|LETTER TO EDITOR
|Year : 2016 | Volume
| Issue : 1 | Page : 86-87
Modafinil augmentation of atypical antipsychotic agents: Duplicate publication, self-plagiarism, salami publication, and other matters
Girish Banwari1, Sagar Karia2, Sankaran Avudaiappan3, Harish M Tharayil4, Chittaranjan Andrade5
1 Neuron Psychological Care Center, Abu Dhabi, United Arab Emirates
2 Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
3 Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
4 Department of Psychiatry, Government Medical College, Kozhikode, Kerala, India
5 Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
|Date of Web Publication||28-Jan-2016|
Neuron Psychological Care Center, P. O. Box 27304, Abu Dhabi
United Arab Emirates
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Banwari G, Karia S, Avudaiappan S, Tharayil HM, Andrade C. Modafinil augmentation of atypical antipsychotic agents: Duplicate publication, self-plagiarism, salami publication, and other matters. Indian J Psychol Med 2016;38:86-7
|How to cite this URL:|
Banwari G, Karia S, Avudaiappan S, Tharayil HM, Andrade C. Modafinil augmentation of atypical antipsychotic agents: Duplicate publication, self-plagiarism, salami publication, and other matters. Indian J Psychol Med [serial online] 2016 [cited 2019 Oct 24];38:86-7. Available from: http://www.ijpm.info/text.asp?2016/38/1/86/175141
Prasuna and Sudhakar  present a randomized controlled trial of modafinil (200 mg/day) augmentation of risperidone, olanzapine, and clozapine in patients (n = 72) with unspecified diagnoses. We were surprised that the paper contained no data at all and that only one reference was cited in the bibliography. A little further investigation revealed that the paper bears striking similarities to two earlier publications , in the same journal; in fact, the present paper  appears to have been extracted almost verbatim from the original publication  with all references to the metabolic effects of atypical antipsychotics, and the effect of modafinil on weight removed for the creation of the present paper.  There is also extensive verbatim content overlap among the three papers. ,, Finally, all three papers describe the same study with only minor changes in outcome measures. In other words, the publication of these three papers constitutes duplicate publication, self-plagiarism, and salami publication, all of which violate publication ethics. ,,
We use this opportunity to also address a pharmacological concern that the authors may have wished to consider. Modafinil induces the cytochrome P450 (CYP) 1A2 and CYP3A4 metabolic enzymes, and armodafinil induces CYP3A4. These two CYP enzymes are responsible for the metabolism of almost all the atypical antipsychotic drugs including the 3 drugs risperidone, olanzapine, and clozapine, which the patients received in the described study. ,, Physicians consequently need to be aware of the risk of relapse into psychosis as a delayed drug interaction between modafinil/armodafinil and atypical antipsychotics. , It would have helped had the authors included the assessment of efficacy among their outcome measures because attenuation of negative symptom burden and worsening of psychosis have both been examined in this regard. 
On a parting note: The papers ,, declare no support or conflict of interest, but their text refers to unblinding of medication by the sponsors. Perhaps, this was an oversight on the part of the authors. We realize that the authors of the papers ,, and the editors of the journal will view our letter with consternation and chagrin, and we hope that they will take our submission constructively. This letter was prepared as a group activity by E-Journal Club (eJCIndia),  an educational initiative for postgraduate students and academic faculty, launched by the Task Forces on Psychopharmacology and the Task Force on Workshops and Training, Indian Psychiatric Society, and the Department of Psychopharmacology, National Institute of Mental Health and Neurosciences, Bengaluru.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
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Sudhakar TP, Rao GP, Prasuna PL, Vijay Sagar KJ. Study of effects of modafinil add-on therapy on excessive day time drowsiness and weight gain in patients on atypical antipsychotics. Indian J Psychol Med 2008;30: 24-31.
Prasuna PL, Vijay Sagar KJ, Sudhakar TP, Rao GP. A placebo controlled trial on add-on modafinil on the anti-psychotic treatment emergent hyperglycemia and hyperlipidemia. Indian J Psychol Med 2014;36:158-63.
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Andrade C. Modafinil and armodafinil in schizophrenia. J Clin Psychiatry 2012;73:e1062-4.
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Sathyanarayana Rao TS, Andrade C. Initiative for capacity building in academic psychiatry in India: The E-Journal Club of the Indian Psychiatric Society. Indian J Psychiatry 2015;57:115-6.