5 h intervals following ingestion at 2000 hours of pemoline (10, 20, 30 and 40 mg) and, on two occasions, p lacebo. The work period was preceded by a 6-h sleep period with temaze pam 20 mg, and followed by a 4-h recovery sleep with no medication. Al l sleep periods were recorded electroencephalographically. Results: Th ere was no difference between sleep periods preceding the work period. Subjective alertness and performance on all tasks deteriorated signif icantly during the work period, with the earliest impairments in perfo rmance observed at 0200 hours. Pemoline increased subjective alertness and performance on all but two tasks, compared with placebo. The onse t of activity was seen 4.5 h after drug ingestion and alerting effects of 30 and 40 mg pemoline persisted beyond the work period, disturbing morning recovery sleep. Doses of 10 and 20 mg pemoline had no effect on recovery sleep. Conclusion:The present studies indicate that a 20 m g dose of pemoline may-be suitable for maintaining nocturnal performan ce without having adverse effects on recovery sleep.