Date of Award

2013

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not modafinil (Provigil®) is effective in improving cognitive function in adults with narcolepsy.

STUDY DESIGN: Review of all English language primary randomized controlled trials from 1996 to 2010.

DATA SOURCES: Double-blind, randomized controlled trials that compared modafinil (Provigil®) to a visually matched placebo were found using OVID, MEDLINE, and Cochrane Databases.

OUTCOME(S) MEASURED: Each of the three trials assessed the effect of modafinil on cognitive and executive function by Low-Resolution Brain Electromagnetic Tomography (LORETA), and the following assessment tools: Epworth Sleepiness Scale (ESS), Multiple Sleep Latency Test (MSLT), Clinical Global Impression of Change (CGI-C), Maintenance of Wakefulness Test (MWT), Wisconsin Card Sort Test (WSCT) and Pauli Test.

RESULTS: Two trials demonstrated a statistically significant improvement in cognitive performance achieved with treatment of modafinil versus placebo, which is related to medial prefrontal activity processes identified by LORETA. The third study demonstrated a significant improvement of executive function achieved with treatment of modafinil.

CONCLUSIONS: Based on the three trials, modafinil (Provigil®) is effective in improving cognitive function in adults with narcolepsy.