The effect of a combination of motivational counselling with armodafinil therapy in obese patients with shift work disorder in primary care

Background
Obesity is a complex medical problem which still needs options of pathogenetic treatment.

Objectives
To determine the effect of the complex therapy of patients with obesity and circadian rhythm sleep-wake disorders (shift work disorder) by armodafinil in addition to motivational counselling in primary care.

Material and methods
38 obese patients with shift work disorder were treated with armodafinil 150 mg daily and an motivational interview regarding healthy lifestyle. The examinations were at baseline after the 1st, 3th and 6th months and included: BMI, waist and hip circumference, body surface area, Waist-to-Hip Ratio, Conicity Index, A body shape index, Abdominal Volume Index, blood pressure, levels of serotonin, leptin, glucose, lipidogram, International Questionnaire on Physical Activity, FINDRISC, HADS, Beck&Hamilton Scale, Dutch Eating Behaviour Questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Questionnaire, and SF-36. Statistical analysis was carried out with SPSS Statistics, Statistica 12, Excel 2010.

Results
BMI at baseline of the study was 33.85 ± 0.5 kg/m2. The percentage of body weight showed a significant loss starting from the 3rd month ( < 0.0001). Impaired carbohydrate tolerance, dyslipidaemia, moderate risk of developing diabetes, low serotonin levels and physical activity improved their values over time. Patients had clinically pronounced depression and anxiety, disturbed eating behaviour, excessive daytime sleepiness, poor sleep quality and quality of life at baseline, which normalised by the 6th month.

Conclusions
The complex treatment of obese patients with shift work disorder by motivational counselling with a patient-oriented approach enhanced by armodafinil 150 mg daily allowed them to reduce body weight by 15% in 6 months, as well as reduce metabolic, eating, mental and sleep disorders and improve quality of life.