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Modafinil and cognitive enhancement in schizophrenia and healthy volunteers: the effects of test battery in a randomised controlled trial

Published online by Cambridge University Press:  03 May 2017

J. Lees ,
P. G. Michalopoulou ,
S. W. Lewis ,
S. Preston ,
C. Bamford ,
T. Collier ,
A. Kalpakidou ,
T. Wykes ,
R. Emsley  and
G. Pandina
...Show all authors
J. Lees*
Affiliation:
Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
P. G. Michalopoulou
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, London, UK
S. W. Lewis
Affiliation:
Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
S. Preston
Affiliation:
Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
C. Bamford
Affiliation:
Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
T. Collier
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, London, UK
A. Kalpakidou
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, London, UK
T. Wykes
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, London, UK
R. Emsley
Affiliation:
Division of Population Health, Health Services Research & Primary Care, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
G. Pandina
Affiliation:
Janssen Research & Development, LLC, New Brunswick, New Jersey, USA
S. Kapur
Affiliation:
Institute of Psychiatry, Psychology and Neuroscience, King's Health Partners, London, UK
R. J. Drake
Affiliation:
Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
*
*Address for correspondence: J. Lees, Division of Psychology & Mental Health, IBBMH, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Jean McFarlane Building, Oxford Rd, Manchester, M13 9PL, UK. (Email: jane.lees@manchester.ac.uk)
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Abstract

Background

Cognitive deficits in schizophrenia have major functional impacts. Modafinil is a cognitive enhancer whose effect in healthy volunteers is well-described, but whose effects on the cognitive deficits of schizophrenia appear to be inconsistent. Two possible reasons for this are that cognitive test batteries vary in their sensitivity, or that the phase of illness may be important, with patients early in their illness responding better.

Methods

A double-blind, randomised, placebo-controlled single-dose crossover study of modafinil 200 mg examined this with two cognitive batteries [MATRICS Consensus Cognitive Battery (MCCB) and Cambridge Neuropsychological Test Automated Battery (CANTAB)] in 46 participants with under 3 years’ duration of DSM-IV schizophrenia, on stable antipsychotic medication. In parallel, the same design was used in 28 age-, sex-, and education-matched healthy volunteers. Uncorrected p values were calculated using mixed effects models.

Results

In patients, modafinil significantly improved CANTAB Paired Associate Learning, non-significantly improved efficiency and significantly slowed performance of the CANTAB Stockings of Cambridge spatial planning task. There was no significant effect on any MCCB domain. In healthy volunteers, modafinil significantly increased CANTAB Rapid Visual Processing, Intra-Extra Dimensional Set Shifting and verbal recall accuracy, and MCCB social cognition performance. The only significant differences between groups were in MCCB visual learning.

Conclusions

As in earlier chronic schizophrenia studies, modafinil failed to produce changes in cognition in early psychosis as measured by MCCB. CANTAB proved more sensitive to the effects of modafinil in participants with early schizophrenia and in healthy volunteers. This confirms the importance of selecting the appropriate test battery in treatment studies of cognition in schizophrenia.

Keywords

CANTABcognitionMATRICS MCCBmodafinilschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 13 , October 2017 , pp. 2358 - 2368
Copyright
Copyright © Cambridge University Press 2017 

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