ARMODAFINIL
The R-enantiomer of modafinil; a long-acting wakefulness-promoting agent prescribed for narcolepsy, sleep apnea, and shift work disorder.
Four large double-blind multinational trials (n > 195 each, 12 weeks) demonstrated that once-daily armodafinil (150 or 250 mg) significantly improved wakefulness in narcolepsy, obstructive sleep apnea, and shift work sleep disorder compared to placebo. A meta-analysis in res-OSA found improvements in subjective and objective sleepiness but noted tripled adverse events and doubled withdrawals due to adverse events. A systematic review and meta-analysis in post-TBI excessive daytime sleepiness showed modest ESS improvement but significantly increased insomnia risk. Evidence for ADHD treatment in adults is scarce but suggests potential benefit in wakefulness, memory, and executive function. Armodafinil is classified as Schedule IV with low abuse potential.