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Modafinil, a centrally active α1-adrenergic agonist, was marketed in France as a psychostimulant for the treatment of narcolepsy and idiopathic hypersomnia including Gelineau's syndrome. In monkeys, modafinil was found to induce potent behavioral stimulation and awakening without stereotyped behavior. In narcoleptic patients, modafinil reduces the daily number of sleep attacks significantly and markedly improves performance. The mechanism of action for its locomotor effects was reported to be due to the stimulation of the central α1-adrenergic system, opposite to amphetamine and methylphenidate, which act mainly by dopaminergic mechanisms. Modafinil has been reported to exhibit minimal peripheral side effects at therapeutic doses and appears to have low abuse potential. The use of modafinil in the treatment of cerebral infarction and ischemia has been claimed.
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