An Open-Label Study of Adjunctive Modafinil in Patients With Sedation Related to Serotonergic Antidepressant Therapy

Schwartz, Thomas L.; Azhar, Nouman; Cole, Kimberly; Hopkins, Geoffrey; Nihalani, Nikhil; Simionescu, Mihai; Husain, Juhi; Jones, Nicole M.

doi:10.4088/jcp.v65n0910

Cited by 33 publications

(25 citation statements)

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“…The FSS was developed and standardized for patients with physical illnesses (MS and SLE) [11] but has been used since in a variety of populations, including MDD patients [16,[20][21][22][23][24][25]. However, the FSS has not been validated in depressed patients, reflecting a more general lack of specific fatigue measures standardized for this population [9].…”

Section: Discussionmentioning

confidence: 99%

“…More recent studies have suggested categorizing FSS scores into three groups of 'high fatigue' (FSS C 5), 'borderline fatigue' (4 \ FSS \ 5) and 'no fatigue' (FSS B 4) on the basis of a difference of two standard deviations between mean FSS scores of MS patients and healthy controls [44,45]. The cutoff score of 5 for 'high fatigue' has since been used in additional studies in MS patients and in the general population [35,46]; however, many more studies, especially those in MDD patients, have persisted on the originally suggested cutoff score of 4 without having provided evidence for its clinical validation in this population [21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…It has also been used in various other populations: patients with Parkinson's disease [15], chronic fatigue syndrome [16], brain injury [17], sleep disorders [18] and cancer [19]. Moreover, the FSS is the most frequently used fatigue measure in MDD patients (and especially, to assess the fatigue-alleviating effects of adjunctive modafinil in depressed patients) [16,[20][21][22][23][24][25] although it has not been validated in this population [9].…”

Section: Introductionmentioning

confidence: 99%

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Psychometric evaluation of the Fatigue Severity Scale in patients with major depression

et al. 2010

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Objectives: To investigate (1) the diagnostic value of the Signs of Depression Scale (SODS) in a Likert scale format and (2) whether the Likert scale improves the diagnostic value compared with the original dichotomous scale. Design: Cross-sectional multicentre study. Setting: One general and one university hospital in the Netherlands. Subjects: A total of 116 consecutive hospitalized stroke patients, of whom 53 were patients with communicative impairment. Main measures: Depression was diagnosed with the Composite International Diagnostic Interview (CIDI) administered to the patients' relatives. The Barthel Index (BI) was used as an external validator. Results: The correlation between the CIDI and the SODS-Likert or the SODS was small (r b = 0.18), and the correlation between the Barthel Index and the SODS-Likert (r s = −0.30) or the SODS (r s = −0.33) was moderate. For both instruments, the discriminatory power for diagnosing depression when compared with the CIDI was best at a cutoff score of ⩾2. The internal consistency of the SODS-Likert was acceptable (α = 0.69) and slightly higher than that of the SODS (α = 0.57). The inter-rater reliability of the SODS-Likert and the SODS was acceptable (intraclass correlation coefficient (ICC) 0.66 and ICC 0.80, respectively). The clinical utility was rated good. Conclusion: The diagnostic value of the SODS did not improve using a Likert scale format. However, the diagnostic value of the original dichotomous SODS is reasonable for the initial mood assessment of stroke patients with communicative impairment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychometric evaluation of the Fatigue Severity Scale in patients with major depression

et al. 2010

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“…The successful use of modafinil and methylphenidate to treat sedation caused by psychotropic drugs has been noted in case reports and uncontrolled studies in relation to sodium valproate (Berigan 2004), antipsychotics, including clozapine (Miller 1996), and selective serotonin reuptake inhibitors (Schwartz 2004). The possibility of adverse effects must be considered whenever using psychostimulants in people with psychotic disorders, with case reports noting the exacerbation of psychotic symptoms with modafinil (Narendran 2002) and movement disorder symptoms with methylphenidate (Miller 1996).…”

Section: Other Areas Of Psychiatrymentioning

confidence: 99%

Beyond ADHD and narcolepsy: psychostimulants in general psychiatry

Ng¹,

O'Brien²

2009

Adv. psychiatr. treat

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SummaryPsychostimulants (dexamphetamine, methylphenidate, modafinil) reduce fatigue, promote alertness and wakefulness, and have possible mood-enhancing properties. In modern psychiatric practice, their use has been limited to attention-deficit hyperactivity disorder and sleep disorders such as narcolepsy. Despite this, research has continued into psychostimulant use in general psychiatry, especially in the treatment of depression and fatigue. This article reviews the recent literature regarding psychostimulant use in general and consultation-liaison psychiatry. Although psychostimulants continue to attract clinical research, there is currently not enough evidence to recommend their routine use for general psychiatric conditions.

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“…A total of 694 patients suffering from major depression (n = 681) or dysthymia (n = 13) were included. Of these studies, 6 were trials concerning the efficacy of modafinil as an adjunctive treatment in major depression [6,[8][9][10][11][12] . The fatigue instruments used were: Fatigue Severity Scale (FSS) in 7 studies [4-6, 8-10, 12] , Brief Fatigue Inventory (BFI) in 2 [7,12] , Fatigue Questionnaire (FQ) in 1 [3] , Fatigue Assessment Instrument (FAI) in 1 [13] and Fatigue Scale Inventory (FSI) in 1 study [11] .…”

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confidence: 99%