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Schizophrenia Bulletin Advance Access published online on July 18, 2007
Schizophrenia Bulletin, doi:10.1093/schbul/sbm090
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© The Author 2007. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

A Review of the Effects of Modafinil on Cognition in Schizophrenia

Sharon Morein-Zamir1,2,3, Danielle C. Turner3,4 and Barbara J. Sahakian2,3
2 Department of Psychiatry, University of Cambridge School of Clinical Medicine, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, U.K
3 Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Site, Cambridge CB2 3EB, U.K
4 Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, U.K

1 To whom correspondence should be addressed; tel: +44-1223-767035; fax: +44-1223-336968; e-mail: sm658{at}cam.ac.uk.

Modafinil, a wake-promoting agent believed to operate via the hypocretin/orexin system, has a similar clinical profile to that of conventional, dopaminergic stimulants but different biochemical and pharmacological properties. There is increasing interest in the use of modafinil to improve cognition in schizophrenia as well as in other disorders such as attention-deficit/hyperactivity disorder. Recent research has focused on enhancing cognition in patients with schizophrenia because of the association between cognitive performance and functional outcome. Initial findings indicate that modafinil may lead to better executive functioning and attentional performance in patients with schizophrenia. The results further suggest that patient characteristics such as overall current cognitive functioning levels, genetic polymorphisms, and medication status may be important mediators for the effectiveness of modafinil, allowing for future treatment to be targeted to those most likely to benefit. Currently, further research is required to address the potential benefits and risks of chronic administration of modafinil to patients with schizophrenia.

Keywords: attention / executive functions / methylphenidate / dopamine / hypocretin / orexin


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