A recent study, reported in the American Journal of Psychiatry, reported on an interesting potential treatment approach for bipolar disorder, utilizing modafinil as an add-on to other substances:
The study randomly assigned 85 patients with bipolar disorder and clinically significant depression despite ongoing treatment with mood stabilizers. Forty-four percent of the patients who were designated to receive modafinil add-on responded within the 6 weeks of the study, and only 23% of those receiving placebo add-on responded, a significant difference.
Previous studies have not found modafinil effective in unipolar depression. It is tempting to think that this may reflect a higher prevalence of psychomotor retardation in bipolar depression, which is therefore more responsive to modafinil. However, measures of fatigue and sleepiness did not differ after modafinil and placebo treatment in the study by Frye and associates.
The dense article makes clear that this is only one study that needs to be confirmed among larger populations, but it's still interesting; the list of potential benefits for modafinil continues to increase. Of course, the article's author also points out that modafinil is - currently, at least - an expensive treatment, which is a shame. Personally I want this stuff over the counter in gigantic bottles. However, I'm left surprised that "measures of fatigue and sleepiness did not differ" between modafinil and placebo, especially given that, even though this was a double blind study, all the doctors and patients knew that the medicine being studied had stimulant effects. Very curious...
