Comparison of the effectiveness  of modafinil and methylphenidate  in treatment of excessive daytime sleepiness in patients with  Parkinson’s disease

Ahmad Chitsaz; Mohammad Reza Najafi; Farzaneh Habibi; Sajad Amirhajloo

doi:10.18502/cjn.v23i1.16431

Ahmad Chitsaz Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Mohammad Reza Najafi Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Farzaneh Habibi Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Sajad Amirhajloo Department of Statistics, Isfahan University of Technology, Isfahan, Iran

DOI: https://doi.org/10.18502/cjn.v23i1.16431

Keywords: Parkinson Disease; Excessive Daytime Sleepiness; Sleep Quality; Modafinil; Methylphenidate

Abstract

Background: A large percentage of patients with Parkinson's disease (PD) suffer from excessive daytime sleepiness (EDS). This study aims to compare the effectiveness of modafinil and methylphenidate on EDS and side effects.

Methods: Fifty nine patients with PD and EDS [Epworth Sleepiness Scale (ESS) more than 9] were recruited in a double-blind placebo controlled trial. Twenty-two patients received modafinil 200 mg daily, twenty-six patients received methylphenidate 10 mg daily, and 11 patients received placebo for 6 weeks. Pittsburgh Sleep Quality Index (PSQI) and ESS were filled out at baseline and 6 weeks later.

Results: There was no significant difference in demographics, PSQI, and ESS variables at baseline. The mean of ESS scores decreased significantly in modafinil (17.36 ± 5.05 vs. 10.55 ± 4.62, P < 0.001) and methylphenidate (16.27 ± 5.40 vs. 12.23 ± 6.28, P < 0.001) groups after 6-week trial, compared with control group (14.27 ± 4.49 vs. 14.09 ± 4.46, P = 0.710). The effectiveness of modafinil and methylphenidate on improving daytime sleepiness and night sleep of patients was not significantly different.

Conclusion: Both modafinil and methylphenidate were effective drugs in improving EDS and quality of sleep without significant difference in efficiency and side effects.