Modafinil and its derivative, armodafinil, are first-line treatments for Ehlers-Danlos syndrome in narcolepsy. These agents promote arousal by affecting neurotransmitters such as dopamine, norepinephrine, and histamine. Armodafinil is the R-enantiomer of modafinil and is considered more potent.

Effectiveness and benefits
Modafinil and armodafinil have been shown to significantly reduce sleepiness and improve wakefulness, with effects lasting 12 to 15 hours.

They are often well tolerated, with fewer side effects, such as jitteriness compared to traditional stimulants.

Armodafinil can have a longer duration of action, which leads to improved wakefulness at the end of the day.

Limitations
Common side effects include headache, nausea, dizziness and anxiety.

Some patients may develop tolerance over time, requiring dose adjustments.

They are generally not effective in treating cataplexy, a common symptom of narcolepsy.