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Link to original content: http://www.ncbi.nlm.nih.gov/pubmed/25222185
Hemodynamic profiles and tolerability of modafinil in the treatment of postural tachycardia syndrome: a randomized, placebo-controlled trial - PubMed Skip to main page content
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Randomized Controlled Trial
. 2014 Dec;34(6):738-41.
doi: 10.1097/JCP.0000000000000221.

Hemodynamic profiles and tolerability of modafinil in the treatment of postural tachycardia syndrome: a randomized, placebo-controlled trial

John Kpaeyeh Jr  1 , Philip L Mar, Vidya Raj, Bonnie K Black, Amy C Arnold, Italo Biaggioni, Cyndya A Shibao, Sachin Y Paranjape, William D Dupont, David Robertson, Satish R Raj
Affiliations
Randomized Controlled Trial

Hemodynamic profiles and tolerability of modafinil in the treatment of postural tachycardia syndrome: a randomized, placebo-controlled trial

John Kpaeyeh Jr et al. J Clin Psychopharmacol. 2014 Dec.

Abstract

Background: Postural tachycardia syndrome (POTS) is characterized clinically not only by an exaggerated increase in heart rate (HR), but an associated cognitive impairment that disables many patients. Modafinil might be effective in improving the cognitive symptoms, but modafinil may stimulate the sympathetic nervous system and worsen tachycardia in POTS. We tested the hypothesis that modafinil would worsen tachycardia and orthostatic symptoms in POTS.

Methods: Patients with POTS (n = 54) underwent a randomized crossover trial with modafinil 100 mg versus placebo. Heart rate and systolic blood pressure (SBP) were measured seated and standing before modafinil or placebo administration and then hourly for 4 hours.

Results: Over 4 hours, standing HR was not significantly different between the modafinil and placebo groups (analysis of variance [ANOVA] Pdrug = 0.328), but seated SBP was significantly higher in the modafinil group (mean [SD], 109 [12] mm Hg vs 104 [10] mm Hg; P = 0.004). Modafinil also significantly increased both the seated SBP (ANOVA Pdrug = 0.004) and the standing SBP (ANOVA Pdrug = 0.041) over time. There was no significant difference between modafinil and placebo over the 4-hour period with regard to POTS symptom burden scores (14 [12] vs 14 [12]; P = 0.962).

Conclusions: Modafinil did not significantly worsen standing HR or acute orthostatic symptoms in patients with POTS compared with the placebo group and improved upright blood pressure. Therefore, modafinil could be tested as a potential treatment for the cognitive impairment in POTS.

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Figures

Figure 1
Figure 1. Measured effects of modafinil and placebo on patients with POTS over time
Modafinil used resulted in no change in the standing heart rate (HR; Panel 1A), seated HR (Panel 1B) or orthostatic tachycardia (Panel 1C) over time. In contrast, modafinil increased standing systolic blood pressure (SBP; Panel 1D), seated SBP (Panel 1E), but not the orthostatic increase in SBP (Panel 1F). *P<0.05 was considered significant.
See this image and copyright information in PMC

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References

    1. Low PA, Sandroni P, Joyner M, et al. Postural tachycardia syndrome (POTS) J Cardiovasc Electrophysiol. 2009;20:352–358. - PMC - PubMed
    1. Raj V, Haman KL, Raj SR, et al. Psychiatric profile and attention deficits in postural tachycardia syndrome. J Neurol Neurosurg Psychiatry. 2009;80:339–344. - PMC - PubMed
    1. Taneja I, Haman K, Shelton RC, et al. A randomized, double-blind, crossover trial of modafinil on mood. J Clin Psychopharmacol. 2007;27:76–79. - PubMed
    1. Turner DC, Robbins TW, Clark L, et al. Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology (Berl) 2003;165:260–269. - PubMed
    1. Taneja I, Diedrich A, Black BK, et al. Modafinil elicits sympathomedullary activation. Hypertension. 2005;45:612–618. - PubMed

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