Summary
background Relapse in alcohol dependence affects more than 50% of all alcohol-dependent patients. Diminished impulse control may perhaps provoke these high relapse rates and may therefore be a mechanism that can be targeted for treatment.
aim To explain and discuss the findings of a clinical trial which assessed the effectiveness of modafinil, a cognitive enhancer, when used to treat relapse and increase impulse control in alcohol-dependent patients.
method A randomised double-blind placebo-controlled study was conducted in 83 alcohol-dependent patients who were treated during 10 weeks with modafinil (300 mg/day) or placebo.
results Treatment with modafinil reduced alcohol use, but only in patients with reduced baseline impulse control (neurocognitive measure: response inhibition). Modafinil did not reduce alcohol use in alcohol-dependent patients with optimum baseline impulse control.
conclusion Modafinil reduces relapse in alcohol-dependent patients with poor response inhibition. However, it is essential that relevant subtypes be identified if personalised treatment methods are to be developed.