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Impact of Armodafinil on Cognition in Multiple Sclerosis: A Randomized, Double-blind Crossover Pilot Study

Bruce, Jared PhD*; Hancock, Laura MA*,†; Roberg, Brandon MS*; Brown, Amberly BS; Henkelman, Erik BS; Lynch, Sharon MD

Cognitive and Behavioral Neurology: September 2012 - Volume 25 - Issue 3 - p 107–114
doi: 10.1097/WNN.0b013e31826df7fd
Original Studies

Objective: Examine the efficacy of armodafinil in improving cognition in patients with multiple sclerosis (MS).

Background: Many patients with MS experience cognitive difficulties. Armodafinil has shown promise as a cognitive enhancer in other patient populations. No studies have examined whether armodafinil improves cognition in patients with MS.

Methods: We conducted a double-blind, placebo-controlled, crossover study testing the efficacy of armodafinil in reducing cognitive problems in patients with MS. We randomized 17 patients to receive a dose of lactose placebo about 2 hours before they underwent a neuropsychological testing session. After a week-long washout period, we gave them a single 250-mg dose of armodafinil about 2 hours before testing them a second time. We randomized another 16 patients to receive the active drug first, then the placebo. We excluded 3 of the participants before analyzing the data.

Results: After correcting for multiple comparisons of the 8 neuropsychological dependent measures, we found that the patients had significantly improved delayed memory on a list-learning task after they took armodafinil (P=0.0005), but no improvement on measures of executive function, visual memory, processing speed, or self-reported fatigue.

Conclusions: Results provide preliminary evidence that armodafinil may improve delayed verbal recall in patients with MS. A larger trial showing enhanced memory among patients taking long-term armodafinil could serve as a foundation for its possible clinical use as a memory enhancer in patients with MS.

*Department of Psychology, University of Missouri-Kansas City, Kansas City, MO

Department of Neurology, University of Kansas Medical Center, Kansas City, KS

Supported in part by an investigator-initiated research grant from Cephalon Inc. to J.B. (Cephalon is the manufacturer of armodafinil). S.L. has participated in multi-center trials with Teva Pharmaceuticals, which now owns the rights to armodafinil. The other authors have no conflicts of interest.

Reprints: Jared Bruce, PhD, Department of Psychology, University of Missouri-Kansas City, Cherry Hall Rm 324, 5030 Cherry Street, Kansas City, MO 64110 (e-mail:

Received January 7, 2012

Accepted March 29, 2012

© 2012 Lippincott Williams & Wilkins, Inc.