急性莫达非尼对甲基苯丙胺依赖者注意和抑制控制的影响。
Acute modafinil effects on attention and inhibitory control in methamphetamine-dependent humans.
机构信息
Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1759, USA.
出版信息
J Stud Alcohol Drugs. 2011 Nov;72(6):943-53. doi: 10.15288/jsad.2011.72.943.
OBJECTIVE
Individuals who are methamphetamine dependent exhibit higher rates of cognitive dysfunction than healthy people who do not use methamphetamine, and this dysfunction may have a negative effect on the success of behavioral treatments for the disorder. Therefore, a medication that improves cognition, such as modafinil (Provigil), may serve as a useful adjunct to behavioral treatments for methamphetamine dependence. Although cognitive-enhancing effects of modafinil have been reported in several populations, little is known about the effects of modafinil in methamphetamine-dependent individuals. We thus sought to evaluate the effects of modafinil on the cognitive performance of methamphetamine-dependent and healthy individuals.
METHOD
Seventeen healthy subjects and 24 methamphetamine- dependent subjects participated in this randomized, double-blind, placebo-controlled, crossover study. Effects of modafinil (200 mg, single oral dose) were assessed on participants' performance on tests of inhibitory control, working memory, and processing speed/attention.
RESULTS
Across subjects, modafinil improved performance on a test of sustained attention, with no significant improvement on any other cognitive tests. However, within the methamphetamine-dependent group only, participants with a high baseline frequency of methamphetamine use demonstrated a greater effect of modafinil on tests of inhibitory control and processing speed than those participants with low baseline use of methamphetamine.
CONCLUSIONS
Although modafinil produced limited effects across all participants, methamphetamine-dependent participants with a high baseline use of methamphetamine demonstrated significant cognitive improvement on modafinil relative to those with low baseline methamphetamine use. These results add to the findings from a clinical trial that suggested that modafinil may be particularly useful in methamphetamine-dependent subjects who use the drug frequently.
目的
与不使用冰毒的健康人群相比，冰毒依赖者表现出更高的认知功能障碍发生率，而这种障碍可能对该障碍的行为治疗的成功产生负面影响。因此，一种改善认知的药物，如莫达非尼（Provigil），可能是行为治疗冰毒依赖的有用辅助手段。尽管已经在几种人群中报道了莫达非尼的认知增强作用，但对于莫达非尼在冰毒依赖者中的作用知之甚少。因此，我们试图评估莫达非尼对冰毒依赖者和健康个体认知表现的影响。
方法
17 名健康受试者和 24 名冰毒依赖者参加了这项随机、双盲、安慰剂对照、交叉研究。评估了莫达非尼（200mg，单次口服剂量）对参与者抑制控制、工作记忆和处理速度/注意力测试表现的影响。
结果
在所有受试者中，莫达非尼改善了持续注意力测试的表现，而其他认知测试则没有显著改善。然而，仅在冰毒依赖组中，基线冰毒使用频率较高的参与者在抑制控制和处理速度测试中，莫达非尼的作用大于基线冰毒使用量较低的参与者。
结论
尽管莫达非尼在所有参与者中产生的效果有限，但基线使用冰毒频率较高的冰毒依赖者在莫达非尼治疗后认知功能显著改善，而基线冰毒使用量较低的参与者则没有。这些结果增加了一项临床试验的结果，该试验表明，对于经常使用冰毒的冰毒依赖者，莫达非尼可能特别有用。
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