Freudenreich 2009.

Methods	Allocation: randomised. Blindness: double‐blind. Duration: 8 weeks. Settings: outpatients. Design: parallel. Country: USA. Study dates: September 2003 to September 2007.
Participants	Diagnosis: schizophrenia or schizoaffective disorder (DSM‐IV). N = 37. Age: ˜45 years. Sex: 27 M, 8 F. History: treated with clozapine, length of illness 18 to 20 years.
Interventions	1. Modafinil: modafinil (flexible dose 50 mg to 300 mg) + clozapine. 2. Placebo: placebo + clozapine.
Outcomes	Usable data: Mental state: worsening psychosis. Leaving the study early. Adverse effects: requiring discontinuation from the trial, clinically important adverse events (dizziness, abdominal pain, depression, headache, fatigue). Service utilisation: hospital admission. Unable to use: Mental state: PANSS, SANS (unable to impute ‐ data were presented in units not usable in a meta‐analysis). Cognitive function: COGBAT (unable to impute ‐ data were presented in units not usable in a meta‐analysis). Adverse effects: movement disorder: ESS, FSS (unable to impute ‐ data were presented in units not usable in a meta‐analysis).
Notes	Trial registry: NCT00573417. Funding: Cephalon Inc (modafinil manufacturer).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"Randomly assigned." Comment: probably done.
Allocation concealment (selection bias)	Unclear risk	No information provided.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	"Double blind" Comment: Probably done.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	"Double blind" Comment: Probably done.
Incomplete outcome data (attrition bias) All outcomes	High risk	6/18 (33%) in the placebo group did not complete the study.
Selective reporting (reporting bias)	High risk	Continuous data were presented as a slope, so we were unable to impute the information in the meta‐analysis.
Other bias	Low risk	We found no other bias.