The effect of modafinil on fatigue, cognitive functioning, and mood in primary brain tumor patients: a multicenter randomized controlled trial
Fatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients with primary brain tumors (PBTs). To evaluate the effects of the psychostimulant modafinil on fatigue, depression, health-related quality of life (HRQ...
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Published in | Neuro-oncology (Charlottesville, Va.) Vol. 15; no. 10; pp. 1420 - 1428 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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England
Oxford University Press
01.10.2013
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Abstract | Fatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients with primary brain tumors (PBTs). To evaluate the effects of the psychostimulant modafinil on fatigue, depression, health-related quality of life (HRQOL), and cognitive functioning in PBT patients, we performed a multicenter, double-blind placebo-controlled crossover trial.
Patients randomly received either 6 weeks of treatment with modafinil (up to 400 mg/day) or 6 weeks with placebo. After a 1-week washout period, the opposite treatment was provided. Assessments took place at baseline and immediately after the first and second condition. Patients completed self-report questionnaires on fatigue (Checklist Individual Strength [CIS]), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), HRQOL (Short-Form Health Survey [SF-36]), and self-perceived cognitive functioning (Medical Outcomes Study [MOS]). They also underwent comprehensive neurocognitive testing.
In total, 37 patients participated. Relative to baseline, patients reported lower fatigue severity (CIS) and better motivation (CIS) in both the modafinil (P = .010 and P = .021, respectively) and the placebo condition (P < .001 and P = .027, respectively). The same held for physical health (SF-36 Physical Component Summary score; P = .001 and P = .008, respectively), working memory (P = .040 and P = .043), and information processing capacity (P = .036 and P = .040). No improvement in depressive symptoms was found in either condition.
Modafinil did not exceed the effects of placebo with respect to symptom management. Patient accrual was slow, and relatively many patients dropped out during the trial, due mostly to side effects. Other, preferably nonpharmacologic intervention studies should be considered to improve symptom management of PBT patients. |
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AbstractList | Fatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients with primary brain tumors (PBTs). To evaluate the effects of the psychostimulant modafinil on fatigue, depression, health-related quality of life (HRQOL), and cognitive functioning in PBT patients, we performed a multicenter, double-blind placebo-controlled crossover trial.
Patients randomly received either 6 weeks of treatment with modafinil (up to 400 mg/day) or 6 weeks with placebo. After a 1-week washout period, the opposite treatment was provided. Assessments took place at baseline and immediately after the first and second condition. Patients completed self-report questionnaires on fatigue (Checklist Individual Strength [CIS]), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), HRQOL (Short-Form Health Survey [SF-36]), and self-perceived cognitive functioning (Medical Outcomes Study [MOS]). They also underwent comprehensive neurocognitive testing.
In total, 37 patients participated. Relative to baseline, patients reported lower fatigue severity (CIS) and better motivation (CIS) in both the modafinil (P = .010 and P = .021, respectively) and the placebo condition (P < .001 and P = .027, respectively). The same held for physical health (SF-36 Physical Component Summary score; P = .001 and P = .008, respectively), working memory (P = .040 and P = .043), and information processing capacity (P = .036 and P = .040). No improvement in depressive symptoms was found in either condition.
Modafinil did not exceed the effects of placebo with respect to symptom management. Patient accrual was slow, and relatively many patients dropped out during the trial, due mostly to side effects. Other, preferably nonpharmacologic intervention studies should be considered to improve symptom management of PBT patients. BackgroundFatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients with primary brain tumors (PBTs). To evaluate the effects of the psychostimulant modafinil on fatigue, depression, health-related quality of life (HRQOL), and cognitive functioning in PBT patients, we performed a multicenter, double-blind placebo-controlled crossover trial.MethodsPatients randomly received either 6 weeks of treatment with modafinil (up to 400 mg/day) or 6 weeks with placebo. After a 1-week washout period, the opposite treatment was provided. Assessments took place at baseline and immediately after the first and second condition. Patients completed self-report questionnaires on fatigue (Checklist Individual Strength [CIS]), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), HRQOL (Short-Form Health Survey [SF-36]), and self-perceived cognitive functioning (Medical Outcomes Study [MOS]). They also underwent comprehensive neurocognitive testing.ResultsIn total, 37 patients participated. Relative to baseline, patients reported lower fatigue severity (CIS) and better motivation (CIS) in both the modafinil (P = .010 and P = .021, respectively) and the placebo condition (P < .001 and P = .027, respectively). The same held for physical health (SF-36 Physical Component Summary score; P = .001 and P = .008, respectively), working memory (P = .040 and P = .043), and information processing capacity (P = .036 and P = .040). No improvement in depressive symptoms was found in either condition.ConclusionsModafinil did not exceed the effects of placebo with respect to symptom management. Patient accrual was slow, and relatively many patients dropped out during the trial, due mostly to side effects. Other, preferably nonpharmacologic intervention studies should be considered to improve symptom management of PBT patients. |
Author | Taphoorn, Martin J B de Groot, Marjolein van Thuijl, Hinke F Heimans, Jan J Boele, Florien W Douw, Linda Reijneveld, Jaap C Cleijne, Wilmy Klein, Martin |
AuthorAffiliation | Department of Medical Psychology , VU University Medical Center , Amsterdam, the Netherlands (F.W.B., W.C., M.K.); Department of Neurology , VU University Medical Center , Amsterdam, the Netherlands (L.D., M.G., H.F.T., J.J.H., J.C.R.); Department of Neurology , Medical Center Haaglanden , The Hague , the Netherlands (M.J.B.T.) |
AuthorAffiliation_xml | – name: Department of Medical Psychology , VU University Medical Center , Amsterdam, the Netherlands (F.W.B., W.C., M.K.); Department of Neurology , VU University Medical Center , Amsterdam, the Netherlands (L.D., M.G., H.F.T., J.J.H., J.C.R.); Department of Neurology , Medical Center Haaglanden , The Hague , the Netherlands (M.J.B.T.) |
Author_xml | – sequence: 1 givenname: Florien W surname: Boele fullname: Boele, Florien W email: f.boele@vumc.nl organization: Corresponding Author: Florien W. Boele, MSc, Department of Medical Psychology, D-345, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. f.boele@vumc.nl – sequence: 2 givenname: Linda surname: Douw fullname: Douw, Linda – sequence: 3 givenname: Marjolein surname: de Groot fullname: de Groot, Marjolein – sequence: 4 givenname: Hinke F surname: van Thuijl fullname: van Thuijl, Hinke F – sequence: 5 givenname: Wilmy surname: Cleijne fullname: Cleijne, Wilmy – sequence: 6 givenname: Jan J surname: Heimans fullname: Heimans, Jan J – sequence: 7 givenname: Martin J B surname: Taphoorn fullname: Taphoorn, Martin J B – sequence: 8 givenname: Jaap C surname: Reijneveld fullname: Reijneveld, Jaap C – sequence: 9 givenname: Martin surname: Klein fullname: Klein, Martin |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23925452$$D View this record in MEDLINE/PubMed |
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Snippet | Fatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients with... BackgroundFatigue, cognitive deficits, and depression are frequently reported but often undertreated symptoms that can profoundly affect daily life in patients... |
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SubjectTerms | Adult Aged Aged, 80 and over Benzhydryl Compounds - adverse effects Brain Neoplasms - drug therapy Clinical Investigations Cognition Disorders - chemically induced Cross-Over Studies Double-Blind Method Fatigue - chemically induced Female Follow-Up Studies Glioma - drug therapy Humans Male Meningeal Neoplasms - drug therapy Middle Aged Mood Disorders - chemically induced Neoplasm Grading Prognosis Psychiatric Status Rating Scales Quality of Life Surveys and Questionnaires Wakefulness-Promoting Agents - adverse effects |
Title | The effect of modafinil on fatigue, cognitive functioning, and mood in primary brain tumor patients: a multicenter randomized controlled trial |
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