Wake-promoting pharmacotherapy for psychiatric disorders

Bernardo Dell'Osso, Cristina Dobrea, Laura Cremaschi, Chiara Arici, A. Carlo Altamura

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Medications promoting wakefulness are currently used in psychopharmacology in different contexts and with different objectives. In particular, they may be used for the treatment of syndromes that primarily show significant impairment in alertness/wakefulness (e.g., excessive sleepiness and other sleep disorders) as well as for the symptomatic treatment of different neuropsychiatric disorders that, in turn, are not exclusively characterized by sleep-wake disturbances (like mood disorders, for instance). In addition, several psychotropic compounds, including some antipsychotics, mood stabilizers, antidepressants, and anxiolytics have well-established sedating side effects that may go beyond the therapeutic target and require the symptomatic use of wake-promoting agents. Even though such a clinical scenario reflects millions of individuals affected (alterations of wakefulness have a prevalence rate of 20-43% in the general population), relatively few pharmacotherapies are available, mainly including compounds with psychostimulating effects, such as methylphenidate, modafinil, and armodafinil and some amphetaminic agents. In light of their side effects and potential for abuse, such compounds have received FDA approval only for a limited number of psychiatric disorders. Nonetheless, their clinical application has recently become more widespread, including attention deficit hyperactivity disorder, narcolepsy, treatment-resistant depression, bipolar disorder, shift work sleep disorder, schizophrenia, and addictions. Wake-promoting agents have different mechanisms of action, peculiar clinical strengths and specific limitations, with novel drugs in the field under extensive investigation. The present review is aimed to provide an updated overview of the aforementioned compounds as well as investigational drugs in the field, in terms of mechanism of action, indications and use in clinical practice.

Original languageEnglish
Pages (from-to)524
Number of pages1
JournalCurrent Psychiatry Reports
Volume16
Issue number12
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Wakefulness-Promoting Agents
Wakefulness
Psychiatry
Drug Therapy
Circadian Rhythm Sleep Disorders
Investigational Drugs
Treatment-Resistant Depressive Disorder
Narcolepsy
Psychopharmacology
Methylphenidate
Anti-Anxiety Agents
Attention Deficit Disorder with Hyperactivity
Mood Disorders
Bipolar Disorder
Antidepressive Agents
Antipsychotic Agents
Schizophrenia
Sleep
Therapeutics
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wake-promoting pharmacotherapy for psychiatric disorders. / Dell'Osso, Bernardo; Dobrea, Cristina; Cremaschi, Laura; Arici, Chiara; Altamura, A. Carlo.

In: Current Psychiatry Reports, Vol. 16, No. 12, 01.12.2014, p. 524.

Research output: Contribution to journalArticle

Dell'Osso, Bernardo ; Dobrea, Cristina ; Cremaschi, Laura ; Arici, Chiara ; Altamura, A. Carlo. / Wake-promoting pharmacotherapy for psychiatric disorders. In: Current Psychiatry Reports. 2014 ; Vol. 16, No. 12. pp. 524.
@article{101af7c443c640129e0fa3c2ebd81628,
title = "Wake-promoting pharmacotherapy for psychiatric disorders",
abstract = "Medications promoting wakefulness are currently used in psychopharmacology in different contexts and with different objectives. In particular, they may be used for the treatment of syndromes that primarily show significant impairment in alertness/wakefulness (e.g., excessive sleepiness and other sleep disorders) as well as for the symptomatic treatment of different neuropsychiatric disorders that, in turn, are not exclusively characterized by sleep-wake disturbances (like mood disorders, for instance). In addition, several psychotropic compounds, including some antipsychotics, mood stabilizers, antidepressants, and anxiolytics have well-established sedating side effects that may go beyond the therapeutic target and require the symptomatic use of wake-promoting agents. Even though such a clinical scenario reflects millions of individuals affected (alterations of wakefulness have a prevalence rate of 20-43{\%} in the general population), relatively few pharmacotherapies are available, mainly including compounds with psychostimulating effects, such as methylphenidate, modafinil, and armodafinil and some amphetaminic agents. In light of their side effects and potential for abuse, such compounds have received FDA approval only for a limited number of psychiatric disorders. Nonetheless, their clinical application has recently become more widespread, including attention deficit hyperactivity disorder, narcolepsy, treatment-resistant depression, bipolar disorder, shift work sleep disorder, schizophrenia, and addictions. Wake-promoting agents have different mechanisms of action, peculiar clinical strengths and specific limitations, with novel drugs in the field under extensive investigation. The present review is aimed to provide an updated overview of the aforementioned compounds as well as investigational drugs in the field, in terms of mechanism of action, indications and use in clinical practice.",
author = "Bernardo Dell'Osso and Cristina Dobrea and Laura Cremaschi and Chiara Arici and Altamura, {A. Carlo}",
year = "2014",
month = "12",
day = "1",
doi = "10.1007/s11920-014-0524-2",
language = "English",
volume = "16",
pages = "524",
journal = "Current Psychiatry Reports",
issn = "1523-3812",
publisher = "Current Science, Inc.",
number = "12",

}

TY - JOUR

T1 - Wake-promoting pharmacotherapy for psychiatric disorders

AU - Dell'Osso, Bernardo

AU - Dobrea, Cristina

AU - Cremaschi, Laura

AU - Arici, Chiara

AU - Altamura, A. Carlo

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Medications promoting wakefulness are currently used in psychopharmacology in different contexts and with different objectives. In particular, they may be used for the treatment of syndromes that primarily show significant impairment in alertness/wakefulness (e.g., excessive sleepiness and other sleep disorders) as well as for the symptomatic treatment of different neuropsychiatric disorders that, in turn, are not exclusively characterized by sleep-wake disturbances (like mood disorders, for instance). In addition, several psychotropic compounds, including some antipsychotics, mood stabilizers, antidepressants, and anxiolytics have well-established sedating side effects that may go beyond the therapeutic target and require the symptomatic use of wake-promoting agents. Even though such a clinical scenario reflects millions of individuals affected (alterations of wakefulness have a prevalence rate of 20-43% in the general population), relatively few pharmacotherapies are available, mainly including compounds with psychostimulating effects, such as methylphenidate, modafinil, and armodafinil and some amphetaminic agents. In light of their side effects and potential for abuse, such compounds have received FDA approval only for a limited number of psychiatric disorders. Nonetheless, their clinical application has recently become more widespread, including attention deficit hyperactivity disorder, narcolepsy, treatment-resistant depression, bipolar disorder, shift work sleep disorder, schizophrenia, and addictions. Wake-promoting agents have different mechanisms of action, peculiar clinical strengths and specific limitations, with novel drugs in the field under extensive investigation. The present review is aimed to provide an updated overview of the aforementioned compounds as well as investigational drugs in the field, in terms of mechanism of action, indications and use in clinical practice.

AB - Medications promoting wakefulness are currently used in psychopharmacology in different contexts and with different objectives. In particular, they may be used for the treatment of syndromes that primarily show significant impairment in alertness/wakefulness (e.g., excessive sleepiness and other sleep disorders) as well as for the symptomatic treatment of different neuropsychiatric disorders that, in turn, are not exclusively characterized by sleep-wake disturbances (like mood disorders, for instance). In addition, several psychotropic compounds, including some antipsychotics, mood stabilizers, antidepressants, and anxiolytics have well-established sedating side effects that may go beyond the therapeutic target and require the symptomatic use of wake-promoting agents. Even though such a clinical scenario reflects millions of individuals affected (alterations of wakefulness have a prevalence rate of 20-43% in the general population), relatively few pharmacotherapies are available, mainly including compounds with psychostimulating effects, such as methylphenidate, modafinil, and armodafinil and some amphetaminic agents. In light of their side effects and potential for abuse, such compounds have received FDA approval only for a limited number of psychiatric disorders. Nonetheless, their clinical application has recently become more widespread, including attention deficit hyperactivity disorder, narcolepsy, treatment-resistant depression, bipolar disorder, shift work sleep disorder, schizophrenia, and addictions. Wake-promoting agents have different mechanisms of action, peculiar clinical strengths and specific limitations, with novel drugs in the field under extensive investigation. The present review is aimed to provide an updated overview of the aforementioned compounds as well as investigational drugs in the field, in terms of mechanism of action, indications and use in clinical practice.

UR - http://www.scopus.com/inward/record.url?scp=84931082431&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84931082431&partnerID=8YFLogxK

U2 - 10.1007/s11920-014-0524-2

DO - 10.1007/s11920-014-0524-2

M3 - Article

C2 - 25312027

AN - SCOPUS:84912573243

VL - 16

SP - 524

JO - Current Psychiatry Reports

JF - Current Psychiatry Reports

SN - 1523-3812

IS - 12

ER -