Modafinil/armodafinil in the treatment of narcolepsy

Modafinil has been available in the USA since 1998 and is now regarded as the first-line therapy for the treatment of excessive sleepiness associated with narcolepsy. Modafinil does not help cataplexy or other ancillary features of narcolepsy, such as hypnagogic hallucinations or sleep paralysis. In 2004, the indication for modafinil was expanded to include the treatment of excessive sleepiness associated with obstructive sleep apnea/hypopnea syndrome (OSAHS) and shift-work sleep disorder (SWSD). Since that time modafinil has become the most widely prescribed agent in the U.S. for excessive sleepiness of all types. In 2007, armodafinil, the r-enantiomer of modafinil (racemic), was approved for the treatment of excessive sleepiness associated with narcolepsy, obstructive sleep apnea/hypopnea syndrome (OSAHS) and shift-work sleep disorder (SWSD). However, armodafinil is not yet available in pharmacies for use.