The Journal of clinical psychiatry
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Randomized Controlled Trial Multicenter Study
A double-blind, placebo-controlled study of armodafinil for excessive sleepiness in patients with treated obstructive sleep apnea and comorbid depression.
Treatment of excessive sleepiness in the context of obstructive sleep apnea (OSA) may be particularly difficult in those with depression because depression and/or antidepressant medications may cause sleepiness and fatigue in addition to that due to the OSA. This study evaluating armodafinil, a nonamphetamine wakefulness-promoting medication, is the first trial for treatment of excessive sleepiness in patients with treated OSA and comorbid depression. ⋯ Armodafinil significantly improved overall clinical condition related to excessive sleepiness as rated by the CGI-C and was well tolerated in patients with treated OSA and comorbid depression.
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Misdiagnosis of bipolar disorder and inappropriate pharmacotherapeutic treatment is common. Clinicians should screen for manic/hypomanic symptoms during depressive episodes to differentiate bipolar depression from other depressive disorders. ⋯ Few pharmacologic treatments have evidence supporting both short- and long-term efficacy for bipolar depression. Clinicians must consider the existing evidence on the long-term efficacy of various pharmacologic and psychosocial interventions for preventing and treating bipolar mood episodes.