From the Department of Psychological and Brain Sciences, Boston University, Boston, MA.
Department of Psychology, New York University, New York, NY.
J Clin Psychopharmacol. 2019 Sep/Oct;39(5):455-461. doi: 10.1097/JCP.0000000000001085.
Animal models and human studies have identified the potential of modafinil as a cognitive enhancing agent, independent of its effects on promoting wakefulness in sleep-deprived samples. Given that single-dose applications of other putative memory enhancers (eg, D-cycloserine, yohimbine, and methylene blue) have shown success in enhancing clinical outcomes for anxiety-related disorders, we conducted a meta-analytic review examining the potential for single-dose effects for modafinil on cognitive functioning in non-sleep-deprived adults.
A total of 19 placebo-controlled trials that examined the effects of single-dose modafinil versus placebo on the cognitive domains of attention, executive functioning, memory, or processing speed were identified, allowing for the calculation of 67 cognitive domain-specific effect sizes.
The overall positive effect of modafinil over placebo across all cognitive domains was small and significant (g = 0.10; 95% confidence interval, 0.05-0.15; P < 0.001). No significant differences between cognitive domains were found. Likewise, no significant moderation was found for modafinil dose (100 mg vs 200 mg) or for the populations studied (psychiatric vs nonpsychiatric).
In conclusion, the available evidence indicates only limited potential for modafinil to act as a cognitive enhancer outside sleep-deprived populations.
动物模型和人类研究已经确定了莫达非尼作为认知增强剂的潜力，而不考虑其在促进睡眠剥夺样本清醒方面的作用。鉴于其他假定的记忆增强剂（如 D-环丝氨酸、育亨宾和亚甲蓝）的单次应用已显示出在增强与焦虑相关障碍的临床结果方面的成功，我们进行了一项荟萃分析审查，以检查莫达非尼对非睡眠剥夺成年人认知功能的单次剂量效应的潜力。
共确定了 19 项安慰剂对照试验，这些试验研究了单剂量莫达非尼与安慰剂对注意力、执行功能、记忆或处理速度等认知领域的影响，允许计算 67 个认知领域特定的效应大小。
莫达非尼在所有认知领域对安慰剂的总体积极影响较小但显著（g = 0.10；95%置信区间，0.05-0.15；P < 0.001）。未发现认知领域之间存在显著差异。同样，未发现莫达非尼剂量（100 mg 与 200 mg）或研究人群（精神科与非精神科）存在显著调节作用。
总之，现有证据表明，莫达非尼在睡眠剥夺人群之外作为认知增强剂的潜力有限。
