Modafinil, a medication used to treat narcolepsy and related disorders, dramatically improves sleep among recently abstinent cocaine abusers. Better sleep may boost patients' attention, memory, and mood—helping them benefit from behavioral therapy for addiction.
Ten inpatients in a behavioral therapy program who received a daily morning dose of modafinil for the 16 days of the study fell asleep more quickly, spent more time in deep sleep, and slept longer than 10 inpatients in a placebo group, reports a team of NIDA-funded addiction and sleep researchers at the Yale and Harvard schools of medicine. All the inpatients were abstinent throughout the study, and the sleep of patients in the placebo group deteriorated during the weeks of abstinence. After 1 and 2 weeks of abstinence, patients treated with modafinil reported less daytime sleepiness and demonstrated less fatigue on tests than those who received placebo. On most measures, the sleep of the modafinil-treated cocaine abusers by the end of the study was more similar to that of 12 nonaddicted volunteers than to that of the cocaine abusers receiving the placebo, reports the team, headed by Yale's Dr. Peter Morgan.
The new results, the first to show modafinil's sleep-enhancing effects among abstinent drug abusers, extend the team's previous finding that during early abstinence, cocaine abusers demonstrate disrupted sleep without being aware of it ("Chronic Cocaine Abusers Have Occult Insomnia in Early Abstinence"). If the beneficial effects of modafinil are verified, clinicians may incorporate the medication into addiction treatment.
American Journal of Psychiatry 167(3):331–340, 2010. [Abstract]