The effect of armodafinil on drowsiness level in patients with high BMI

Victoria Tkachenko, Taisia Bagro

Keywords: drowsiness, daytime sleepiness, Epworth scale, treatment, obesity and overweight

A significant number of patients with overweight report the drowsiness during the day, which caused by metabolic disorders, hypoxia and complicates the treatment process. The drowsiness and daytime sleepiness can be assessed by Epworth Sleepiness Scale (1990), that has proven to be a very convenient and effective tool. American Academy of Sleep Medicine recommend to treat the excessive daytime sleepiness with armodafinil (K Maski, LM Trotti, S Kotagal, et al 2021).

Research questions:
Does the armodafinil have positive effect on drowsiness in complex treatment of obese and overweight patients?

75 people (25-55 age) with BMI>25 kg/m2 with drowsiness were studied. The level of drowsiness was determined by Epworth scale. Patients were divided into two groups: 1st group - 37 people with traditional treatment of obesity, and 2nd group - 38 people with addition of armodafinil 150 mg/day. The follow up was 6 months with control of Epworth scale changes and other indexes (baseline, 1 month, 3 months, 6 months). Statistical data processing was performed by Statistica 12, Excel 2010.

The groups didn't differ at baseline in levels of drowsiness by Epworth scale (I=7.97±0.65; II=9.18±0.95), p=0.202. However, 2nd group was identified as having excessive daytime sleepiness, so armodafinil was prescribed. The 6 months of follow up showed no significant drowsiness’ changes in 1st group (p=0.137), but significant reduction was observed in 2nd group in 3 months (p=0.04) and 6 months (p = 4.79E-6), the difference between groups in 6 months was significant (p=0,03). The reduction of BMI was in both groups.

The use of armodafinil at dose of 150 mg/day allows to achieve a significant reduction in drowsiness and is effective in complex treatment of overweight patients.

Points for discussion:
Does the armodafinil have positive effect on drowsiness in patients with other concomitant conditions?

Is the armodafinil included in national guidelines?

Does the armodafinil have other known positive/nagative effects?