Trial reportDrug and alcohol dependence2016
Modafinil and sleep architecture in an inpatient-outpatient treatment study of cocaine dependence.
Trial report in Drug and alcohol dependence, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Efficacy and safety of pharmacological interventions for the treatment of cocaine use disorder: A systematic review and network meta-analysis.Addiction (Abingdon, England) · 2026Pooled it
- The wake of addiction: Pharmacological strategies for sleep disturbances in stimulant use disorders, a systematic review.Drug and alcohol dependence · 2026Pooled it
- Objective and subjective measurement of sleep in people who use substances: Emerging evidence and recommendations from a systematic review.Journal of sleep research · 2025Pooled it
- Prescription psychostimulants for the treatment of stimulant use disorder: a systematic review and meta-analysis.Psychopharmacology · 2020Pooled it
- The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.Journal of addiction medicineGuideline
- Substance use outcomes in cocaine-dependent tobacco smokers: A mediation analysis exploring the role of sleep disturbance, craving, anxiety, and depression.Journal of substance abuse treatment · 2019Trial
- Trial
- Sleep regulates drug seeking and relapse - a perspective.Molecular psychiatry · 2026Review
- The use ofFrontiers in cell and developmental biology · 2026Review
- Sleep alterations in substance use disorders: a systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Novel Ways of Targeting the Dopamine Transporter.Advances in neurobiology · 2025Review
- Modafinil, an atypical CNS stimulant?Advances in pharmacology (San Diego, Calif.) · 2024Article
- Sleep-mediated regulation of reward circuits: implications in substance use disorders.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Review
- Rapid Eye Movement Sleep Engages Melanin-Concentrating Hormone Neurons to Reduce Cocaine Seeking.Biological psychiatry · 2022Article
- Modafinil Does Not Reduce Cocaine Use in Methadone-Maintained Individuals.Drug and alcohol dependence reports · 2022Article
- Helpful or Harmful? The Therapeutic Potential of Medications with Varying Degrees of Abuse Liability in the Treatment of Substance Use Disorders.Current addiction reports · 2022Review
- Temporal instability in brain activation: a novel paradigm for evaluating the maintenance of attention among substance dependent patients.Psychopharmacology · 2021Article
- At the intersection of sleep deficiency and opioid use: mechanisms and therapeutic opportunities.Translational research : the journal of laboratory and clinical medicine · 2021Review
- Interaction between cocaine use and sleep behavior: A comprehensive review of cocaine's disrupting influence on sleep behavior and sleep disruptions influence on reward seeking.Pharmacology, biochemistry, and behavior · 2021Review
- Modafinil reduces smoked cocaine self-administration in humans: effects vary as a function of cocaine 'priming' and cost.Drug and alcohol dependence · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine whether the increase in slow-wave sleep associated with modafinil treatment in chronic cocaine users mediates improved clinical outcomes.
method57 cocaine dependent participants were randomized to receive modafinil 400mg or placebo daily during a period of inpatient treatment followed by six weeks of outpatient treatment. Participants underwent polysomnographic sleep recording during inpatient treatment prior to and after starting modafinil. Outpatient treatment consisted of weekly cognitive behavioral therapy. Contingency management was used to promote participation in treatment and research demands, including thrice weekly visits during the outpatient phase for urine toxicology screens and other assessments. The primary clinical outcome was the percent of urine toxicology screens that were negative for cocaine.
resultsModafinil treatment was associated with a higher mean percentage (52% vs. 26%) of cocaine-free urine screens (p=0.02) and an increase in N3 sleep time (p=0.002). The change in N3 sleep time mediated the higher rate of cocaine-free urine screens. Modafinil treatment was also associated with more consecutive days abstinent during outpatient treatment, greater survival of abstinence, higher daily rates of abstinence, and less sleep degradation typically associated with abstinence from chronic cocaine use.
conclusionsMorning-dosed modafinil improves slow-wave sleep in abstinent cocaine users in the inpatient setting, and this effect is a statistical mediator of improved clinical outcomes associated with continued modafinil treatment. The high rates of abstinence achieved in this trial suggest that promoting healthy sleep physiology in an inpatient setting may be important in the effective treatment of cocaine dependence.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.