Armodafinil in the treatment of excessive sleepiness.

IMPORTANCE OF THE FIELD: Excessive sleepiness causes impaired quality of life and increases the risk of poor health and accidents. Armodafinil is a wake-promoting agent approved in 2007 by the US Food and Drug Administration for the treatment of excessive sleepiness arising from narcolepsy, obstructive sleep apnea (OSA; even after optimal treatment for the underlying obstruction) and shift-work disorder (SWD). It is the R-enantiomer of modafinil, which is a racemic mixture of R- and S-enantiomers.

AREAS COVERED IN THIS REVIEW: This review summarizes the recent primary data on the pharmacokinetics, clinical efficacy and safety of armodafinil using literature published since 2005 that was identified from PubMed.

WHAT THE READER WILL GAIN: The review describes recent advances in the understanding of the pharmacokinetic profile of the drug and why this may improve wakefulness later after dosing compared with modafinil. It also describes the recent efficacy and safety data supporting the use of armodafinil to treat excessive sleepiness in indicated patients.

TAKE HOME MESSAGE: Armodafinil is a useful therapy for the treatment of excessive sleepiness arising from a number of clinical conditions. It is generally well tolerated and has a low potential for abuse or tolerance.