Modafinil for the treatment of cocaine dependence

Ann L. Anderson, Malcolm S. Reid, Shou Hua Li, Tyson Holmes, Lynn Shemanski, April Slee, Edwina V. Smith, Roberta Kahn, Nora Chiang, Frank Vocci, Domenic Ciraulo, Charles Dackis, John D. Roache, Ihsan M. Salloum, Eugene Somoza, Harold C. Urschel, Ahmed M. Elkashef

Research output: Contribution to journalArticlepeer-review

185 Scopus citations


Aim: Modafinil was tested for efficacy in facilitating abstinence in cocaine-dependent patients, compared to placebo. Methods: This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 4-week follow-up. Six outpatient substance abuse treatment clinics participated in the study. There were 210 treatment-seekers randomized, having a diagnosis of cocaine dependence; 72 participants were randomized to placebo, 69 to modafinil 200 mg, and 69 to modafinil 400 mg, taken once daily on awakening. Participants came to the clinic three times per week for assessments and urine drug screens, and had one hour of individual psychotherapy weekly. The primary outcome measure was the weekly percentage of cocaine non-use days. Results: The GEE regression analysis showed that for the total sample, there was no significant difference between either modafinil group and placebo in the change in average weekly percent of cocaine non-use days over the 12-week treatment period (p > 0.79). However, two secondary outcomes showed significant effects by modafinil 200 mg: the maximum number of consecutive non-use days for cocaine (p = 0.02), and a reduction in craving (p = 0.04). Also, a post hoc analysis showed a significant effect of modafinil that increased the weekly percentage of non-use days in the subgroup of those cocaine patients who did not have a history of alcohol dependence (p < 0.02). Conclusions: These data suggest that modafinil, in combination with individual behavioral therapy, was effective for increasing cocaine non-use days in participants without co-morbid alcohol dependence, and in reducing cocaine craving.

Original languageEnglish (US)
Pages (from-to)133-139
Number of pages7
JournalDrug and Alcohol Dependence
Issue number1-2
StatePublished - Sep 1 2009


  • Alcoholism
  • Cocaine-related disorders
  • Modafinil
  • Pharmacotherapy
  • Risk factors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Toxicology
  • Pharmacology


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