ABSTRACT
Excessive daytime sleepiness (EDS) in narcolepsy is often irresistible and requires pharmacological treatments such as with amfetamine-like compounds (L-and D-amfetamine, methamfetamine, methyl - phenidate, and pemoline) and modafinil. Mazindol and some antidepressants have stimulant properties (e.g. bupropion), but are used much more infrequently. Caffeine consumption (including over-thecounter tablets) may also be used for milder cases or before the diagnosis. Although amfetamines and amfetamine-like compounds have been the most popular medications for EDS in narcolepsy over decades, modafinil has rapidly become the first-line treatment. Its safety and efficacy are well established, but its mechanism of action remains poorly understood. This chapter summarizes the neuropharmacology of modafinil, and outlines how research on this unique and clinically important drug has shed light on the basic neurobiology of sleep and wakefulness.
