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August 7, 2007

Sleep Disorder Medication Studied as Treatment for Bipolar Disorder

A new study conducted by the Mayo Clinic, and in the August issue of the American Journal of Psychiatry is looking at the possible success of a sleep disorder medication to treat bipolar disorder. This study is only preliminary with 85 participants, but they have already found that it might be successful in controlling the depressive symptoms of bipolar disorder.

Mark Frye, author of the study, states that this is groundbreaking because currently there aren't many options for treating the depressive symptoms associated with bipolar disorder.

"Mood stabilizers in general are better at treating mania than depression, but the depressive phase of the illness is far more common. We really need continued research in this area."

The study looked at Modafinil, commonly called the "wake-up pill", because it's used to treat chronic sleepiness or excessive sleepiness like narcolepsy. Researchers put this drug together with bipolar disorder because the depressive symptoms are similar to the disorders it treats; excessive sleepiness and fatigue. Modafinil has been prescribed "off label" for other disorders, including ADHD, MS, and is even said to be a "smart drug" or a cognitive enhancer.

"This is a placebo-controlled study with real world community impact," Dr. Frye says. Half of the patients in the study were given modafinil, 100-200 milligrams daily, and the other half were given a placebo over a six-week period."

"While the trial was small, the 44 percent response rate was greater than that of the placebo group. Forty-four percent said they felt better, while 39 percent said their symptoms were in remission after six weeks. This compares to 23 percent and 18 percent in the control group. Modafinil was not associated with any greater risk of the manic and depressive mood swings associated with bipolar disorder."

Although there was this 44% response rate of decreased depressive symptoms in the group given Modafinil, the researchers are not sure what affect the drug had to alleviate these symptoms. They do not know how it works, but only that it is showing promising preliminary results. However, they do believe it's entirely different than psycho stimulants.

Though these results are promising, and the drug is deemed safe for other uses, it will be a while before we see psychiatrists prescribing it for bipolar disorder. More research is needed.

Press Release:
Mayo Clinic in Rochester: "Wake-Up Pill" Under Study to Treat Patients with Bipolar Disorder: Preliminary study shows drug's potential in treating the depressive phase of bipolar disorder

Research Article:
A Placebo-Controlled Evaluation of Adjunctive Modafinil in the Treatment of Bipolar (2007). Am J Psychiatry 164:1242-1249.

Corresponding Editorial:
Modafinil Add-On in the Treatment of Bipolar Depression


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