Modafinil as an Adjunct Agent in the Treatment of Major Depressive Disorder: a Meta-Analysis

Persistent Link:
http://hdl.handle.net/10150/614260
Title:
Modafinil as an Adjunct Agent in the Treatment of Major Depressive Disorder: a Meta-Analysis
Author:
Gustin, Amber; Magsarili, Heather; Slack, Marion; Martin, Jennifer
Affiliation:
College of Pharmacy, The University of Arizona
Issue Date:
2013
Rights:
Copyright © is held by the author.
Collection Information:
This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
Publisher:
The University of Arizona.
Abstract:
Specific Aims: To assess the effectiveness of modafinil as an adjunct agent in the treatment of major depression and depression-related fatigue. Methods Seven databases were searched for articles that met predetermined inclusion criteria and reported sufficient data. Meta-analysis was employed to synthesize study findings, with standardized mean difference (SMD) being the primary summary measure. The I-squared statistic was used to evaluate heterogeneity among studies. Additionally, publication bias was assessed via funnel plots and Kendall’s tau.      Main Results: Ten studies (N = 848) were included in the Hamilton Depression Rating Scale (HAM-D) meta-analysis, composed of 5 RCTs and 5 pre-post studies. The pooled SMD was -0.67, a moderate effect indicating an improvement in depression scores. However, the overall SMD varied when stratified by study design; pre-post studies showed a large pooled effect (SMD = -1.54) that reached significance, whereas RCT's displayed a moderate effect (SMD = -0.41) that was not significant. Additonally, heterogeneity was substantial (I-squared = 91.54) among all studies, and publication bias was suggested by the funnel plot and Kendall's tau. Regarding modafinil and fatigue, the Epworth Sleepiness Scale (ESS) meta-analysis had a small but statistically signficant overall SMD (-0.23; p = 0.03), and the Fatigue Severity Scale (FSS) meta-analysis yielded an overall SMD which was not significant (p = 0.24). Similar to the HAM-D analysis, the overall SMD varied between study designs. Conclusion: The effect of modafinil on major depressive disorder is unclear, as the findings are largely variable and the impact of modafinil was stratified by study design.
Description:
Class of 2013 Abstract
Keywords:
Modafinil; treatment; disorder; meta-analysis
Advisor:
Slack, Marion; Martin, Jennifer

Full metadata record

DC FieldValue Language
dc.contributor.advisorSlack, Marionen
dc.contributor.advisorMartin, Jenniferen
dc.contributor.authorGustin, Amberen
dc.contributor.authorMagsarili, Heatheren
dc.contributor.authorSlack, Marionen
dc.contributor.authorMartin, Jenniferen
dc.date.accessioned2016-06-22T21:41:27Z-
dc.date.available2016-06-22T21:41:27Z-
dc.date.issued2013-
dc.identifier.urihttp://hdl.handle.net/10150/614260-
dc.descriptionClass of 2013 Abstracten
dc.description.abstractSpecific Aims: To assess the effectiveness of modafinil as an adjunct agent in the treatment of major depression and depression-related fatigue. Methods Seven databases were searched for articles that met predetermined inclusion criteria and reported sufficient data. Meta-analysis was employed to synthesize study findings, with standardized mean difference (SMD) being the primary summary measure. The I-squared statistic was used to evaluate heterogeneity among studies. Additionally, publication bias was assessed via funnel plots and Kendall’s tau.      Main Results: Ten studies (N = 848) were included in the Hamilton Depression Rating Scale (HAM-D) meta-analysis, composed of 5 RCTs and 5 pre-post studies. The pooled SMD was -0.67, a moderate effect indicating an improvement in depression scores. However, the overall SMD varied when stratified by study design; pre-post studies showed a large pooled effect (SMD = -1.54) that reached significance, whereas RCT's displayed a moderate effect (SMD = -0.41) that was not significant. Additonally, heterogeneity was substantial (I-squared = 91.54) among all studies, and publication bias was suggested by the funnel plot and Kendall's tau. Regarding modafinil and fatigue, the Epworth Sleepiness Scale (ESS) meta-analysis had a small but statistically signficant overall SMD (-0.23; p = 0.03), and the Fatigue Severity Scale (FSS) meta-analysis yielded an overall SMD which was not significant (p = 0.24). Similar to the HAM-D analysis, the overall SMD varied between study designs. Conclusion: The effect of modafinil on major depressive disorder is unclear, as the findings are largely variable and the impact of modafinil was stratified by study design.en
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author.en
dc.subjectModafinilen
dc.subjecttreatmenten
dc.subjectdisorderen
dc.subjectmeta-analysisen
dc.titleModafinil as an Adjunct Agent in the Treatment of Major Depressive Disorder: a Meta-Analysisen_US
dc.typetexten
dc.typeElectronic Reporten
dc.contributor.departmentCollege of Pharmacy, The University of Arizonaen
dc.description.collectioninformationThis item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.en
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