Divalproex is recognized as a first-line agent in the treatment of bipolar disorders (BDs) (1). However, sedation can be an unwelcome side effect of divalproex sodium treatment (2), and unwanted side effects can lead to patient noncompliance (3). Ultimately, noncompliance can contribute to hospitalizations (4). I present 2 cases in which patients treated with divalproex sodium for BD experience...

Modafinil is a stimulant compound with an unknown mechanism of action that has been used successfully to control excessive daytime sleepiness in narcoleptic patients in Europe (1,2). The compound also has a minimal effect on cataplexy and other accessory symptoms of the narcolepsy tetrad (1,2). It is well tolerated and is generally preferred to amphetamine and related compounds in the countries...

Brain histaminergic neurons play a prominent role in arousal and maintenance of wakefulness (W). H(3)-receptors control the activity of histaminergic neurons through presynaptic autoinhibition. The role of H(3)-receptor antagonists/inverse agonists (H(3)R-antagonists) in the potential therapy of vigilance deficiency and sleep-wake disorders were studied by assessing their effects on the mouse c...

Lisdexamfetamine dimesylate, which consists of L-lysine covalently bound to D-amfetamine, is the first prodrug for treating ADHD. Its metabolic conversion to yield D-amfetamine by rate-limited, enzymatic hydrolysis is unusual because it is performed by peptidases associated with red blood cells. Other stimulants shown to be effective in managing ADHD include D-amfetamine, methylphenidate and mo...

OBJECTIVE This study examined the effects of modafinil on apathetic symptomatology, performance of activities of daily living (ADLs), and caregiver burden in individuals with Alzheimer's disease (AD). METHOD 23 participants with a diagnosis of mild-to-moderate probable AD according to National Institute of Neurologic and Communicative Disorder and Stroke-Alzheimer's Disease and Related Disord...

OBJECTIVES To investigate the effect of modafinil 200 mg on the performance of a cohort of healthy male doctors after 1 night of supervised sleep deprivation. SUMMARY BACKGROUND DATA Sleep-deprived and fatigued doctors pose a safety risk to themselves and their patients. Yet, because of the around-the-clock nature of medical practice, doctors frequently care for patients after periods of exte...

The first organocatalyzed sulfoxidation reaction towards enantioenriched (R)-modafinil (Armodafinil®), a drug against narcolepsy, is reported here. A series of chiral organocatalysts, e.g., different chiral BINOL-phosphates, or a fructose-derived N-substituted oxazolidinone ketone (Shi catalyst) were applied for the sulfoxidation reaction with environmentally friendly H2O2 as a convenient oxyge...